![San Diego plastic surgeon Dr. Katerina Gallus and her scrub tech Bri on the episode of their podcast "All the B's" where they chat about Avéli [Booty Dimples Be Gone! With Avéli]](https://restoresdplasticsurgery.com/wp-content/uploads/2025/05/ALL022-1-1024x576.jpg)
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Avéli cellulite treatment won’t magically give you Sabrina Carpenter’s Met Gala legs (we wish), but it will smooth out some of those stubborn dimples on your thighs and booty that drive you nuts.
Dr. G and Bri discuss the cellulite treatments that totally flopped, and why Avéli actually delivers. Find out how this lightsaber-looking device works and what to expect for downtime.
Trending stories:
Daily Mail, Rihanna reveals she’s PREGNANT with her third child as she shows off bump at Met Gala
The Independent, Katy Perry mocked for dance moves on Lifetimes tour: ‘Shockingly bad’
Daily Mail, Ryan Reynolds mercilessly mocked by fans over awkward fake tan fail: ‘Why is he so orange?’
Avéli-related story:
Allure, I Tried the Avéli Cellulite Treatment on My Butt and Thighs — With Before and Afters
Transcript
Dr. G (00:02):
You are listening to another episode of All the B’s with me, Dr. G and my scrub tech Bri. Welcome back. We are nearly ready in our office to have an intervention where we offer, we say we know and love you, Bri, but you’re not allowed to use the word slay anymore.
Bri (00:28):
I just got back from a trip and I’m pretty sure my vocabulary only consisted of the word slay and then my daughter gave me a Mother’s Day, things she likes about you and the top line, I have a picture, says I love my mom because she slays and I was like, okay.
Dr. G (00:45):
Fitting. Yeah.
Bri (00:47):
So fitting I think
Dr. G (00:47):
Our anesthesiologist is, he’s going to start one of those coin jars where every time you say slay, you have to put a quarter in or something. I don’t know,
Bri (00:57):
Right? Yeah, or go to therapy.
Dr. G (01:01):
But we’re back, and today we’re going to talk about Aveli, which is a cellulite reduction treatment that we like a lot in this office. We just did, did we do three of them that Friday before you left, I think, or two?
Bri (01:15):
We did.
Dr. G (01:16):
We did three that week, yes. But first we have to dissect the current events and not the depressing kind, so I feel like we might kick off with the Met Gala cuz it’s topical.
Bri (01:30):
Let’s do it.
Dr. G (01:31):
I would say my first disappointment was to see that Rihanna was pregnant again.
Bri (01:37):
Again and she’s like, I guess she’s not going to be at Lollapalooza, is she? I was like, you never know. She slayed at the Super Bowl pregnant, so, oh, I said Slay again. Dang it.
Dr. G (01:49):
I feel like it matches the number of times I drop a lap on the floor when we’re operating. Maybe it’s matching my energy.
Bri (01:57):
Yesterday back day one after vacation.
Dr. G (02:02):
Another lap down, another lap down.
Bri (02:04):
And another one, I feel like she just retired so she could whip out a whole football team. I feel like she’s going to be the female version of Nick Cannon without all the baby mamas.
Dr. G (02:14):
I know. I mean, she looks gorgeous. I am simultaneously excited for her and upset that we’re not getting either a new album or at Lollapalooza when I’m there to see ASAP Rocky that she’s not going to probably bounce onto stage. Probably going to be on bedrest or something. I don’t know. She’s pretty pregnant there.
Bri (02:36):
I give her high hopes. Her outfit is very close to Kylie Jenner’s outfit, like the skirt they both have.
Dr. G (02:44):
I mean, I will have to say that this Met Gala with the black inspired, tailored look, got people all on the same page. There wasn’t crazy. There were a lot of pinstripe suits. There were women wearing suits as deconstructed or the front of a suit. I don’t know. It was interesting, but a lot of the same theme. I mean Zendaya and that one girl basically had the same three piece white suit on everyone. There was a lot of the same looks, which is tough. I feel like there was some room for creativity, but then when people vary too much, then we’re all like, wait, what? What’s that?
