vela shape%20 study winter mar%2013%2008[1]
DESCRIPTION
Cellulite Reduction with Syneron Laser TechnologyTRANSCRIPT
Final Results of VelaShape Study
Presented by Yoni Iger
What is body shaping?
Reshaping of different anatomical zones of the body by altering structure and function of superficial connective tissues.
The mission The target
Before After
EpidermisStratum corneum
Basel laminaDermis
Hypodermis
Atrophic degeneration of the hypodermal and dermal zones:– Hypertrophic and hyperplasic changes of fat cells– Mal-performance of the venous and lymphatic
system– Glycation of collagen and hypertrophic septae – Disturbed blood perfusionResulting in– Advantage to the fat cells
having relatively low metabolism– Cyclic atrophy leading to - Increased circumferences
- Bumpy appearance
What is the etiology?
To initiate anabolic (construction) processes in the dermis, together with catabolic (destruction) processes in the hypodermis:
- Blood circulation ↑
- Fibroblasts activity ↑
- Lymphatic and venal drainage ↑
- Fat cell activity ↑
Using a set combination of technologiesfor performing two opposite activitiesin two different tissue depths
Is it do-able?
What is the need?
What is the challenge?
• Infrared light heats the tissue up to 3mm depth
• RF heats tissue from 2 to ~20mm depth
• Vacuum +/- massage enables determination of location of target versus energy, together with other impacts
Lamp
Parabolic reflector
Infraredfilter
RF electrodes
A B
Synergistic use of energies
What is the actual biological impact?Increased metabolism - Anabolic ↔ Catabolic • Mechanical manipulation (vacuum +/- massage):
– Stimulates lymphatic drainage and blood perfusion– Facilitates fibroblast activity– Reduces viscosity of fat cells clusters– Promotes vasodilation & extravasation oxygen & nutrients
– Heating at pre-determined depths• Heating (IR + RF)
– Enhances blood perfusion & increases oxygen dissociation from oxy-hemoglobin
– Facilitates fibroblast activity – Increases metabolism of fat cells– Tightens the skin (septae and overall collagen)
VelaShape History• VelaSmooth (precursor product) received
FDA clearance for cellulite reduction (2005) and thighs circumferences reduction (2007)
• A large scale multi-center clinical study based on up to 12 treatments with VelaSmooth showed:- Cellulite and skin texture improvement.- An average of 1.9 cm , and up to 7.2 cm circumferences reduction.
• Circumferences reduction was also proved in a randomized controlled trial (hence, currently specific FDA clearance for thighs).
FDA Controlled Trial Summary
2.5%
12.5%
22.5%
42.5%
12.5%
2.5%5%
7.5%7.5%
30%
35%
17.5%
2.5%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
-2 (-1)-(-2) 0-(-1) 0 0-1 1-2 2-3 3-4 4-5 5+
Circumference reduction categories
% o
f su
bje
cts
(n=4
0)
Treated Control
significant differences between control and treated sides
Before Post 10 VelaSmooth tx
Before
Post 8 VelaSmooth tx
VelaShape Development• Performance - VelaShape was developed on the
scientific principles discussed, with a modified vacuum pattern and increased RF (50 Watts), while maintaining IR levels (i.e., keeping the device’s suitability to all skin types). This lead to increased efficacy, while maintaining a high safety profile.
• Business model considerations - VelaShape offers shorter treatment sessions and a reduced number of treatments for high-volume medical clinics:- 4-6 sessions- Each session shortened on average by 30%
• Technical improvements, including option of dual connector for VContour and VSmooth applicators.
VelaShape Research
• IRB-approved clinical studies were submitted to FDA and CE with safety data of 92 tx. sessions.
• The company is actively engaged in more than 15 investigational sites worldwide:- Efficacy- Treatment protocols- New indications (e.g., sagging skin following pregnancy or liposuction)
VelaShape Study - Demographics
• 1 clinical site, US• 20 patients, all females• Regular exclusion
criteria, including no obesity
• Average age 43.7 ± 1.7 years (27-56 years)
• 5 tx, weekly interval, FU• Enhanced treatment
mode
Age 21-3010%51-60
20%
41-5050%
31-4020%
VelaShape –Trial – Treated areas
• 40 anatomical areas; abdomen most requested:
• All patients treated on abdomen were pregnant before (on average 11 years earlier)
abdomen50%
buttocks30%
thighs20%
tx 2Less0%
More15%
Same85%
tx 4Less10%
More20%
Same70%
FULess15%
More10%
Same75%
VelaShape – Final Results – Patient Diaries
Diet Drinking Exercise
tx 2
Less10%
Same90%
More0%
tx 4Less
5%
Same70%
More25%
FU Less5%
Same85%
More10%
tx 2 Less15%
Same85%
More0%
tx 4 Less0%
Same100%
More0%
FU Less0%
Same85%
More15%
VelaShape – Final Results - Distribution
Circumferential Reduction 1-5
5%
28% 28%
18%
10%13%
0%
5%
10%
15%
20%
25%
30%
0 up to 2cm up to 4cm up to 6cm up to 8cm >10cm
% o
f ar
eas
(n=3
8)
Circumferential Reduction 1-FU
0%
21% 21%
24%
18%
16%
0%
5%
10%
15%
20%
25%
0 up to 2cm up to 4cm up to 6cm up to 8cm >10cm
% o
f ar
eas
(n=3
8)
Circumferential Reduction 1- 3
18%
40%
20%
13%
5% 5%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
0 up to 2cm up to 4cm up to 6cm up to 8cm >10cm
% o
f are
as (
n=38)•Average distribution of treated areas
•Non responders declined with tx to 0
•Shift of responders score to the right
•Tx 3 (post 2) 58%<2, 33%=2-6, 10% >6cm
•Tx 5 (post 4) 33%<2, 46%=2-6, 23%>6cm
•FU (4Wks) 21%<2, 45%=2-6, 34>6 cm
•Delta between pre 1 and pre 3rd treatment, pre 1 and pre 5th, pre 1 and FU
VelaShape – Final Results - Average
• Following 2 weekly treatments, the average circumferences reduction was 2.82 ± 0.55 cm.
