Objectives: The audience will learn how Acoustic wave therapy (AWT) as a physical modality is acting via stem cell activation, antifibrotic effects and enhance lymphatic drainage. The audience will receive an evidence-based systematic review on the currently published clinical trials in cellulite and body contouring.

Introduction: Acoustic wave therapy (AWT) as acoustic waves act via extracorporeal shockwaves (ESWT) on biological tissues. Besides stem cell activation, a number of additional effects of AWT have been discovered over the past decade including antifibrotic actions. AWT includes radial and focused shockwave technologies.

Materials / method: In December 2018 electronic databases as well as reference lists of the available studies were evaluated. Assessment of each study's methodological quality was performed with the help of the published quality index tool. Evidence-based study designs (randomized-controlled trials RCTs, cohort studies, non-controlled studies) were evaluated.

Results: This meta-analysis included a total of eleven clinical trials on the effects of AWT on cellulite with a total of 322 included females. Among the twelve clinical trials five randomized controlled trials on AWT in cellulite with a total number of 123 females have been published by Nov 2017. Both, focused as well as radial AWT devices have been found effective in treating cellulite so far with follow-up assessment among 3 to 12 months following AWT. Typically, one or two sessions per week and six to eight sessions overall were studied in the published clinical trials.

Conclusion: Both, focused and radial AWT improve cellulite as well as body contouring. As of now, 12 clinical trials with 5 RCTs among them have been published beneficial results in cellulite. There is growing evidence that both, radial as well as focused AWT and the combination of both improve the degree of cellulite with various outcome parameters. Typically, six to eight treatments once or twice a week have been studied without any adverse effects noted. Combination therapy with other modalities like LPG, cryolipolysis or lasers is an intriguing future option of AWT in cellulite and body contouring.

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