Bri (03:27):
Right? You were either in a pants suit, a skirt, or no pants.
Dr. G (03:32):
Yes, no pants, definitely. Speaking of Aveli, no pants look was quite the thing on the Met Gala. So if you’re
Bri (03:41):
Sponsored by Aveli.
Dr. G (03:43):
If you’re wanting to show up those gams in a formal setting, literally in panties and hose, then yes, maybe Aveli’s, probably your next stop.
Bri (03:58):
Aveli and slay.
Dr. G (04:01):
I don’t think we have any other, I feel like I saw an article about Halle Berry in plastic surgery and her presence at the Met Gala, and I thought, what? She looks great and she didn’t look overdone or undone. I didn’t love her dress, but I don’t know. I feel like sometimes people are just trying too hard about the plastic surgery connection there.
Bri (04:26):
I know. The first thing my mom asked me, she was like, has Demi Moore had a facelift? And I was like, don’t you listen to our podcast?
Dr. G (04:31):
Apparently not.
Bri (04:33):
We’ve addressed her, I feel like so many times.
Dr. G (04:35):
Yeah, she’s had at least two facelifts and then the lip lift, that was not it.
Bri (04:44):
I do have to say Anne Hathaway. Okay. I know we weren’t going to talk about her, but I just remembered something. She has incredibly pointy ears.
Dr. G (04:54):
Oh, you and your ears.
Bri (04:56):
Can we pull up a picture? I don’t know. You know how some, that’s my thing.
Dr. G (05:00):
You have your Nicole Kidman
Bri (05:01):
Can we put a picture? Yeah. Her ear lobes are huge, but I feel like I saw her in a picture and her ear lobes were so pointy. I was like, this kind of looks like it was cosmetically.
Dr. G (05:12):
You think she had her ears done to make them elf like body modification?
Bri (05:18):
Yeah, ears and the little pointy collarbone that I want to have. They looked very pointy. Right? Or my tripping.
Dr. G (05:28):
Yeah. Again, I didn’t love her outfit. It was fine. But yeah, it looks pointy. I mean, I think one of the tricks to looking great on the red carpet is to have your hair pulled up like that. It definitely is kind of like a mini facelift. Yeah. Got to hide that face tape. So yeah, her ears do look a little pointy. I don’t know, but they’re not surgically altered. Also, she doesn’t have any earrings in because she doesn’t want to distract from the necklace, which is fair, but it’s a risky run when you pull your hair up is that everyone will then look at your ears.
Bri (06:05):
I know. Maybe I saw this video where she was turning and I was like, Ugh.
Dr. G (06:10):
Not the angles for the ears.
Bri (06:11):
Not the angles. Okay. We can move on from the Met Gala. I’ve said my peace.
Dr. G (06:18):
Yeah, so moving on to less favorable. Yeah, so we’re going to talk about Katy Perry just because I really thought, well, we talked about her in her terrible, terrible space trip, but then her current tour, her opening night in Mexico City, I thought it was like an SNL skit or a throwback to sometime in her early days question mark where she was dancing, and then I was like, oh no, this is current. I mean, I feel like you could throw me up on stage and I’d do better. And we know Bri has tried many times to teach me how to twerk and
Bri (06:59):
I have videos. Lots of videos.
Dr. G (07:02):
Not good at it, but I feel like if I knew I had to do a world tour and I’m sure I could spend some hours in the studio and figure it out. Right?
Bri (07:11):
Right, exactly. Don’t go on a world tour if you don’t know how to twerk, I don’t know. I know Taylor Swift puts on a phenomenal show, but she also, she may not be able to dance very well, but she puts on a great show. Katy Perry, I feel like the next thing she’s going to come out with is like space tour, sex tape. It has to be a bad threes because she can’t go to space. I don’t know if she’s trying to stay relevant, but.
Dr. G (07:41):
She’s having a midlife crisis at 40. I don’t know.
Bri (07:46):
She took Lorazepam and then tried to dance.
