Can filler treat large divot in front of thigh Cellfina treatment which was completed one year ago? (Photos)

Question

I had Celfina performed on the front of my thighs one year ago. I was left with terrible bruising still evident today, and divots in my thighs, the worst pictured below. The treating physician is no longer practicing, so my dermatologist injected the area with Restylane in hopes of improving the appearance of the large indentation. The photo was taken after the filler! Should I try more filler in the area? What can be done to improve the appearance?

Carlos Mata, MD, MBA, FACS · Answer

Hello Pepper,Thank you for your question and I am so sorry to hear about your experience.  I often re-evaluate and re-treat patients who have had upsetting experiences in the past with Cellfina because sometimes, providers are not properly trained or experienced and performing this treatment incorrectly may make the areas look worst.  I advise you to seek a formal evaluation with a board-certified medical professional who has extensive experience with this procedure.  There are several routes that could possibly aid in resolving the divots.  Actually being able to see the areas of concern would allow your medical professional to recommend the best treatment protocol in order to meet your expected outcome.  Hope this helps.All the best,Carlos Mata, MD, MBA, FACSBoard-Certified Plastic Surgeon

Jaime S. Schwartz, MD, FACS · Answer

Thank you for your question.
  
Cellfina is an FDA approved minimally invasive procedure that reduces the appearance of cellulite for at least two years on the buttocks and back of the thighs of women.
  
It works by releasing the internal bands that cause the cellulite dimpling and so we have not seen any fat atrophy.     I recommend Cellfina in combination with Sculptra or renuva for optimal results.  You should not see much of a difference with weight gain or loss but this also has not been studied.
  
Other areas of the body with dimpling, it is important to make sure it is truly cellulite before treatment.
  
It is common to have swelling bruising and firmness after the procedure. This can last for a few weeks.
  
It is different than Cellulaze which is a laser. 
  
If you have had previous poor results with cellulaze, you can still do Cellfina.
  
Cellfina has shown 100% noticeable improvement and 96% satisfaction in all patients at 2 years. 
  
Cellfina is designed to be a one time procedure. 
  
It can be used on women with all skin types but caution should be taken if theres a history of keloiding.
  
It can also be combined with other treatments such as Thermi or
  
Ulthera if skin tightening is needed.
  
We have done Sculpsure and Coolsculpting if fat reduction is wanted, but its best to wait 3 months to see the results before proceeding.
  
It can also be done at the same time as other procedures such as liposuction and BBL or as a stand alone procedure in the office.
  
Since Cellfina outcomes can be based on technique and experience, please see a board certified plastic surgeon that specializes body contouring to see if Cellfina or other treatments are available to meet your goals. 
  
Take care,
  
Dr. Schwartz 
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Jason Emer, MD · Answer

This can be improved with office subcision and fillers or renuva.  I suggest you see an expert for treatment options. Best, Dr. Emer.

Richard E. Moore, MD · Answer

Thank you for your question and I am sorry to hear that you had this experience. Your divot appears to be caused by a fibrous band that must be released. Putting filler under the divot will not force the tissue out unless it is first released. Cellfina is ideal for releasing these bands but some physicians can manually release a single site like this. I would then considering using Sculptra or ALMI to fill the area in. Sculptra promotes collagen tissue formation to fill in the space where as ALMI (pronounced All Me) combines PRP (platelet rich plasma) with a small syringe of your fat that has been processed to isolate pre-adipocytes (early fat cells) and regenerative cells. This should give a long term solution to the problem. The persistent bruising appearance is likely hemosiderin staining from the bruise. I find that 1-3 IPL treatments will often diminish this significantly. I hope this was helpful - Dr. Moore

Diana L. Elias, MD (retired) · Answer

Use of fillers in such a large divot is not cost-effective. You will need a large volume and the process will need to be repeated for ever. Your best bet is a combination of micro-suctioning around the periphery of the defect to "camouflage" the step-off and blend it into the surrounding thigh along with fat grafting to the center, deepest part. We have had success with this approach in several patients with traumatic contour deformity.

Can filler treat large divot in front of thigh Cellfina treatment which was completed one year ago? (Photos)

Answers (5)

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