Validated Assessment Scales for Skin Laxity on the Posterior Thighs, Buttocks, Anterior Thighs, and Knees in Female Patients

Kaminer, Michael S.; Casabona, Gabriela; Peeters, Wouter; Bartsch, Rolf; Butterwick, Kimberly J.; Chao, Yates Yen-Yu; Costa, Joana; Eviatar, Joseph A.; Fabi, Sabrina G.; Geister, Thorin L.; Goldie, Kate; Grice, Jenny; Hexsel, Dóris; Lorenc, Paul; Lupo, Mary P.; Pooth, Rainer; Sattler, Gerhard; Waldorf, Heidi A.; Yutskovskaya, Yana; Kerscher, Martina

doi:10.1097/dss.0000000000001994

Cited by 13 publications

(20 citation statements)

References 21 publications

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“…Cellulite severity is also influenced by skin laxity, particularly in older individuals. 3,4 Treating skin laxity by improving dermal strength and elasticity are potentially important elements for treatments targeting the appearance of cellulite dimples. [4][5][6] The acoustic subcision device (Soliton, Inc.) uses rapid acoustic pulses designed to improve the appearance of cellulite.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Treating skin laxity by improving dermal strength and elasticity are potentially important elements for treatments targeting the appearance of cellulite dimples. [4][5][6] The acoustic subcision device (Soliton, Inc.) uses rapid acoustic pulses designed to improve the appearance of cellulite. The authors hypothesize that rapid acoustic pulses noninvasively disrupt the fibrous septae (i.e., subcision) in the subcutaneous extracellular matrix space, leading to tissue release that results in the improvement in the appearance of cellulite.…”

Section: Introductionmentioning

confidence: 99%

“…Magnetic resonance imaging demonstrates that in cellulite these fibrous septae are contracted and sclerosed ultimately tethering the skin at a fixed length.” Kaminer et al 2 demonstrated long‐lasting improvement in the appearance of cellulite through minimally invasive mechanical subcision of these septae. Cellulite severity is also influenced by skin laxity, particularly in older individuals 3,4 . Treating skin laxity by improving dermal strength and elasticity are potentially important elements for treatments targeting the appearance of cellulite dimples 4–6 …”

Section: Introductionmentioning

confidence: 99%

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Improvement in the appearance of cellulite and skin laxity resulting from a single treatment with acoustic subcision: Findings from a multicenter pivotal clinical trial

Tanzi¹,

Capelli

Robertson

et al. 2021

Lasers Surg Med

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Introduction and Objectives: Surface depressions and skin laxity together play a role in the appearance of cellulite. Cellulite depressions can be improved through disruption of the subcutaneous fibrous structures. Some currently utilized approaches accomplish this through invasive techniques requiring local anesthesia and potential down time. Skin laxity can exacerbate the appearance of cellulite, however current invasive approaches do little to improve skin laxity. The objective of this study was to evaluate a noninvasive approach to improving both cellulite depressions and skin laxity through the use of rapid acoustic pulses (acoustic subcision). Safety, efficacy, tolerability, and participant satisfaction results were measured. Methods: Women (n = 56) with moderate to severe cellulite were treated in a single acoustic subcision treatment session without anesthesia. Posttreatment adverse events (AEs) and tolerability were recorded. At 12-weeks cellulite outcomes were assessed using a 6-point simplified Cellulite Severity Scale (CSS), Global Aesthetic Improvement Scale (GAIS), and a participant satisfaction questionnaire. Additionally, laxity improvement was measured using a 4-point Laxity Score (LS) and GAIS. Results: Improvement in cellulite appearance measured at 12-weeks showed that participants (n = 56) had a mean CSS reduction of 1.01 (a 29.5% reduction from baseline). The posttreatment photograph was correctly identified by blinded independent reviewers from randomized pairs of pre/posttreatment photographs for 96.4% of participants. Cellulite was graded as improved, much improved or very much improved using the GAIS at 90.9% of treated locations. Finally, 92.9% of participants reported positive satisfaction responses. Scoring for improvement in skin laxity appearance at 12-weeks showed a mean LS reduction of 0.57 (a 27.9% reduction from baseline). GAIS for laxity was graded as improved, much improved or very much improved in 67.3% of treated areas. No unexpected or serious AEs were noted at treatment or follow-up. Overall average pain score during treatment was 2.4 (0-10 pain scale) and 0.3 immediately posttreatment. Conclusion: A single noninvasive acoustic subcision session can safely provide meaningful improvement in the appearance of cellulite in terms of depressions, as well as skin laxity, with minimal treatment pain and no posttreatment down time. Further improvement in appearance is expected with multiple treatments over time. Additional trials to verify this are planned.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improvement in the appearance of cellulite and skin laxity resulting from a single treatment with acoustic subcision: Findings from a multicenter pivotal clinical trial

