Abstract
BACKGROUND: Cellulite affects 80% to 98% of postpubertal females, and most patients with the condition are bothered by it. Targeted Verifiable Subcision (TVS; Avéli; Revelle Aesthetics, Inc., Mountain View, CA) is a minimally invasive mechanical subcision device that reduces the appearance of cellulite dimples in the buttocks and thighs. Although clinical trials have demonstrated efficacy, information on real-world surgical and nonsurgical approaches to managing cellulite in buttocks and thighs is needed. OBJECTIVES: To describe how TVS is being used by the authors to improve patient outcomes in the lower body in both surgical and nonsurgical settings. METHODS: Each of the authors described their current practices using TVS for lower body rejuvenation. Author practices have varied proportions of surgical vs nonsurgical cases (from 10% to 100% surgical cases) and a variety of focuses, ranging from primarily facial aesthetics to a near exclusive focus on body contouring. RESULTS: The authors' diverse approaches to integrating TVS into clinical practice are detailed, along with pearls of clinical success. TVS is discussed as a companion treatment for surgical procedures, while the patient is already under anesthesia, as well as a part of a nonsurgical approach, where the local anesthesia required for TVS can make additional energy-based procedures more comfortable for the patient. The authors provide several examples and include considerations for optimal timing and ordering of treatments. CONCLUSIONS: TVS may become a valuable addition to the treatment armamentarium for surgical or nonsurgical buttock and thigh rejuvenation and can be integrated into surgical and nonsurgical workflows.