Endermologie versus Liposuction with External Ultrasound Assist

Abstract

Background: Endermologie has been presented as a treatment to reduce cellulite and as a noninvasive method of body contouring. Objective: The purpose of this study was to (1) evaluate the effectiveness of Endermologie in cellulite reduction and body contouring, (2) compare the results of external ultrasound-assisted liposuction (EUAL) with those of Endermologie with regard to body contouring and cellulite reduction, and (3) determine whether EUAL is as effective in cellulite reduction as it is in body contouring. Methods: A prospective study comparing 2 closely matched, nonrandomized groups of 36 women each was conducted. Group 1 underwent a 20-week course of Endermologie, concentrating on the abdomen, flanks, hips, and thighs. Group 2 underwent EUAL to the superficial and deep subcutaneous areas of the flanks, hips, and thighs. Methods of evaluation included analysis of standardized 35-mm photography, standardized circumferential body measurements, and body composition. Photographic results were evaluated by objective blind grading from 4 physicians. Patient satisfaction was assessed through use of a questionnaire. Results: No significant complications were noted in either group. In the EUAL group, the average volume of aspirate was 1900 mL, with a subsequent contour revision required in 11% of cases. The standardized circumferential body measurements of the waist, hips, thighs, and right knees of the EUAL patients demonstrated a reduction greater than that noted in the Endermologie patients; this difference was statistically significant (P < .05). The body composition analysis of the EUAL patients demonstrated a greater reduction in the percentage of body fat, fat mass, body weight, lean body mass, and impedance than that seen in the Endermologie group; this difference was statistically significant (P < .05). The EUAL patients exhibited an increase in total body water greater than that noted in the Endermologie group; this difference was statistically significant (P < .05). In the Endermologie group, the results of objective blind photographic grading demonstrated a mean improvement of 25% in body contour, which was largely proportional to weight loss, and a mean cellulite reduction of 50%. In the EUAL group, a mean improvement of 87% in body contour, which represented a true alteration of body contour rather than a proportional reduction, and a mean cellulite reduction of 0% were noted. Mean patient satisfaction was 92% in the Endermologie group and 96% in the EUAL Group. Conclusions: EUAL has no role in reducing cellulite. Endermologie is the superior choice when cellulite reduction is the goal, but it is not an effective method of body contouring.