Tanzi¹,

Capelli

Robertson

et al. 2021

Lasers Surg Med

Self Cite

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“…11 The current study found that skin laxity contributed positively to KCSS, and the authors hypothesize that this may be due to the area evaluated, where skin laxity is integral to the appearance of the skin above the knee. Kaminer et al, 13 recently created and validated photonumeric grading scales for skin laxity in female patients for the anterior thigh and knee areas, respectively, with significant validity and reliability. These scales do not assess cellulite, thus the number and depth of depressions are not included.…”

Section: Resultsmentioning

confidence: 99%

“…Kaminer et al ., recently created and validated photonumeric grading scales for skin laxity in female patients for the anterior thigh and knee areas, respectively, with significant validity and reliability. These scales do not assess cellulite, thus the number and depth of depressions are not included.…”

Section: Discussionmentioning

confidence: 99%

A validated photonumeric cellulite severity scale for the area above the knees: the knee cellulite severity score

Longhitano

Galadari

Cascini³

et al. 2020

Acad Dermatol Venereol

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Background Treatment for cellulite above the knees is increasingly requested. However, a classification of cellulite of this area has not yet been developed. Objective To validate the proposed knee cellulite severity score (KCSS) for the assessment of cellulite and skin laxity above the knee. Materials and methods Based on standardized photographs of cellulite and skin laxity above the knees of 57 females (114 knees), three key morphological aspects of cellulite were identified. A photonumeric KCSS was developed and validated by three independent assessors. Results The three key cellulite morphological features (number of depressions, depth of depressions and presence of laxity) are each graded from 0 to 3, producing a classification of no lesions (0), mild (1–3), moderate (4–6) and severe (7–9). Evaluators at different time points repeated similar classifications (intraclass correlation coefficient >0.9), which were also similar among the assessors (inter‐observer reliability >0.9). All three key morphological aspects were deemed necessary, and positively contributed, to the overall scale (item‐total correlation analysis values >0.89, P < 0.05). Conclusions The KCSS is a consistent, comprehensive, reliable, and reproducible tool for standardized and objective assessment of the severity of cellulite and skin laxity above the knees.

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Comparison of Cellulite Severity Scales and Imaging Methods

Young¹,

DiBernardo²

2020

Aesthetic Surgery Journal

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Cellulite is characterized by dimpled contour alterations of the skin and is present in approximately 85% to 90% of postpubertal females. Although the pathophysiology of cellulite remains to be fully elucidated, experimental evidence indicates a multifactorial process involving the number and types of fibrous septae, microvascular dysfunction, subcutaneous inflammation, decreased dermal thickness with age, and fat deposition. Cellulite is a major cosmetic concern for many women, and a number of both noninvasive (eg, massage, cosmeceuticals, laser therapy) and minimally invasive techniques (eg, subcision, collagenase injection) have been evaluated to improve the appearance of the affected skin. However, evidence for many of these treatments is limited, largely due to the lack of a validated, convenient tool for the standardized evaluation of cellulite severity. Various imaging modalities have been used to characterize cellulite severity and the impact of treatment, but only 2-dimensional and 3-dimensional digital photography have been adequately validated. However, in many cases, imaging findings do not correlate with subjective measures of cellulite severity. A number of cellulite rating scales have been developed; some provide only a qualitative measure, while others do not fully capture all clinically relevant aspects of cellulite, including the perspective of the patient. There remains an unmet need for global adoption of a validated scale that can be used easily by clinicians and patients in clinical and research settings. We propose features that should be included in an ideal rating scale for assessment of cellulite severity.

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Validated Assessment Scales for Skin Laxity on the Posterior Thighs, Buttocks, Anterior Thighs, and Knees in Female Patients

Cited by 13 publications

References 21 publications

Improvement in the appearance of cellulite and skin laxity resulting from a single treatment with acoustic subcision: Findings from a multicenter pivotal clinical trial

Improvement in the appearance of cellulite and skin laxity resulting from a single treatment with acoustic subcision: Findings from a multicenter pivotal clinical trial

A validated photonumeric cellulite severity scale for the area above the knees: the knee cellulite severity score

Comparison of Cellulite Severity Scales and Imaging Methods

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