Dr. G (07:51):
Yeah, because she also was going through the moves, but no energy in the moves. There’s all these memes now because one of the moves is her cradling a baby and it’s just what is even what happening. She’s standing there in those boots. I don’t know.
Bri (08:10):
My 10-year-old can whip out dance moves better than that.
Dr. G (08:15):
It’s crazy. Yes. There’s the cradling the baby and then there’s the I can do that.
Bri (08:19):
Oh no.
Dr. G (08:19):
But she’s not twerking. She’s just
Bri (08:22):
Katy Perry.
Dr. G (08:22):
Doing a football run with her butt facing us.
Bri (08:26):
I revoke it. Send her back to space.
Dr. G (08:29):
Yeah,
Bri (08:30):
She was meant to be. Well, you know what? I wonder if that was connected.
Dr. G (08:34):
Oh yes. This was my best part actually, because she does the dead drop. Not the dead drop. Jesus.
Bri (08:43):
At least her labia stayed in.
Dr. G (08:47):
I can thank a plastic surgeon for that probably, but no, she does the death drop. So that’s a move. Right, and instead of just committing to it, I mean you have not watched Dance Moms. I’ve watched Dance Moms. It’s a known thing. It’s actually originates from drag queens. But anyway, she does that last move as a death drop, but first she has those two people come help her. They hold her arms so that she doesn’t do the death drop. And then ironically, some little kid at my youngest daughter’s school enacted a death drop at their most recent school production. So it was like some sort of play and she’s like, yeah, Astrid did the death drop at the end. Wow. So if a 13-year-old can pull it off and how much are these tickets going for? If you’re going to pull off that choreography, I want to see that you’ve done a season on Dances with the Stars or something where you’ve learned some technique or don’t dance. I don’t care. There was another scene of her running around, literally running a lap around the stage, but she’s bounding and she’s going kind of slow. It’s just so weird. I know that doesn’t have anything to do with plastic surgery, but the whole thing is so bizarre and her hair looks weird. The whole thing is weird.
Bri (10:11):
I wonder if her going into space was a setup for her Galactic space tour and if she was trying to,
Dr. G (10:18):
I’m sure it was. She was trying to tie it all in and she has a handheld mic and a headset mic. There’s so many weird things.
Bri (10:26):
It’s just all bad in so many ways.
Dr. G (10:31):
She just should have stayed. Yeah,
Bri (10:34):
I love how they said it’s giving school talent show don’t throw school talent shows under the bus like that saying, because Astrid is coming for you. I’m a Barbie girl. Yeah, I slayed, slay, slay. I sang it to you the other day in the OR.
Dr. G (10:51):
That’s right. You did. Yes. Our singing.
Bri (10:56):
I also whipped out a whole,
Dr. G (10:59):
Oh, you whipped out some ms, slim shady. You knew all the words
Bri (11:04):
I did. Shocking. We were putting the patient in their garment.
Dr. G (11:08):
Mom spaghetti. Okay,
Bri (11:10):
Kees weak, arms are heavy.
Dr. G (11:13):
We’re going to move on to Ryan Reynolds fake tan, which is so good.
Bri (11:20):
Okay, I have
Dr. G (11:22):
Finally we can talk about, wait, I have to say finally we can talk about Ryan Reynolds and we’re not going to discuss the lawsuit. This is just completely unrelated.
Bri (11:32):
Don’t say the name, there’s no, okay, that’s either a terrible, terrible spray tan or he’s doing that like intranasal type stuff.
Dr. G (11:44):
The stuff that
Bri (11:44):
Turns you orange.
Dr. G (11:45):
One patient of ours had that made him orange, right? Wasn’t he taking something?
Bri (11:49):
So orange? Yeah, he was putting it up his nose and every single time and it wasn’t like a beautiful tan. I mean this shit was orange crap was oranges
Dr. G (12:01):
Day glow orange. You’ve eaten too many carrots, but there is something you can take that supposedly gives you this tan, but the tan always comes out looking orange.
Bri (12:11):
You got a spray tan after being completely jaundiced. The color combo doesn’t sit well.
