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Superficial plane: <15 mm from skin surface(this area includes dermal and sub-dermal zones)
Subcutaneous TissueAnatomy & Histology
VelaSmoothPro II, LipoLite
LiposuctionLipoLite
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Subcutaneous Tissue
A person’s body layout depends on:
Pattern of adipocytes distribution
Increased size of fat cells (hypertrophy)
Enlargement of the number of adipocytes (hyperplasia)
Fat-cell replication by postadipocytes
Eating and exercise habits
Poor lymphatic drainage
Major human fat depots-
white adipose tissue
Anatomy & Histology
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Atrophic degeneration of the hypodermal and dermal zones:
Hypertrophic and hyperplasic changes
of the fat cells Poor blood flow and lymphatic drainage Glycation of collagen and hypertrophic septae
Resulting in Favorable environment for fat cells having a
relatively low metabolism Cycle of atrophy leading to
- Increased circumferences
- Bumpy appearance (cellulite)
What is the etiology?
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Fat cells swell and push skin upwards as septae are rigid
Blood and lymph vessels are compressed
Accumulation of intercellular fluids and physiological
waste
Cellulite and Circumference
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Factors inducing Cellulite
Heredity
Hormones
Smoking
Lack of exercise
Poor diet
Physiological status
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Classification of Cellulite
Class 1:
No spontaneous dimpling
Pinch test positive for dimpling
Class 2:
Spontaneous dimpling
while standing
Class 3:
Spontaneous dimpling while
standing and lying
(morbid obesity or menopausal)
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Regulatory Clearance
FDA, CE
The VelaSmoothPro II is indicated for:
Temporary reduction in the appearance of cellulite
Temporary reduction of thighs circumferences
Temporary improvement in the local blood circulation
Relief of minor muscle aches and spasms
Body contouring*
Additional treatment programs:
Post-liposuction treatment via circumferential reduction
Post-baby treatment via circumferential reduction
Indications For Use
*CE only
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What is VelaSmoothPro?
More powerful - RF energy increased by 75% to 35 Watts
Higher efficacy
Faster patient’s turnover
Disposable applicator Covers – ‘per patient’- Large: 16H /
Small: 4H
Optimize treatment results
Eliminate cross contaminations
Improved quality and reliability
Higher patient comfort
Easier and more comfort for operation
Diagnostic Terminal
Better control of patients treatment protocol
Monitors device’s activity and performance
Intuitive feedback for user
Service diagnostics
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The Technologies
Vacuum (Suction) Infrared (IR) Radiofrequency (bipolar RF) Mechanical massage (Rollers)*
*Large appl. only
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Applicators Specifications
Large SmallApplicator Applicator
RF Power Up to 35W Up to 8W
IR electrical power Up to 35W Up to 20W
Spot Size 40x40 mm 30x30 mm
Penetration 5-20 mm
Wavelength 700-2000 nm (Broad Band
IR)
Vacuum Pulsed 180-380 mbar
Disposable covers 16 hrs 4 hrs
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VelaSmoothPro Applicators
RF IR Vacuum Massage (Rollers) -
The Technology Large SmallApplicator Applicator
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VelaSmooth/ VelaSmoothProApplicator Specs. VelaSmoo
thVelaSmoot
hPro
Large
RF electrical power 20W 35W
IR electrical power35W 35W
Vacuum ? 420 mbar
Disposable covers/filters 30 hrs/10 hrs 16 hrs/10 hrs
Small
RF electrical power8W 8W
IR electrical power20W 20W
Vacuum ? 340 mbar
Disposable covers/filters 10 hrs
(cover with filter)
4 hr/4 hrAlternate filter for every
treatment
Communication Terminal
- +
Dual Connector
- +
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Small covers Large covers Bundle box5 pack 5 pack 1 large 5pck+ 1 small 5pck
Consumables
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Button Treatment Mode Description
IR mode Continuous infrared light energy is applied
RF mode Radio frequency current is applied
Vacuum mode Pressing this button activates the vacuum pump
Applicator cover indicators Green LED: cover is operative and installed properly
Red LED: cover is expired or not installed properly
Applicator’s operating panels
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Communication Terminal
:Communication Terminal Messages
Ready – the applicator is connected, the treatment level configured, but the trigger is not yet pressed.Treatment - the applicator is connected, the treatment level configured, and the trigger is pressed.
