ENDERMOLOGIE® The Mechanical Treatment of Cellulite Over 95% of women suffer from unsightly cellulite: lumpy, dimpled skin on the thighs and buttocks.
Cellulite is not a disease process, but is the result of a combination of factors, from fluctuating oestrogen levels to genetic predisposition, which cause an alteration in the fat lobules and the connective tissues of the subcutaneous fat cell layer.
The term 'Endermologie®' is from the French meaning 'through the dermis'. This scientifically proven treatment works through the skin to mobilize the underlying tissues and to cause positive change in the anatomy and physiology.
To understand the mechanics of Endermologie®, we need to understand the anatomy and physiology of the fat layers and of cellulite formation.
Four distinct fat layers exist in a woman's body. They are different anatomically and respond to different stimuli. The layers are:
• Subcutaneous fat layer (also known as the hypodermic layer or cellulite layer)
• Superficial reserve fat layer (also known as the alimentary fat layer)
• Deep reserve fat (also known as the steatomeric fat)
• Intracavity fat
The subcutaneous fat layer is found directly under the skin. Cellulite forms in this fat layer. The formation of cellulite can happen at any time in a woman's life, but is more likely at times of hormonal fluctuation, such as puberty, pregnancy, pre and post menopause. Hypodermic fat is not sensitive to diet and exercise, which is why we have all seen thin, fit women who still have 'orange peel' thighs and buttocks! In addition, this layer is not suitable for liposuction, but will respond to Endermologie®
The fat cells are arranged in columns ('standing fat cell chambers'), with arching vertical connective tissue bands (septa) supporting them. The fat cells are densely packed with fat. (Females can store three times more fat than males!) When some of the fat projects into the dermis, it causes the bumps of cellulite.
The superficial fat layer is found beneath the subcutaneous fat layer and is thicker in certain areas, depending on the basic body shape. A gynaecoid figure ('pear shape') tends to carry fat on the buttocks and thighs, while an android figure ('apple shape') tend to carry fat around the abdomen, on the upper arms and breasts. The fat cells expand and contract as one gains and loses weight. (Remember, one doesn't gain and lose fat cells when dieting and gaining weight; the cells you already have expand and contract!) The superficial reserve fat layer is a storage area for excess calories eaten and will respond to diet and exercise by shrinking. This layer is also responsive to Endermologie® and is also the layer which is reduced by liposuction
The deep reserve fat is found in only certain areas on the body, such as 'saddlebags', 'love-handles' and inner thigh bulges, for example. These fat stores are only used as the last source of nutrients, should one starve. (Not just diet, really starve!) These thick, hard deposits will not respond to diet and exercise and are too deep to be totally eradicated by Endermologie®. The only solution here is liposuction.
The intracavity fat is situated in amongst the abdominal organs and is seen more in men and android shaped women. Intracavity fat is very responsive to diet and exercise, but is too deep for Endermologie®. This fat is also not suitable for liposuction.
Changes occur in the subcutaneous fat layer, causing unsightly lumps and dimples to form. This is referred to as CELLULITE. What are the characteristics of cellulite?
The skin has an uneven appearance, often referred to as 'peau de orange' or 'orange peel' skin. Dimpling can often cover a large surface area, but is most often seen on buttocks and thighs.
Cellulite is no respecter of persons and affects obese, thin and normal weight women. Cellulite often co-exists with obesity of the underlying superficial reserve fat cell layer, but the two conditions should not be confused.
The orange-peel appearance of the skin, known as cellulite, results from the abnormal storage of fat under the skin as well as from the retraction of the vertical connective tissue septa, which usually hold the standing fat cell chambers in place. This phenomenon is more common in women and involves the enlargement of the fat cells of the subcutaneous fat layer as well as the retention of fluid in the dermis and hypodermis The fat cells are arranged in columns ('standing fat cell chambers'), with arching vertical connective tissue bands (septa) supporting them. These fat cells are densely packed with fat. (Females can store three times more fat than males!) When some of the fat projects into the dermis, it causes the bumps of cellulite. These septa are anchored to the base of the dermis and to the fascia separating the cellulite layer from the superficial reserve fat layer beneath it. The fat cells in a male are arranged in a 'net' of cris-cross septa, making bulging less visible, should the fat cells bloat
Fluctuation in oestrogen levels causes disruption of the micro-circulation and alteration in fluid exchanges. The fat cells are starved of oxygen and nutrients, the venous drainage and removal of waste products and carbon dioxide slows down. The normal drainage and replenishment of the tissue fluid decreases
Waste products build up in the fluid around the fat cells, which disturbs the osmotic gradient and the elimination of waste products from the fat cells is compromised.
As a result, the volume of the fat cells increases and restricts the flow of the arterial, venous and lymphatic systems even further. Excess tissue fluid builds up within the cellulite layer. As the fat cells increase in size, the standing fat cell chambers project into the dermis, causing the 'bumps' of cellulite.
The vertical connective tissue septa, also starved of nutrients, become hard and inelastic, pulling on their points of fixation within the skin and causing the dimpled effect. Because the circulation is impaired, metabolic exchanges slow down and fibrosis begins.
