Cellulite and the Aesthetic Management of the Buttocks and Thighs: Six Cases Illustrating Targeted Verifiable Subcision™ as Part of a Multimodal Approach to Lower Body Rejuvenation

Abstract

Abstract Background In the buttocks and thighs, skin quality, focal adiposity and/or volume deficiency, skin laxity, and textural issues each contribute to overall appearance. For patients undergoing rejuvenation/beautification procedures, global improvement is desired, making multimodal treatment to address these mechanistically distinct concerns the standard of care. Resolution of cellulite depressions is central to patient satisfaction and aesthetic outcomes: Without management, the overall aesthetic suffers, and patients are left partially unsatisfied with treatment results. With minimally invasive Targeted Verifiable Subcision™ (TVS; Avéli® [Revelle Aesthetics, Inc, Mountain View, CA]), septa with a confirmed role in dimple formation can be released via mechanical verified subcision, permitting consistent outcomes. Objectives Discuss application of TVS as part of a multimodal approach to buttock and thigh rejuvenation and share best practices for obtaining optimal improvement. Methods A group of 6 experts in aesthetic plastic surgery and dermatology convened for a 2-hour roundtable discussion of select case studies, best practices, and their approaches for obtaining optimal outcomes in clinical practice. Results Clinical cases from 6 patients who presented for buttock and/or thigh rejuvenation/beautification are presented where TVS was applied as part of a multimodal approach. Before-and-after images, details of patient cases, and a discussion of best practices for patient education and evaluation, treatment planning, technique, safety, postprocedure care, and open research questions are included. Conclusions TVS is emerging as a valuable tool for the treatment of cellulite in the buttocks and thighs that may potentially be used alongside surgical and nonsurgical approaches, often on the same day.