Not Available – the applicator is not connected.
Also various Maintenance or Error messages will be displayed, these appear in
the troubleshooting guide in User Manual .
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System Type – VelaSmoothPro VelaSmoothPro - System S/N – the
system's factory serial number. LA/SA S/N – the Large applicator or
Small applicator type and factory serial number.
LA/SA Working Hours – the total number of hours already performed by the connected Large or Small applicator.
Disposable Status – how much time remains to operate the disposable covers.
System Freq: 50 or 60 Hz – the system's electrical frequency
Communication Terminal – info button
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VelaSmooth Treatment Mechanism
Improved blood supply:
90% of vessels are compressed at normal atmospheric pressure
Applying negative pressure → vessel dilation and blood flow ↑↑
Vacuum also enables deeper penetration of RF
Fibroblast stimulation
Vacuum Effects
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VelaSmoothPro Treatment Mechanism
Mechanical massaging effect enhances drainage of trapped intercellular fluid to lymphatics
Mechanical Effect of Rollers – Massage
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IR light heats the tissue down to the deep dermis
RF heats tissue down to the subcutis
VelaSmoothPro Treatment Mechanism
Deep Heating by IR + RF
RF electrodes
Lamp
Infrared filter
Parabolic reflector
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Temperature,˚C
Viscosity of H2O, centipoises
Diffusivity of O2,cm2/s
20 1.002 1.97x10-5
40 0.653 3.24x10-5
50 0.547 3.99x10-5
VelaSmoothPro Treatment MechanismHeating Effect On Oxygen Diffusivity
Heat increases oxygen diffusivity →
delivering more oxygen from capillaries to fat
cells
Oxygen Diffusivity in Water
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VelaSmoothPro Treatment Mechanism
Deep heat is produced by IR/RF in dermal blood vessels
→ Oxygen dissociation from Oxy-Hb ↑↑
→ Extravasation of nutrients and oxygen ↑↑
Fat metabolic reactions in fat cells ↑↑
Extended use of stored energy from fat cells (lipolysis)
results in shrinkage of cells themselves
• The septae, and consequently the fat chambers, shrink
Stimulation of fibroblasts for collagen synthesis ↑↑
Collagen shrinkage for overall skin surface improvement
Heating Effect On Metabolism
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Clinical Procedure
Proper patient selection
Aligning expectations
Pre-treatment :
Exfoliate the skin
Avoid anticoagulants if medical condition permits
(advisable)
Shave hair (advisable)
Weigh patient, photograph and measure circumference
Define treated areas, and set treatment parameters
Pre-Treatment
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Clinical Procedure
Skin type I-VI
No medical contraindications to IR/RF/Vacuum treatment
Not recommended to treat:
Varicosity
BMI > 30
Marginal results with:
Obese patients
Patients with edema due to lymphatic drainage problem
Avoid thyroid area if there are thyroid pathologies
Patient Selection
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Clinical Procedure
Aligning expectations
Improvement – not elimination
Temporary results – maintenance is essential
Skin tightening by RF may occur
Not for excessive loose skin
Stretch marks may improve – not always
Diet and exercise may improve results – not essential
Weight gain may worsen results
Patient Selection
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Clinical ProcedureDefining Treatment Areas
Large:
Treatment area: thighs / buttocks / abdomen
Each area divided into strips
Each strip: ~30 cm long and as wide as the Large
applicator
Small:
Arms / calf / bra-line / flanks
Curved areas and localized fatty deposits
~15x20 cm (large hand palm)
Possible to combine Large and Small
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Clinical Procedure
Recommended Treatment Motions
Backward & ForwardForwardCircular
Large Applicator
Work in motion to achieve best contact:
Backward & Forward/ Forward: preferred motion
Possible with Small
Circular, Zig-Zag: reinforcement motions
Small Applicator
Stacks: preferred motion
Possible with Large, when movement and seal are difficult,
Zig-Zag
Stacks
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Clinical Procedure
Applying the applicator:
In a perpendicular orientation to the skin
With slight pressure for good contact
10-20% overlap
Release trigger before lifting applicator from skin!
