Elena Fasola, Andreea Boca, Giorgio Reggiardo, Vincenzo Nobile, Dhouha Dridi
Edematous fibrosclerotic panniculopathy (EFP) affects ∼80% to 98% of postpubertal women and has a significant impact on quality of life. Its unclear etiopathology and the multifactorial origin pose a significant challenge for its clinical management. This study aimed to evaluate the efficacy and the safety of a commercially available mixture of hyaluronic acid and amino acids in an alkaline solution. A prospective multicenter clinical trial was carried out on 46 women with EFP Stage I to early Stage IV. The improvement of cellulite severity was evaluated by the modified Clinician-Reported Photonumeric Cellulite Severity Scale (CR-PCSS) and the modified Patient-Reported PCSS (PR-PCSS) before the first (T1), the second (T2), and the third injection (T3) and after 3 (T4) and 6 (T5) months of treatment. The psychological impact of cellulite was measured using the Objectified Body Consciousness (OBC) scale. The PR-PCSS revealed that 95.3% of participants reported an improvement in their appearance. These positive outcomes remained consistent up to 6 months following the initial treatment. Similarly, the CR-PCSS showed that as early as 2 weeks after the first treatment, 76.7% of participants demonstrated objective improvement based on the Global Aesthetic Improvement Scale. These improvements also remained stable for up to 6 months. Self-esteem (OBC scale) was improved. No major adverse events were reported; minor bruising occurred as expected because of injections. Sunekos Cell 15 is a possibly effective and well-tolerated treatment for cellulite, particularly in cases with pronounced fibrosis, potentially offering a minimally invasive therapeutic option. Level of Evidence: 4 (Therapeutic) For image description, please refer to the figure legend and surrounding text.