• In percentage reduction vs. baseline: 2.86 ± 0.52%. • Following 4 weekly treatments, the average
circumferences reduction was 4.7 ± 0.77 cm.• In percentage reduction vs. baseline: 4.77 ± 0.77%. • At follow up, the average circumferences reduction
was 5.93 ± 0.79 cm.• In percentage reduction vs. baseline: 6.07 ± 0.69%.
VelaShape – Final Results - Areas
• Patients’ weight did not change significantly (167.9 vs. 167.7 lb).
Circumferences significantly reduced– Looking at the anatomical area categories:
Tx # versus cm improvement buttocks thigh abdomen
2 2.58 1.28 3.58
4 5.17 2.19 5.43
FU 5.93 2.50 7.37
VelaShape –Final Results – Skin texture
Skin texture improvement as per the physicians’ evaluation:
•Tx 3 <30%, peak 11-20%•Tx 5 <50%, peak 21-30%•FU <60%, peak 31-40%
•At least 30%– Tx 3 0%– Tx 5 21%– FU 68%
physician improvement tx 5
15%18%
48%
18%
3% 0%0%
10%
20%
30%
40%
50%
60%
1-10% 11-20% 21-30% 31-40% 41-50% 51-60%
physician improvement FU
3%
11%
18%
39%
26%
3%
0%
10%
20%
30%
40%
50%
60%
1-10% 11-20% 21-30% 31-40% 41-50% 51-60%
physician improvement tx 3
28%
55%
18%
0% 0% 0%0%
10%
20%
30%
40%
50%
60%
1-10% 11-20% 21-30% 31-40% 41-50% 51-60%
Comfort tx1
3%
30%
55%
10%
3%
0%
10%
20%
30%
40%
50%
60%
veryuncomfortable
somew hatuncomfortable
somew hatcomfortable
comfortable very comfortable
Comfort tx3
0.00%
17.50%
72.50%
10.00%
0.00%0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
veryuncomfortable
somew hatuncomfortable
somew hatcomfortable
comfortable verycomfortable
Comfort tx5
2.50% 5.00%
70.00%
20.00%
2.50%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
veryuncomfortable
somew hatuncomfortable
somew hatcomfortable
comfortable very comfortable
VelaShape – Final Results - Comfort
More than 80% of the patients found the treatmentto be somewhat to very comfortable; the rest felt some slight discomfort
VelaShape – Final Results – Patient Ratings
improvement tx 5
5%
28%
38%
20%
10%
0%
5%
10%
15%
20%
25%
30%
35%
40%
none slight moderate good excellent
improvement tx FU
5%
29%32%
26%
8%
0%
5%
10%
15%
20%
25%
30%
35%
none slight moderate good excellent
satisfaction tx 5
3%
10%
40%
30%
18%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
not satisf ied slightlysatisf ied
satisf ied very satisf ied extremelysatisf ied
satisfaction tx FU
3%
21%
50%
13% 13%
0%
10%
20%
30%
40%
50%
60%
not satisf ied slightlysatisf ied
satisf ied very satisf ied extremelysatisf ied
improvement tx 3
13%
40%
25%20%
3%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
none slight moderate good excellent
satisfaction tx 3
3%
23%
48%
28%
0%0%5%
10%15%20%25%30%35%40%45%50%
not satisf ied slightlysatisf ied
satisf ied very satisf ied extremelysatisf ied
VelaShape –Final Results
• Correlation between patients’ assessment of improvement and their satisfaction:
Tx 3 - 76% Tx 5 - 65% FU - 83%
• Response to treatment was limited to erythema and edema that lasted several hours.
Before Post 2 VelaShape tx
Photos courtesy of Marc Winter, MD
Before Post 2 VelaShape tx
Photos Courtesy of Marc Winter, MD
Before Post 2 VelaShape tx
Photos courtesy of Marc Winter, MD
Before Post 2 VelaShape tx
Photos Courtesy of Marc Winter, MD
Before Post 2 VelaShape tx
Photos Courtesy of Marc Winter, MD
Before Post 2 VelaShape tx
Photos Courtesy of Marc Winter, MD
Summary
– VelaShape is intended for circumferences reduction and cellulite appearance improvement due to its concomitant ability to: •Reduce the fat cells and chambers
dimensions•Tighten the skin