Large Applicator& Small Applicator
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Clinical Procedure
Immediate response:
Persistent radiant heat (>40-42˚C) for at least 5-10 min
Can be felt ~5 mm above the skin or using IR thermometer
Erythema/edema accompany heating but are not the endpoint!
Desired Endpoint
Skin Surface40˚C
Dermal Skin45˚C
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Clinical Procedure
Reaching end-point on an anatomical area:
Treat 1 strip repeatedly until endpoint
Move to adjacent strip and treat similarly
Reinforce: cross-hatched pass on all previous strips,
following each new strip, to sustain heat
Enhanced mode:
Step 1: reach endpoint in a certain anatomical area (~10 minutes)
Step 2: treat another anatomical area till endpoint (~10 minutes)
Step 3: return to first anatomical area (after ~10 minutes)
and repeat procedure till reaching endpoint again
Large Applicator Treatment Procedure
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Clinical Procedure
Reaching end-point on a small area: Treat the whole area with “Stacking”
(up to 15 pulses on each spot)
Reduce number of stacked pulses each successive pass*
Enhanced mode: Step 1: reach endpoint in a certain small area (~5 minutes)
Step 2: treat another area till endpoint (or wait) (~5 minutes)
Step 3: return to first anatomical area (after ~5 minutes)
and repeat procedure till reaching endpoint again
* According to patient tolerance and skin response
Small Applicator Treatment Procedure
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Desired Treatment Cellulite Improvement
(Upper Hypodermis)
Circumference Reduction (Deep
Hypodermis)
IR 2-3 1
RF 3 3
Vacuum* 1-2 2-3
Treatment ParametersRecommended Parameters
IR + Vacuum ≤ 5 (For Safety)
For both applicatorsFor both applicators
* * Vacuum levels may be reduced according to patient’s tolerance
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Treatment Parameters
IR
Reduce for deep treatment (to avoid superficial heating)
Reduce on very dark or tanned skin, or when stacking pulses
RF
Set at highest level tolerated
Vacuum
Gradually increase in subsequent sessions
Increase for deep treatment
Reduce on sensitive areas (e.g., inner-thigh), or on loose skin
Adjust according to skin response and patient tolerance
Selecting And Adjusting
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Clinical Procedure
Long-term effect:
Circumference reduction improvement (before)
Cellulite improvement (later)
8-12 sessions
Short-term effect: Transient skin texture improvement – after each session
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Clinical Protocol
Treatment protocol is individual:
8-12 sessions
Twice a week
Maintenance treatment: One maintenance treatment in the month following the initial
series of VelasmoothPro treatments, followed by once in 2–3 months and then with decreasing frequency as needed.
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Combination Treatments with Other Modalities
Alternate with mesotherapy (if same session- Vela
first) 5 weeks with meso 1/w and Vela 2/w
Other protocols
Combined Vela with deoxycholate treatment 4 sessions 6 weeks apart
For circumference reduction only
4-6 weeks post liposuction for homogeneous
healing
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Cellulite Reduction
Photos courtesy of Gerald Boey, M.D., Canada
Post 7 treatmentsBefore
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Skin Tightening via Body Contouring
Photos courtesy of Moshe Lapidot, MD, Israel.
Post 3 treatmentsBefore