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Genetic Linkage

Treat Cellulite, or Rare Diseases?

“Next, news that all women will want to hear!” teased the commentator on the increasingly imbecilic Today Show.

Soon I learned that, finally, we womenfolk need no longer suffer from the “horrible, dimpled ‘orange peel’ skin” of cellulite. The new miracle cure sounded like “cellulase,” an enzyme that breaks down wood.

Googling, I soon discovered that “Cellulaze” is instead a new laser technique that “pinpoints and disrupts dimpled pockets of herniated fat” and melts away the collagen cords that hold in place the vile lipid, while promoting formation of new collagen and elastin. It joins a long list of cellulite remedies, including sound waves, radio waves, massage, retinol, red algae patches, and extracts from licorice roots, horse chestnut, and kola. The market is $2.3 billion.

Those selling cellulite cures call it “a modern epidemic,” but the fact that 85% of postpubertal women have cratered thighs suggests that the condition is normal. Actually, cellulite is more common in women due to differences in the pattern of collagen fibers in the fat beneath the skin: in men it’s a network, but in women the fibers align longitudinally, pushing bulging adipocytes up into the dermis. The difference may be Darwinian, a fat-storing adaptation of pregnancy.

One can diagnose cellulite with a “pinch test,” and then classify oneself using the Nurnberger-Mulle scale of advancing decrepitude. A stage 0 butt, thigh, or hip has inoffensive folds but no “mattress-like appearance,” whereas the dread stage 3 brings “spontaneous dimpling.”

Intrigued, I checked out Cellulaze. On the Patent and Trademark Office website I found two entries: a composite material, and cereal by-products. I had better luck with the FDA. The agency approved Cellulaze as a medical device in January 2012. It hails from Westford, MA-based CynoSure. Next I tracked down the article in the Aesthetic Surgery Journal describing the device, the invention of Barry DiBernardo, MD, of Montclair, NJ.

Dr. DiBernardo conducted the clinical trial for the “laser lipolysis” in his own clinic. Into one dimpled thigh of each of ten women, he slipped a fiberoptic tube bearing a laser that emits energy both straight ahead and to the side, an innovation called “side-firing technology.” The invasiveness – 4 small cuts -- is what sets this anti-cellulite laser apart from earlier ones that simply shine light from the outside. I envisioned lifting the skin on a chicken and scraping out the fat below as I read the journal description: “When laser treatment was completed, the liquefied adipocytes were removed by gently squeezing the incision-point tissue.”

Judging from the ten human thighs displayed in the paper, photographed next to their untreated control mates, Cellulaze works, and the effect lasts at least a year. The procedure takes a little more than an hour, and the patient stays awake and recovers quickly.

But getting your cottage cheese deposits zapped away isn’t cheap – it costs $2,500 a “spot,” whatever that means. One plastic surgery practice on Park Avenue offers a “virtual consultation,” which evoked You Tube images of butt scans on copiers.

The more I thought about cellulite and its $2,500-a-pop treatment, the madder I got. That’s because since writing my book about gene therapy, The Forever Fix, I’ve met, on Facebook and in person, many families raising funds to help develop treatments for their children, all of whom have diseases so rare that they can’t wait for pharma to take an interest. So I have a suggestion.

Every post-pubertal woman considering spending thousands to blast away cottage cheese deposits should instead send the money to Hannah’s Hope Fund, or Canavan Research Illinois, or Families Curing Retinal Blindness Together or the Cystinosis Research Foundation, or any of the organizations listed at CheckOrphan or the
National Organization for Rare Disorders.

The world is full of medical conditions much more serious than cellulite.

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