Abstract
Cellulite affects 85% to 98% of postpubertal females and is characterized by fibrous septa contraction, dermal thinning, and fat lobule herniation, resulting in visible skin dimpling and textural irregularities. Although multiple treatment modalities exist, most target only select aspects of this multifactorial condition. This study evaluates the safety and efficacy of a novel approach combining targeted verifiable subcision (TVS) and helium plasma radiofrequency (RF) to disrupt fibrous septa, stimulate collagen remodeling, and improve skin elasticity. A prospective, single-center, investigator-initiated trial enrolled 22 patients who received a single-session treatment. Efficacy was assessed using quantitative imaging, the Physician and Subject Global Aesthetic Improvement Scale (PGAIS, SGAIS) at Day (D) 30, D90, and D180. Histological analysis evaluated collagen remodeling, elastin regeneration, and epidermal restructuring. Safety assessments included adverse events and procedural tolerability. Quantitative imaging showed progressive improvement through D180. By D180, improvement was observed in 77.3% (right thigh) and 81.8% (left thigh). PGAIS scores increased from 38% at D30% to 68% at D90 and D180. SGAIS peaked at D30 (57%), declining to 55% at D90% and 45% at D180. Histology confirmed progressive remodeling and increased extracellular matrix integrity. Two mild, self-resolving adverse events were reported (9%).Combining TVS and helium plasma RF may be a safe, well-tolerated, and effective treatment for improving cellulite appearance and skin laxity. Objective, histological, and physician-assessed outcomes confirmed dermal regeneration and clinical improvement, supporting integration of mechanical and energy-based therapies for minimally invasive cellulite treatment. Level of Evidence: 4 (Therapeutic).