Cellfina Explained
Dr. Darren M. Smith does not offer Cellfina. This page explains what it is, because patients ask about it, and why the practice uses Avéli for the same problem. The two share a mechanism: both release the fibrous bands under the skin that pull cellulite dimples down. They differ in how that release is carried out and in how the person doing it confirms which bands have actually been released.
This practice does not offer Cellfina
Cellfina is not offered at this practice. For cellulite dimpling, Dr. Smith performs Avéli.
That is not a comment on whether Cellfina works. Both devices are cleared by the FDA and both act on the same underlying structure. The reason for the choice is a mechanical one, and it is set out below.
What causes a cellulite dimple
A cellulite dimple is caused by a tether, not by fat sitting too close to the surface. Fibrous bands called septae run from the deeper tissue up to the underside of the skin. Where a band is tight, it holds that point of skin down while the fat around it pushes up, and the result is a dimple with a shadow beside it.
That is why creams, massage and fat-reduction treatments do so little for dimpling. They act on the surface or on the fat layer, and the tether is still there. Treatments that change a dimple do so by cutting the band that is holding it. Both Cellfina and Avéli work this way. The procedure is called subcision.
How Cellfina works
Cellfina is a vacuum-assisted subcision device. The dimple to be treated is marked, the area is numbed with local anesthetic, and a tissue stabilizer is placed over the marked dimple. Suction draws the tissue up into that stabilizer, which puts the septae under tension and holds the area still.
A small blade is then advanced through a guide in the device at a set depth, cutting across the tissue that has been drawn into the chamber. The tether is divided, the skin is released, and the device is moved to the next marked dimple.
The design point is standardization. The depth is fixed by the instrument, the tissue is held in a known position by the vacuum, and the cut is made in a controlled and repeatable way. That is a real advantage for consistency.
It also defines the limit. The cut is made across whatever the vacuum has drawn into the chamber, at the depth the device is set to. The individual band is not sought out, identified and divided one at a time, and the person performing the treatment cannot see inside the chamber while the blade passes. Whether every tether under that dimple has been released is inferred from the result afterward rather than confirmed during the release.
Why Dr. Smith uses Avéli instead
Avéli performs the same release, but the clinician works band by band and can confirm what has been released as the treatment happens.
A slim handheld device is passed into the plane just beneath the skin through a small entry point. The tip carries a light. Because the tip is directly under the skin, that light shows through, so the surgeon can see from outside exactly where the tip sits at every moment. A small hook at the tip is used to catch an individual fibrous band, and a blade at the tip releases it.
Three things follow from that arrangement:
- Each band is identified before it is cut. The hook engages a specific tether, which the surgeon feels, rather than cutting across a volume of tissue that has been drawn into a chamber.
- Release is confirmed rather than assumed. After a band is divided, the surgeon can pass back over the same point and check whether resistance is gone, and can see the dimple respond. If a tether remains, it is dealt with in the same pass.
- Several dimples can be reached through one entry point. The device moves within the plane rather than being repositioned over each dimple individually, so an area is treated as an area.
The practical difference is in that middle point. With cellulite, the result comes from whether the specific tethers producing the specific dimples were actually divided. A method that lets the person doing it locate each band, release it and then verify that it is released gives more control over that than a method that standardizes the cut and assesses the outcome afterward.
Avéli is performed in a single session in the office under local anesthesia, usually in under an hour. Details of the treatment, the recovery and who it suits are on the Avéli page.
Who septal release helps, and who it does not
Releasing septae helps patients whose complaint is visible dimpling on the buttocks or thighs, with reasonably firm skin and a stable weight.
It does not help two other problems that patients describe with the same words. Loose or crepey skin is a laxity problem, and heat delivered into the right tissue plane is what addresses it, which is what BodyTite and Morpheus8 do. Generalized fullness is a fat problem, and liposuction addresses that.
Many patients have more than one of the three, and in that case treatments are combined or sequenced. Sorting out which parts of what you see come from which problem is the most useful thing that happens at consultation, and Dr. Smith will tell you plainly which parts a septal release will change and which parts it will not.
What to expect from a septal release
Subcision of any kind is a procedure performed under the skin with a blade, not a device passed over the surface.
Bruising, tenderness and soreness in the treated areas are the expected findings afterward, and they settle over a few weeks. Bruising is the part most patients plan around, so timing the treatment away from an event or a holiday is worth thinking about at consultation. Less common problems include an irregularity in the contour or a collection of fluid or blood in the treated area.
Knowing the tissue planes, judging how much release a given dimple needs, and managing a complication if one occurs are surgical matters. Dr. Smith is board-certified by the American Board of Plastic Surgery and a Fellow of the American College of Surgeons, with fellowship training in craniofacial and aesthetic surgery, and he performs the treatment himself.
What determines cellulite treatment cost
Fees for cellulite treatment depend on how many areas and how many dimples are treated, and are quoted individually after consultation.
- The number of areas treated
- The number of dimples within those areas
- Whether anything else is combined at the same time
Dr. Smith is out of network with all insurance plans, and the practice helps patients use out-of-network benefits toward care; cellulite treatment is cosmetic and is not covered. Financing is available through CareCredit and Alphaeon Credit. The consultation fee is $500 and is applied toward any procedure.
Common questions about Cellfina and Avéli
Can I have Cellfina here?
No. Dr. Smith does not offer Cellfina. For cellulite dimpling he performs Avéli.
Does that mean Cellfina does not work?
No. It is an FDA-cleared device that releases the same fibrous bands. The difference is in how the release is carried out and in how the clinician confirms which bands have been released, and that is the basis for the preference.
What is subcision?
Cutting a fibrous band beneath the skin, through the skin, without removing anything. It is what both Cellfina and Avéli do, and it is what changes a cellulite dimple.
Why does it matter whether the band is identified individually?
Because the dimple only changes if the tether holding it is divided. Working band by band means each one is found, released and then checked. Any method that treats a volume of tissue rather than an identified band relies on assessing the outcome afterward instead.
Is the treatment done under general anesthesia?
No. Avéli is performed in the office under local anesthesia. You are awake and you go home afterward.
How many sessions are needed?
Avéli is designed as a single treatment rather than a course. That is the main practical difference between it and the energy-based and topical options, which are repeated indefinitely.
Will it treat loose skin as well?
No. Releasing a tether does not tighten skin. Laxity is treated with heat delivered into the subcutaneous plane, which is what BodyTite does, or with Morpheus8 for skin quality.
How long does recovery take?
Downtime is minimal, but bruising and tenderness are expected and settle over a few weeks. Most patients plan the timing around that.
Will the dimples come back?
A band that has been divided is not expected to re-form. What can change over time is everything around it: weight gain, skin laxity with age, and areas that were not treated. Keeping weight stable is what best protects the result.
What should I bring to the consultation?
Nothing in particular. It is worth being clear about which specific areas bother you and in what light or position you notice them, since dimpling, laxity and fullness look different from one another and are treated differently.