Thank you for your question.
You submitted a question without a photo.
However, you describe in your question a situation where you are wondering whether or not Pelleve
can cause fat loss in your face.
And you state that after undergoing Pelleve that your face looked older starting the next
day and that you were pretty satisfied having Ultherapy approximately one month prior but
you are now noting that the appearance is regressing to the pre-treatment state.
Well, I can certainly share with you my thoughts in this technology and what effect it may
have had in your face as well as some options that I think might be worth considering given
what you are trying to do with these non-surgical treatments.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
The full range of skin enhancement services in our practice starting with the skincare
products that we’ve designed to radiofrequency devices and lasers and injectables and of
course, a wide range of surgical procedures I perform from eyelid surgery to face lifting
surgery to help our patients look their best.
I could tell you from a more global perspective as to the common issues that I come across
when people like yourself come to my practice who have had similar questions with comparable
experiences.
So to begin with, I think it is important to recognize some of the science behind these
technologies that are the radiofrequency devices and Pelleve actually is one of the original
radiofrequency devices that as used for essentially skin remodeling and it is based on a particular
science where the skin is heated to a certain target level of temperature.
And at a certain level, you get skin remodeling and collagen remodeling and you can get wrinkle
improvement and some degree of tightening.
And beyond that and sustained, you can get fat reduction.
Now we have a device in our practice for non-surgical fat reduction in addition to Pelleve which
we’ve had for many years since the beginning when Pelleve was initially introduced in the
market.
We also have a long pulse laser device that we actually use a scanner and can do non-surgical
fat reduction and skin tightening.
So these principles essentially are applied and it’s just a question of what kind of
technology is being used.
Now I can tell you that it seems unlikely that Pelleve would cause fat loss.
In order to get fat loss as I described, you need to have a certain target temperature
maintained for an extended period of time.
And I can say from experience that the Pelleve approach of using a handpiece to roll over
the skin, it’s difficult to get the skin to have that high temperature for a sustained
period to cause fat reduction.
It’s not impossible but it seems unlikely.
Now given that particular technology and other technologies were also being aggressively
used to try to tighten skin, a lot of people share your type of story with other modalities.
And so understand that when fat is disrupted and reduced, a lot of it is diminished relatively
permanently.
However, we have helped a lot of our patients who have had similar situations improve their
skin quality using platelet-rich plasma (PRP).
Platelet-rich plasma (PRP) has been shown in scientific studies to actually stimulate
fat cells.
So in helping people get skin rehabilitation, I have used platelet-rich plasma (PRP) injection
done over let’s say every 3 months to help improve fat cells, improve the skin quality,
to help recover from some of these very aggressive heating devices where they were not necessarily
designed specifically to reduce fat but were trying to actually, intended to tighten the
skin and essentially cross the line where neither the skin got tightened and it actually
further aged the skin.
And beyond that, they didn't have much fat under the skin to begin with.
It’s very important to understand that a youthful appearance is not just about smooth
looking skin.
What I try to explain to my patients is that a young person doesn't look tight.
A young person, we often describe as having baby fat.
And therefore, when you are using a device that is intended to tighten the skin, you
aren't that far away from potentially reducing some fat whatever the device may be but with
the understanding that it still requires a certain amount of time in order to be able
to get that kind of effect.
A lot of times I find that patients don't really appreciate that the skin is only 2
millimeters in thickness.
And further, the fat layer under the skin, as we age, gets thinner.
But in particular, I would say that one area that is fully overlooked almost universally
is bone loss.
People don't understand that as we get older, we actually lose a lot of bone structure and
that bone structure volume loss is really what is the foundational issue that results
in the facial aging issues that we all complain about whether it’s deepening of lines, whether
it is loss of definition and what was perceived as excess skin or loose skin.
So something to consider and it may not apply to you since you didn't submit a photo but
I suspect would probably be likely to be of some value is the idea called Structural Volumizing.
You see, instead of finding more thermal energy devices to tighten the skin, you may want
to consider what is the foundation and restore volume from using this principle.
And this principle means that what I’m doing is I’m using a long lasting hyaluronic acid
filler such as Juvederm Ultra Plus and Juvederm Voluma.
I’m placing it at the bone level.
And when you place it at the bone level, you restore structure and you get this beautiful
harmonious balance in the face whether it’s in the cheekbone, the jawline, the jaw angle
or the chin.
What often is perceived as sagging and loosening becomes restored.
It’s like restoring the real basis of what everyone keeps trying to tighten whether it’s
with non-surgical treatment such as radiofrequency and lasers or with surgery such as facelift.
These are all valid modalities but if you are able to treat the true foundation first
then everything else becomes icing.
So anything from a laser point of view whether it’s discolorations or wrinkles is more
about the shine and the enhancement of what is the foundational issue.
So I would say think about skin rehabilitation and skin quality improvement with platelet-rich
plasma (PRP) and think about Structural Volumizing using this technique to get the volume at
the bone level.
It’s in contrast to putting filler at the skin level, just below the skin or even within
the skin because you aren't going to be able to get enough correction and stability that
it looks natural.
A lot of times people don't like the way a lot of celebrities look because they often
look pillowy and look strange.
And that’s because the filler is placed below the skin as opposed to at the bone level.
So I hope that was helpful, I wish you the best of luck and thank you for your question.