Impact of extracorporeal shock waves on the human skin with cellulite: A case study of an unique instance

Christoph Kuhn1, Fiorenzo Angehrn1, Ortrud Sonnabend2, Axel Voss31Klinik Piano, Biel, Switzerland; 2Pathodiagnostics, Herisau, Switzerland; 3SwiTech Medical AG, Kreuzlingen, SwitzerlandAbstract: In this case study of an unique instance, effects of medium-energy, high-focused extracorporeal generated shock waves (ESW) onto the skin and the underlying fat tissue of acellulite afflicted, 50-year-old woman were investigated. The treatment consisted of four ESW applications within 21 days. Diagnostic high-resolution ultrasound (Collagenoson) was performed before and after treatment. Directly after the last ESW application, skin samples were taken for histopathological analysis from the treated and from the contra-lateral untreated area of skin with cellulite. No damage to the treated skin tissue, in particular no mechanical destruction to the subcutaneous fat, could be demonstrated by histopathological analysis. However an astounding induction of neocollageno- and neoelastino-genesis within the scaffolding fabric of the dermis and subcutis was observed. The dermis increased in thickness as well as the scaffolding within the subcutaneous fat-tissue. Optimization of critical application parameters may turn ESW into a noninvasive cellulite therapy.Keywords: cellulite, extracellular matrix, fat tissue, high-resolution ultrasound of skin, extracorporeal shock wave, histopathology, scaffolding of subcutaneous connective tissu