ARTICLE | DERMAL REJUVENATION |


The safety and efficacy of this procedure strongly depend on the correct execution of the technique. For this reason, it is necessary to clarify the right characteristics of the devices: ■ Medical and sterile CO2


CO2 should be used


■ The equipment used should allow the physician to predetermine the purity of the gas administered; the quantity of gas to be infused; infusion time; the volume of gas administered; the temperature of the gas; the rate of infusion of the gas, which needs to be kept constant


■ The equipment must have certification to ensure it conforms with the technical data listed and the ability to be used for the administration of medical gas ■ A 30 or 32 gauge 13 mm needle should be used.


Figure 3 It is important to treat with small intradermal carbon dioxide infiltrations on landmarks along the great saphenous vein path. Point A = Crosse of great saphenous vein, point B = mid-thigh point, point C = Dodd’s perforator point, point D = Boyd’s perforator point, point E = popliteal fossa point


Treatment of cellulite and localised adiposities The use of CO2


therapy devices


is related to its positive and documented


effects on different aspects of the imperfectionÕs aetiology. Adipose tissue is a connective tissue composed of fat cells, stromal elements, blood and lymph vessels, and a matrix of collagen fibres. Clinical modification of connective tissue can be localised (adiposity) or diffuse (cellulite), and often coexist; for this reason they should be treated together. Localised adipocity refers to the accumulation of fat in


certain areas of the body (abdomen, thighs, trochanters, knees). The goal of therapy is to obtain a reduction in the volume of adipose masses; therefore, the use of CO2


is


indicated either in combination with surgical treatments (in order to optimise and stabilise the results obtained) or alone, especially when patients refuse surgical treatments. Cellulite refers to skin irregularities of the lower limbs


Figure 4 Localised adipocity and early cellulite in a 28-year-old female patient (A). Results after eight treatments, anterior view (B)


related to sexual, genetic, and lifestyle factors, as well as incongruous clothing, such as high heels and tight pants. It can also be conditioned and aggravated by the presence of renal venous and/or lymphatic disease. It is a chronic condition and it is important to explain to patients how many times the treatment should be repeated, the manner and method of which, could differ in each case. Treatment is based on a


Localised


adipocity refers to the accumulation of fat in certain areas of the body.


multidisciplinary approach, including lifestyle changes, the control of venous and/or lymphatic circulation, use of personalised diets, and medical and physiotherapy associated treatments, such as carbon dioxide therapy (used alone or in combination with other methods). Physiopathology of cellulite includes alterations to the microcirculation, venous, and lymphatic systems, which are influenced and worsened by the fat accumulation inside the connectival septa 8


.


Figure 5 Localised adipocity and early cellulite in a 28-year-old female patient (A). Results after eight treatment, posterior view (B)


74 ❚ March 2013 | prime-journal.com The administration of subcutaneous CO2 improves microcirculation by increasing blood flow in treated


C M Y CM MY CY CMY K


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