Dr. G (12:20):
I don’t know. Yeah, just wash it off, bro. I don’t know why we’re looking at this orange oompa loompa situation with Ryan Reynolds.
Bri (12:32):
He looks kind of like Harry Potter.
Dr. G (12:35):
Oh, because of the glasses.
Bri (12:37):
Yes.
Dr. G (12:38):
It’s so weird. He also looks sloppy even though I don’t know.
Bri (12:46):
All this is giving, what is it? What’s the other Ben? Not Ben Affleck. Ben Stiller. Is that the guy? Happy Gilmore. Who is that?
Dr. G (12:59):
Adam Sandler.
Bri (13:00):
Adam Sandler. Wow. I’m not great with names.
Dr. G (13:05):
Yeah. Sloppy.
Bri (13:08):
Not Adam Sandler sloppy, but that’s who I was thinking of.
Dr. G (13:12):
Alright.
Bri (13:12):
When you know this guy is just worth a gazillion dollars and he is coming out here in basketball shorts and some holy T-shirt.
Dr. G (13:20):
Right. Except I’m sure every piece of clothing he’s currently wearing is expensive. It’s just styled weird or not styled.
Bri (13:27):
He should have just worn the white see-through shirt just with nothing underneath.
Dr. G (13:32):
Whole thing’s weird,
Bri (13:33):
Honestly.
Dr. G (13:34):
Well then you would see more of his fake tan, so not really. I know. Not really wanting to go there.
Bri (13:39):
His jaundice orange, fake tan.
Dr. G (13:42):
And then I did point out that his entire body looks like your hands after you do your own self tanner.
Bri (13:51):
Wait, I’m really tempted to take my shoe off right now and show you guys because I did self tanner and then I went on vacation and even my daughter came to my bed last night and she’s like, what is wrong with your feet? And I was like, it’s just self tanner coming off. I’ll put a picture in the chat.
Dr. G (14:07):
Oh no. Yeah.
Bri (14:09):
Unless you want me to get my leg up here.
Dr. G (14:12):
Yeah. One of the side effects of self tanner is your feet and hands are really hard. Even when you go for a spray, tan feet and hands are really hard to get right. It’s the usual, the giveaway that you’ve engaged in some self tanning shenanigans.
Bri (14:27):
I’m convinced because we use so much steril and I mean our hands are so dry all the time. We’re constantly putting alcohol, surgical, scrub on our hands every day that I think even if I lather in lotion in Aquaphor, it sticks. So she was at an event and she sent me a picture of this little, let’s see if I can pull it up on my phone. Please hold. And she’s like, this looks like your spray tan. And I was like, wow.
Dr. G (14:55):
Yeah. So I was at an event and one of the things they were serving were chicken drumsticks.
Bri (15:01):
That’s what she said on my self tan looked like if
Dr. G (15:04):
With the foot still attached to the drumstick, which I took a hard pass on trying that.
Bri (15:15):
Yeah. I was like, first off, who was serving that like that?
Dr. G (15:17):
They ran out of the chicken nuggets with caviar. And so when I rolled back they were like, yeah, no, we’re doing these. And I’m like, is that the foot? And second, I need to text a picture to Bri to let her know this is what her hand looks like when she’s done self tanning.
Bri (15:34):
It’s really bad. Then I was like, sometimes she’ll go in and be ignored when we’re seeing patients and she’ll be like, yeah, just don’t look at Bri’s hands. I’m like, where’s HR?
Dr. G (15:47):
Whatever. At the same time you’re probably scrutinizing their ears. So it’s all win.
Bri (15:52):
Facts.
Dr. G (15:53):
All right, let’s move on to Christina Aguilera’s face. Again, I feel like we’re always talking about her face, girl’s trying to be relevant. I would say who was looking at her face? Why is she wearing a weird bikini over black leggings?
Bri (16:09):
I know. That was the first thing I saw.
Dr. G (16:11):
No one’s looking at your face.
Bri (16:12):
She’s giving a Madonna vibe, like Madonna facelift midlife crisis.
Dr. G (16:19):
I just think the only thing that looks different between her now and maybe six months ago when we talked to her, she’s not returning my calls.
