Abstract

Objectives: To evaluate the benefits of combining assisted subcision with long-pulsed laser photobiomodulation for reducing hematomas and preventing hemossiderin-induced hyperpigmentation in cellulite treatments, with the goal of enhancing patient satisfaction and self-esteem. Introduction: Cellulite, affecting most women, causes skin dimpling and impacts self-esteem. Assisted subcision effectively releases fibrous septae and stimulates collagen for smoother skin texture. However, post-procedural hematomas are common and may lead to hyperpigmentation. Integrating long-pulsed laser (1064 nm) photobiomodulation accelerates recovery by targeting hemoglobin chromophores, reducing hematomas, and minimizing aesthetic risks. Materials / method: Cases observed in clinical practice involved patients with cellulite undergoing assisted subcision, followed by long-pulsed laser photobiomodulation (1064 nm). The protocol used 10-15 J/cm² fluence, tailored pulse durations based on hematoma density, and ≤ 0.5W power. The laser targeted cytochrome c oxidase in mitochondria, enhancing ATP production to accelerate hematoma absorption and prevent pigmentation, aiming to optimize post-treatment aesthetic outcomes. Results: Patients demonstrated rapid hematoma resolution following the combined treatment of assisted subcision with long-pulsed laser. After two sessions, most cases showed minimal ecchymosis and no signs of hemossiderin-induced hyperpigmentation. The laser treatment effectively minimized discoloration and inflammation, leading to a smoother and more uniform skin tone. Patients reported high satisfaction with the aesthetic results, noting faster recovery and increased confidence due to the absence of lingering pigmentation issues. Conclusion: The combination of assisted subcision and long-pulsed laser proved effective in accelerating hematoma resolution and preventing hyperpigmentation, enhancing both aesthetic and psychological outcomes. The integrated approach facilitated a faster recovery with improved skin uniformity, reinforcing patient confidence and satisfaction with cellulite treatment.