Aesthetic Dermatology MCQ - Rapid Acoustic Pulse technology in Cellulite

A 38-year-old woman presents with concerns about dimpling on the posterior thighs, which worsens on standing. She is otherwise healthy. She is interested in non-invasive treatment options and asks about Rapid Acoustic Pulse (RAP) technology. Which of the following statements regarding RAP technology for cellulite is MOST accurate?

A. RAP uses low-frequency ultrasound to induce adipocyte apoptosis and reduce fat thickness.
B. RAP works by delivering rapid acoustic pulses to disrupt fibrous septae responsible for skin dimpling.
C. RAP causes dermal collagen thermal contraction, leading to immediate skin tightening.
D. RAP delivers monopolar radiofrequency energy to heat subcutaneous tissue and stimulate neocollagenesis.
E. RAP is contraindicated in Fitzpatrick skin type IV due to risk of post-inflammatory hyperpigmentation.

Correct Answer:
B. RAP works by delivering rapid acoustic pulses to disrupt fibrous septae responsible for skin dimpling.

Explanation:
Cellulite is characterized by a mattress-like appearance of the skin caused by fibrous septae tethering the dermis to deeper fascia, with herniation of subcutaneous fat. Rapid Acoustic Pulse (RAP) technology is a novel, non-invasive approach that uses high-intensity, rapid acoustic pulses to mechanically disrupt these fibrous septae, thereby releasing dermal dimples and improving skin smoothness.

• Option A: Low-frequency ultrasound for fat reduction (e.g., cavitation) targets adipocytes, not fibrous septae, and is not the primary mechanism of RAP.

• Option C: Thermal collagen contraction is seen with radiofrequency or infrared laser devices, not with acoustic pulse therapy.

• Option D: Monopolar RF heats tissue to stimulate collagen remodeling but does not mechanically disrupt septae.

• Option E: RAP is safe across skin types, as it does not rely on thermal or light energy that risks dyspigmentation.

Key Point:
RAP technology is effective for non-invasive cellulite reduction by mechanically disrupting fibrous septae without heat or tissue ablation, making it suitable for all skin types.