Bri (16:30):
Hey Christina.
Dr. G (16:33):
When we talked about her six months ago where around the same time Lindsay Lohan had debuted her also, what did they call it? The undetectable era face that now she just looks like, first of all, a lot of it is makeup and then the second part is that maybe she had a lip lift and that’s changing her appearance. So if we scroll down and take a look at some of her other images, I think that’s catching on. It’s becoming, yeah, it’s becoming more and more popular to do an upper lip lift at the same time as a facelift. And I think, and again, scroll down a little bit more.
Bri (17:10):
She looks snatched though. She looks like all that was pulled back. Her jawline.
Dr. G (17:19):
Of course they’re Photoshopping the bejesus out of this. So what’s going on with her arm on the one side? It’s too skinny. It’s not even, I think they just photoshopped it. It’s weird.
Bri (17:34):
She’s like a whole different face shape.
Dr. G (17:38):
But I’m telling you, it’s the lip lift is adding to the upper lip looking funny.
Bri (17:45):
And she lost a ton of weight. So I mean right. There’s no way you don’t lose all the weight and do nothing.
Dr. G (17:53):
Everyone should take a cue from Demi Moore and not mess with the upper lip lift if they don’t need it or hide for six months because it’s going to look weird until it settles down. I think it’s a great operation when you’re doing a facelift and someone older. But in these 40-year-old people, I think an upper lip lift will look unnatural for a little bit.
(18:24):
And then one of my friends often is comments that in addition to an upper lip lift in which the incision goes at the base of your nose and the excise skin between your upper lip and the nose, a lot of patients will need a corner lip lift to balance it out. So that’s a little incision at the top of your upper lip at the corners to evert that because if you don’t, then you just get kind of a central pull, which is the Demi Moore effect right now. So I just think you really have to talk to your surgeon about it. It’s just not like, oh, everyone gets one, but she looks good still. Just whatever skinny and she going to get, she doesn’t care. She’s giving the I don’t give a fuck.
Bri (19:13):
I know. I’m so surprised how skinny she is.
Dr. G (19:18):
She’s taken that probably ozempic like the rest of us.
Bri (19:24):
Slay.
Dr. G (19:25):
Slay. Okay, moving on. I think we also, were going to talk about face taping a little bit trending on TikTok.
Bri (19:35):
I can’t ever imagine though going out doing that. Are people not? Can’t you see it? Yeah, that would only work. I think if you maybe wore a wig.
Dr. G (19:46):
Or you were on a photo shoot where they were making sure that no one can see your tape. I know it’s a common thing for red carpet looks or maybe a photo shoot, but you actually have tapes stuck to your head and wrapped around the back. Come on.
Bri (20:04):
Imagine going on a date and then you go home with the guy and you like, hold on, do let me take my face down. And you just start removing. That would be so that has to be just like a model thing, right? I saw one episode on the Housewives, I don’t remember what it was, and she was like, oh, my face tape fell off and she had to re-tape it back at a coffee shop and I was like, girl.
Dr. G (20:29):
Yeah, it’s not really, really effective from a practical standpoint, but maybe we should try some. It would be fun.
Bri (20:39):
Should try some. We’ll do a photo shoot.
Dr. G (20:42):
Okay, we’ll buy some face tape and see.
Bri (20:45):
Good.
Dr. G (20:45):
What it looks like. Let’s do it. It’s nurses week, so maybe an honor of nurses week. We’ll get face tape for everybody.
Bri (20:54):
Happy face tape. So I know you guys are all really tired and exhausted and wrinkly, so we got face tape for everyone.
Dr. G (21:02):
You’re welcome. Okay, Aveli, let’s move on to the meat of this. So Aveli has been around for probably three or four years now, I think. I was at a conference and I was like, Hey team, what do we think? Do we want to get this on board at our practice? And I got a resounding yes.
Bri (21:27):
Yes.