Congestion of the connective gel occurs, resulting in hardening and loss of elasticity. Clinically: the skin is cold, it hardens and can even become painful to the touch.
The area becomes cold, hard and painful to the touch. Unsightly zones of cellulite are inert and unresponsive to either physical exercise or even the most drastic of diets.
What is Endermologie®? How can a mechanical treatment reverse this state of affairs?
Endermologie® was invented in 1985 by a French mechanical engineer, Louis-Paul Guitay. M. Guitay had suffered extensive tissue damage in a car accident and was undergoing four hours of rolling manual massage per day, carried out by four different therapists, in an attempt to loosen and elasticize the scars. He found that these manual massages were so varied in quality that he designed a machine that would deliver a quality rolling massage, together with aspiration to nourish the area. This technique was used to treat burn scars with great success. Later the technique was adapted to treat healthy tissue, resulting in reduced cellulite, improved skin tone and body re-contouring.
Endermologie® is a scientific approach utilizing the principle of negative pressure massage. The Endermologie® treatment head is equipped with detachable Keymodules, which are sets of two rollers, both motorized, which roll and unroll a tissue fold, kneading and massaging the tissues. Between the rollers is a suction chamber, which applies a variable aspiration to this tissue fold, increasing the blood supply to the area. By manipulating the treatment head in various maneuvers, the skin and the subcutaneous fat layer are mobilized and the blood circulation is restored. Improved lymphatic drainage eliminates metabolic toxins from the tissues. The increase in oxygen and nutrients available triggers the body's normal process for fat elimination and the fat cells begin to shrink in size. The connective tissue walls are gently stretched, which encourages the fibroblast cells to produce collagen and elastin, thus toning and firming the body. Collagen banding is laid down in the superficial reserve fat layer, which has a natural 'corset' effect and tightens the area. Extensive scientific studies have substantiated these claims.
Endermologie® was the first mechanical treatment for cellulite and body contouring to be approved by the Food and Drug Administration (FDA) of the USA.
Endermologie® is performed by skilled, trained and certificated therapists. Each therapist must undergo a full training in the practical and theoretical aspects of Endermologie®. These training courses are offered at the Training Centres in Cape Town and in Centurion.
During the treatment session, the patient wears LPG Bodywear®; a specially designed body stocking, allowing all areas of the body to be treated. The suggested number of treatments is prescribed to suit each individual patient. Patients respond to the treatments at different rates, depending on age, degree of cellulite, as well as length of time the cellulite has been present. The treatment session lasts between 35 and 45 minutes and is carried out once or twice per week. . A minimum of 14 treatments is required to begin seeing results, but most patients need at least 20 treatments. After the initial Endermologie® course, a monthly maintenance treatment is recommended.
What does Endermologie® feel like? It is similar to a deep massage and the strength of the suction is adjusted to the comfort level of the patient. Most of our patients look forward to their treatments, as they are so pleasant and de-stressing. In fact we have several patients who have passed the 300-treatment mark!
We do stress that the 'Endermologie® Lifestyle' does not only encompass treatments, but also includes a healthy eating plan, two litres of water daily and a moderate exercise regime.
The Measuring and Evaluation Photostation (the Result 6) is an essential treatment tool. Patients are photographed before and after the course of treatments. Eight photographs are taken at each time (front, back and both side views), once with relaxed muscles and once with contracted muscles. The patients can be positioned in exactly the same position for each photo session, using one of the numbered foot brackets provided. The camera is always at the same distance away from the subject and the camera height is recorded for the close-up shots. Thus the therapist is able to duplicate the photographic conditions for subsequent photo sessions.
There are a few contra-indications to Endermologie® treatments, which must be borne in mind. Pregnant women should not be treated; nor should anyone suffering from cancer. A history of phlebitis and blood clotting problems would also disqualify the patient for Endermologie®
Results…..always the most important factor to be considered. We evaluate results using the following criteria.
Weight loss: This is not necessary for a good result. While most patients do lose weight, due to the fact that they become more health conscious, weight loss is not an important factor
Centimeter loss: This plays a part, but a lot of patients do not have a great deal of centimeters to lose.
Contouring: Here we usually see a change in the contours, especially in the hard-to-treat areas such as the inner thigh.
Skin tone and texture: This is the most impressive area and, as you will see in the accompanying photographs, is an important effect of Endermologie®.
Results…how long do they last? This depends on several factors. When one goes to the gym and gets fit, one has to maintain that fitness. Endermologie® can be likened to 'skin gymnastics'. When you have got the skin and tissues into a 'fit' state, it makes sense to maintain it.
Endermologie® has become a recognized treatment in both the medical and aesthetic fields. Leading plastic surgeons are utilizing this technique before, during and after the liposuction procedure and are achieving very good results.
By improving the appearance and tone of the skin, Endermologie® contributes to one's sense of well-being, both physically and psychologically. Endermologie® gives women that which they have always desired…a younger, healthier and more aesthetically pleasing body.
