Continuing Medical Education Examination—Body Contouring Analysis of the Cutaneous and Systemic Effects of Endermologie ® in the Porcine Model

Abstract

Learning Objectives: The reader is presumed to have a broad understanding of plastic surgical procedures and concepts. After studying the article, the participant should be able to: 1. Understand the design of a study to examine the effect of Endermologie ® treatments on the Yucatan mini-pig model. 2. Realize the histologic changes produced by Endermologie ® treatments in this study animal whose cutaneous and subcutaneous tissues have similarities with human tissues. Physicians may earn 1 hour of Category 1 CME credit by successfully completing the examination based on material covered in this article. The examination begins on page 421. Endermologie ® has been touted as an alternative to or adjunctive therapy with liposuction for the removal of subcutaneous fat, body contouring, and tissue toning. In this study we examined the effects of Endermologie ® treatment with the Yucatan mini-pig model. Pigs were divided into three treatment groups ( n = 4) and underwent 4, 10, or 20 treatment sessions, respectively. Blood and urine analysis was conducted during the study to obtain evidence of tissue trauma or breakdown and excretion of subcutaneous fatty tissue. Matched en bloc tissue sections from treated and untreated areas were examined for possible wound healing, inflammatory response, and tissue architecture changes. Examination of tissues revealed changes of architecture with accumulation of dense, longitudinal collagen bands in the mid and deep subdermal tissue layer; some distortion and disruption of adipocyte cell membranes were also observed. The degree of tissue change found was dependent on the number of treatment sessions performed. Endermologie ® treatments did not elicit a classical wound healing or inflammatory response, with no evidence of either increased tissue vascularity or cell division. No evidence of mobilization of fatty tissue was found, and no fat breakdown products or metabolites were detectable in blood or urine. Treatments did not cause a decrease in subcutaneous tissue thickness. No evidence of skin or muscle injury was noted. Further studies are warranted to determine whether the changes noted are short term or permanent.