Dr. G (21:27):
So it’s not the first cellulite treatment that’s been available, but it definitely is the most effective one that’s been available to date. So there has been an evolution of things to get rid of cellulite. Before there was something called cellulase, some devices that were kind of attached to a big laser machine looking like thing. It was like a hundred grand, it suctioned the cellulite dimple up and then a blade went in there and kind of cut the fibro septae. It just wasn’t very precise, so it wasn’t as effective as Aveli was. And then in between the development of Aveli and these cellulase treatments, we had Qwo, which was an injectable, so you could inject it in the area of the dimple and it targeted and dissolved the septe. So sounds awesome in theory and it had problems. So it was pulled off the market. One of the issues is in dissolving things, there was a lot of bruising. It’s not controlled, you’re just sort of injecting and hoping it does its thing. And so with the bruising, some people got hyperpigmentation from the bruising, which was not ideal. So now instead of cellulite, you have this weird brownish shadow where your cellulite was and then it just wasn’t as effective. I never used it or offered it, but it definitely was popular in the derm community and some plastic surgeons offered it. And so a rate
Bri (23:09):
Is that still the same where you could only use it on your butt and thighs?
Dr. G (23:12):
Yes. So that’s what it was approved for. It came to market and then it didn’t last very long. Aveli has been around now probably three years. It was owned, I can’t remember by whom, but it’s been bought out by Tiger Aesthetics, the people who own the Sientra implants and also who are coming to market with AlloClae, which is a injectable fat off the shelf. So all of these things are relevant, well not the sientra implants, but the Aveli and AlloClae are relevant because a lot of times when you’re treating cellulite, you’re attacking multiple issues. So you could have a little bit of localized adiposity, like little fat bulges. You can have actual cellulite dimples. And then the big problem, which is skin laxity. So laxity is really hard to treat. Now we have something for the cellulite and for little localized fat deposits, oftentimes we can do targeted liposuction. So you’ve seen me do Abilene. I would say this a treatment that we’re showing right now on the screen is pretty consistent, right? With what the results we get.
(24:27):
It’s not a magic eraser, so you’re not going to look like Sabrina Carpenter’s legs on the Met gala carpet with no pants if that’s not what you’re starting with. And she probably has some sort of manual lymphatic massage and a bunch of stuff done right before and whatever. It’s not Photoshop, but it definitely takes out the dimples or a lot of them. So you can see definitely in this patient, she has a kind of dimple right in the middle of her lateral thigh. And I bet that really bothers her. And it’s one thing women will say, oh, well I’m not embracing the pants list look. But if you are wearing leggings in any color, but black, a lot of times you can see that cellulite through the leggings and it bothers women in that respect. So addressing it from just wearing clothing that might be form fitting and then you’re like, great, now you can see my cellulite through my pants. That’s not ideal either. What’s your 2 cents about Aveli having watched it done?
Bri (25:37):
I think Aveli is great. It’s like a easy in-office procedure. I’m not going to say easy, it’s not painful, but I mean they’re in and out in two hours. Everyone is pretty happy with their results. I obviously know that you want my medical rundown of how Aveli works because
Dr. G (25:56):
Oh yeah, do it.
Bri (25:59):
So we have another stick, Renuvion and Aveli, the two sticks. So basically you come in for your appointment, she marks you all up, puts a bunch of drawings around the ones that you want done, takes you back, you put in a tumescent. Kind of the same thing as the way Renuvion is done. That’s all the numbing, the numbing stuff made with lots of love. And then there’s this little wand and it has a little blade on the end and she shoves it up there, obviously much nicer than that.
(26:31):
And she opens the little wand when she gets to the dimple, there’s a little light on the end where you can see it’s actually really cool. You can see exactly what septae that you’re about to be cutting. She goes in, she cuts it, they do some double checking. She goes through it three or four times to make sure that band is all cut and you can see it right then and there. It’s a pretty cool little thing and everyone’s super happy. Some people bruise, some people don’t bruise. But yeah, I feel like it’s pretty fail proof because you can know exactly what you’re doing.
