摘要

Objectives: To describe the author's clinical experience with 3,144 cases treated between January 2019 and April 2025, in Rio de Janeiro and São Paulo, using a protocol that combines biostimulators with fibrous septa release in standing patients for the management of edematous fibrosclerotic panniculopathy (EFSP). Introduction: Edematous fibrosclerotic panniculopathy (EFSP), commonly known as cellulite, affects a significant portion of the adult population, especially women. This study presents the author’s clinical experience with 3,144 cases treated using a combination of biostimulating agents and fibrous septa detachment, with patients positioned standing to better assess natural contours and asymmetries. This protocol aims to restore the structural integrity of the subcutaneous tissue, improve skin appearance, and enhance patient satisfaction. Materials / method: This study involved 3,144 EFSP cases treated from January 2019 to April 2025 in Rio de Janeiro and São Paulo. The treatment combined biostimulators and fibrous septa detachment. Patients were photographed before and after treatment, and the images were analyzed for visual improvements. Patient satisfaction was assessed through questionnaires, and the medical staff's satisfaction was evaluated based on the ease of procedure and clinical outcomes. Data from these assessments were compiled and analyzed to determine the overall effectiveness and satisfaction with the treatment protocol. Results: Photographic evaluations showed significant improvements in overall skin health. The biostimulating agents enhanced circulation and general metabolism, promoting neocollagenesis. The mechanical effect of septa detachment, performed with the appropriate techniques, effectively leveled skin retractions and decompressed fat deposits. This combination protocol addressed the root causes of cellulite by decomposing fat, improving collagen structure, and boosting circulation and metabolism.
 The standing approach allowed more accurate identification of problem areas, leading to optimized results. Conclusion: The integration of biostimulation with targeted fibrous septa release in standing patients is a safe, effective, and reproducible method for treating EFSP. With over 3,000 cases performed, this protocol has demonstrated consistent aesthetic results and high satisfaction rates, representing a valuable advancement in non-surgical body contouring.