DEVELOPMENT OF QUANTITATIVE MODELS FOR THE INVESTIGATION OF GYNOID LIPODYSTROPHY (CELLULITE)
Gynoid lipodystrophy (cellulite) is characterized by the uneven distribution of subcutaneous adipose tissue in the skin in ~85% of post-adolescent women, giving rise to an irregular, dimpled skin surface of the thighs, abdomen, and/or buttocks. Currently, myriad investigator specific, subjective grading scales are used to evaluate cellulite. The development of a novel, non-contact method using three-dimensional laser scanning technology (Cyberware Rapid 3D Digitizer) to objectively characterize cellulite is described in females (n=51) undergoing weight reduction (liquid diet, Weight Watchers®, bariatric surgery, medication) during a six month period. Females (n=11) without visible cellulite served as controls. Additionally, we have examined the skin biomechanical properties (BTC-2000™); tissue density, skin thickness and dermal-subcutaneous border morphology by skin ultrasound; body composition by dual energy x-ray absorptiometry; and the examination of cellulite and non-cellulite affected tissue structure by histology. Quantitative model development by linear regression analysis revealed that the surface roughness parameters Svm (mean depth of the five deepest valleys) and Sdr (surface roughness ratio) quantitatively described the cellulite condition. Visual assessment of the laser-scanned images of cellulite by experts, study subjects, and naïve judges revealed significantly correlated perceptual evaluations of cellulite severity (r? 0.86, p< 0.05). The change in cellulite severity (Sz) with weight loss exhibited a bimodal response (improvement/ worsening of the condition). Subjects experiencing a decrease in the condition had significant reductions in weight, BMI, thigh circumference, subregion % fat of the thigh, whole thigh % fat, and a significant increase in % lean tissue. Histological data revealed that the skin surface changes were dependent upon adipocyte size, fat tissue content, and tissue density. The data generated in this investigation indicates that the severity and manifestations of cellulite are influenced by thigh % fat, tortuosity of the dermal-subcutaneous architecture, and adipocyte size. The quantitative comparison of the heterogeneous surface and sub-architecture of cellulite, related to visual score establishes the basis for treatments targeted to the specific presentation of cellulite, i.e. mild orange peel (surface refinement) and severe cottage cheese (deep tissue assessment). Three-dimensional surface scanning has uses beyond cellulite evaluation: breast reconstruction, wound revision, face-lift, prosthesis fitting and more...
School:University of Cincinnati
School Location:USA - Ohio
Source Type:Master's Thesis
Keywords:gynoid lipodystrophy cellulite weight loss bariatric surgery three dimensional laser scanning dual energy x ray absorptiometry dexa histology
Date of Publication:01/01/2005