Dr. G (27:07):
You just have to be precise. And when I go in and target a cellulite dimple, I’m hooking cutting the septae. A lot of times there’s 10 little septae at each dimple. So I have to go hook cut, hook cut, hook cut, and then I need to keep repeating that until when I pass the hook it doesn’t catch on anything. And that can be a little tedious for both myself and the patient. So it’s great for the first few and then after your lying on your stomach awake for a while, you’re like, ugh, okay, I’m done looking at Instagram. When is this over? It can, depending on the number of targets, that can take a while. I think one of the reasons something like Qwo is so popular was because it was an injectable. And when you’re training to use this device, for me we do Renuvion, we do liposuction.
(27:58):
I inject tumescent solution all the time. And if you’re a derm and that’s not something that you do, you’re like, wait, what do I have to do? I have to put local in and make an incision and inject tumescent solution and then I get to go to target the cellulite. So I think it’s a little more daunting if you’re not surgically inclined or you don’t do a lot of surgery, that might be a little out of your wheelhouse, but it’s very effective. The downtime’s like a week, you should take it easy. We tell people to wear Spanx afterwards. The reason is so that you don’t incur more bruising, you’ll leak that tumescent fluid for a day or two because we’re not suctioning it out like we normally do with liposuction. Here’s the device here, and then this is our demo. So I am woefully unable to get the light off once I turn it on, but
Bri (28:57):
You have to do the clicking.
Dr. G (29:00):
So when you’re having the procedure, you’re like, what is this ratchet noise? But it’s me pushing look, it’s a little light saber, pushing the device in and then that’s the hook part. So then I hook and then if I catch on something, then I depress and a little blade comes out, imagine the blade and then cut and then I have to slide it back so that the profile is thin like that to pull back and then go back out again. So there’s a lot of hook, it becomes a rhythm, right? Sort of like twerking. Just kidding.
Bri (29:41):
I got the twerking part, she’s got the Aveli part.
Dr. G (29:43):
Yeah, I can’t work, but somehow I can manage to do this. So alright, so you push this in hook cut, slide it back to slide back out. And so like I said, there’s a lot of clicking as I’m doing the procedure and then the little light at the end of the device, which is glowing right now, helps me know where I am because I don’t want to be too deep, kind of want to be a little bit superficial and I want to be at the targets that I marked when you’re standing. The good news, the PSA for everybody is that I have to mark people when they’re standing and then when they lay down, your cellulite almost always disappears.
(30:23):
So if you’re at the beach and you’re laying on your belly, just know no one can see your cellulite. It looks for the most part, it really disappears when you’re laying flat, whether you have it treated or not. Speaking of areas I usually treat buttock and posterior thighs. We don’t like to treat the banana roll area because it’s that little area right under your butt, that little gluteal crease area, the skin, the fascia, everything that’s tacked the muscle there is kind of supporting your butt. And so if you either aggressively liposuction that or release too many cellulite dimples, the support for your butt goes and your butt will drop. Nobody wants that.
(31:06):
It’s not approved for anywhere else on the body. You don’t really get cellulite anywhere else on the body. A lot of times patients will ask if I can do their anterior thighs and what they’re talking about is laxity. And so no me releasing those septae between your skin and your anterior thigh muscle and subcutaneous tissue is just going to lead to more laxity. But I did make an exception about a week ago for a lady who had a couple of legitimate dimples on her inner thigh that you could see from the front. And I said, well, I’ll have to make a weird little incision to get to that. It’s not going to be in the gluteal crease, but we can give it a shot. I mean, the worst thing that happens is it doesn’t do anything. And she had one on each side and I saw her back while you were in Alaska and they’re gone. That’s amazing.
Bri (31:59):
That’s awesome. That was the first thing I said. I was like, are you going to do those? Why is her front marked?
Dr. G (32:05):
I was like, we’re going to give it a shot and see, because it was definitely a cellulite or some weird little dimple. It wasn’t laxity. So we targeted those two areas and she did great. And our first patient was a weight loss patient, so she had some cellulite, but quite a bit of laxity. And for that patient we injected dilute Radiesse, which is a bio stimulator. So if you have a budget for it, I would say combination therapy is usually your best bet because even in that photo from that article, the patient’s only problem is not cellulite. There was some localized adiposity, there’s probably some laxity. And so if you want to address all of those things, multimodality therapy is usually the best and the thighs are hard. We talked about thigh lift last sesh.
