Syneron Candela VelaShape III, System User Manual, Page: 50 / 86

Cellulite and Circumference Treatment
PB81499EN
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Cellulite
The suggested cellulite classification method is according to the Nurnberger-
Muller Scale that classifies cellulite into four categories using the pinch test.
By gently pinching a few inches of skin between your thumb and forefinger, in
the area intended for treatment, we can distinguish four (4) stages of cellulite
appearance
(Hexsel et al.) :
1. Stage Zero – there is no alteration to the skin surface (no dimpling is seen on
the skin when the patient is standing naked in front of the mirror). When the
skin is pinched no orange peel effect is seen (see Figure 35-A).
2. Stage One – the skin of the affected area is smooth while the patient is
standing or lying down (no dimpling is seen on the skin when the patient is
standing), but undulations (bumps and lumps) on the skin surface can be seen
on pinching the skin or during muscle contraction (see Figure 35-B).
3. Stage Two – the "orange peel" or "mattress" (dimpling) appearance is evident
when standing, without the use of any manipulation (skin pinching or glutens
muscle contraction, see Figure 35-C)
4. Stage Three – presence of alteration described in stage two, plus presence of
raised and depressed areas and nodules (dimpling that can be seen both when
the patient is standing and lying down, see Figure 35-D).
Table 2: Cellulite stages summary according to Nurnberger-Muller Scale
Standing Supine Pinch Test
Stage Zero
− − −
Stage One
− −
Cellulite / Dimpling
Stage Two Cellulite / Dimpling
−
Cellulite / Dimpling
Stage Three Cellulite / Dimpling Cellulite / Dimpling Cellulite / Dimpling
Figure 35: Illustration of cellulite stages (A- Stage Zero; B- Stage One; C- Stage Two;
D- Stage Three)