Background: Cellulite represents a common cosmetic problem that affects nearly all women. This study aimed to evaluate microwave therapy’s effectiveness for cellulite treatment. Methods: In this study, 26 women showing severe or moderate cellulite underwent four sessions of microwave therapy on the buttocks and posterior thighs. The following assessments were performed at baseline and the three-month follow-up after the last treatment: the Cellulite Severity Scale (CSS), Nürnberger–Müller classification scale, photographic evaluation, and buttocks/posterior thighs circumference measurements. A Likert scale questionnaire was used to assess patient satisfaction at the 3-month follow-up. Results: The treatment positively affected the cellulite severity as confirmed by the Cellulite Severity Scale (CSS) and Nürnberger–Müller classification scale results. CSS showed a significant amelioration in cellulite severity between the initial assessment and the 3-month follow-up for the buttocks and posterior thighs, with total average scores that ranged from 10.7 ± 3.1 to 4.5 ± 1.8 (p < 0.01). The treatment also resulted in a remarkable improvement in comfort/satisfaction and a buttocks and posterior thighs circumference reduction. No serious adverse events were observed. Conclusions: Microwave therapy has proven to be a safe treatment for improving cellulite appearance and reducing body circumferences.

Unwanted abdominal fat is a common aesthetic concern treated through various interventions, including surgical and energy-based devices, often leading to inconsistent results. This study aimed to evaluate the feasibility of a localized, non-invasive microwave (MW) device for preferential heating of subcutaneous adipose tissue using a controlled electromagnetic field. Five female volunteers scheduled for abdominoplasty were enrolled, each undergoing a single MW treatment session five days prior to surgery. Histological analyses of adipose tissue and skin samples were conducted using Hematoxylin and Eosin staining and immunohistochemistry for Perilipin-1 and CD68. Epidermal and dermal layers remained unaffected, as evidenced by unaltered morphology in treated samples. In contrast, the absence of Perilipin-1 expression in disrupted fat cell membranes indicated adipocyte non-viability and irreversible injury. Inflammatory responses, including CD68-positive macrophages surrounding damaged adipocytes, were observed, suggesting the activation of the monocyte/macrophage system for the clearance of adipocyte residues. Microscopic and immunohistochemical findings demonstrate the effectiveness of the MW device in reducing subcutaneous fat. This study also discussed the underlying mechanisms involved in macrophage recruitment and the removal of adipocyte residues.

The body contour market has grown rapidly in recent years, due to persistent requests for noninvasive treatments for localized fat adiposities, cellulite, and skin laxity. A variety of different methods are now available to improve body shaping. This review aims to provide an exhaustive compendium of the main recommendations for the optimal use of an innovative device delivering microwaves (MWs) for unwanted fat and cellulite reduction (Onda Coolwaves, DEKA, Florence, Italy), resulting from the experiences of the most expert international users. The availability of this new technology has led to an increasing number of treated patients and clinical studies. However, what is still missing, to the best of our knowledge, is an evaluation of the long-term efficacy and safety of this method. Based on the most recent data available, this compendium focuses on the ideal parameters, patient selection, and treatment methodology for providing safe and effective treatment protocols. Future research findings may suggest changes to the conclusions or recommendations in this report.