Bri (32:57):
Don’t get me started on a thigh lift.
Dr. G (33:00):
Thighs are rough, man, because you’re fighting gravity. People leave them exposed to sun, whether you’re at the beach or in shorts and yeah, you’re constantly fighting, take the pounding if you’re working out, if you’re a runner, all of that reduces the collagen elastin in your legs. No one’s applying retinol to their thighs. The skin is thicker there. There’s lots of reasons why the thighs age and then trying to reverse that aging is tough.
Bri (33:29):
It’s the hardest part of the body.
Dr. G (33:30):
Really is.
Bri (33:31):
You I assume wouldn’t obviously do lipo in the posterior thighs or the butt. So would you combine it with Renuvion or is there
Dr. G (33:43):
No, we’ve combined it with liposuction before because the cellulite dimples are more superficial and we’ve definitely combined it with Renuvion for skin tightening.
Bri (33:53):
So when you’re doing lipo, it’s deeper than where you’re going to cut the septae?
Dr. G (33:58):
Yes. Yeah. It’s not common that we do the two together, but it can be done together. And then Renuvion for sure, because tightening the subcutaneous tissue, so that generally makes everything better. We like to tighten the skin. I think the one thing Renuvion doesn’t make better is crepey skin. Right? Because if you think about it, it is like if you had tightened the sheet under a blanket and then you pulled that tight and you didn’t do anything with the blanket, the sheet looks great, but the blanket just gets wrinkly on top. And so I think when we tighten the skin underneath the subcutaneous tissue, especially in arms and sometimes in legs, we’re not addressing the dermis epidermis, that top layer. And so that can look crepey or more crepey and Radiesse is a great treatment for that. Radiofrequency microneedling is an option, but they’re all real slow goes, cuz you’re counting on your collagen to rebuild.
Bri (35:00):
And then when you do Aveli, are the results permanent? Does it last forever? Do people get cellulite again?
Dr. G (35:08):
You shouldn’t get cellulite again. If you do develop dimples, it’s usually in another area, so it’s permanent in terms of I release those dimples, they’re not growing back. So you might have new changes with laxity, but not recurrence of cellulite. So it’s a one and done, which is nice.
Bri (35:27):
We love better than the cellulite creams.
Dr. G (35:32):
So a lot of cellulite creams will have caffeine or stuff in it that’s temporarily tightening the skin. So it decreases the appearance of cellulite, but it’s temporary. There are some body lotions that have a retinol in them, which is helping to turn over your skin and build collagen and elastin, but those are, it’s really hard to see a dramatic improvement with that. Should you use it and help strengthen your skin? Sure. But if you’re waiting for some magical change, it usually doesn’t happen. I’ve tried.
Bri (36:05):
I’ve tried too, and I feel like I gave up after seven days. I was like this sucks,
Dr. G (36:11):
I had a whole tube of one of those and I used it pretty religiously and I was like, hmm.
Bri (36:18):
Just can’t really see anything. I bought so many different products and I feel like nothing ever.
Dr. G (36:24):
I agree. I do think though, it’s sort of like sunscreen. You need to put it on. You’re not going to see a reverse of your wrinkles, but you’re preventing things. So using a cream with retinol, if you have the time and energy and money to do that, I would advocate doing that. You’re just am terrible about committing to lotion.
Bri (36:42):
Especially on the legs.
Dr. G (36:45):
I know like busy man.
Bri (36:48):
Gotta get dressed
Dr. G (36:50):
Got time, I don’t got time for that. But if you’re going to do it or put a little tiny bit of your own Retin A or retinol into your lotion and mix it yourself, but that will all help. And then also using sunscreen, so sun damage. If you’re just going to go out there and go, oh, the uv’s 8 today and lay out in the sun with your legs, then it’s almost pointless for the laxity, not for the cellulite.
Bri (37:18):
I know we talked about you can do it local, you can obviously do it under general. Probably choose to do that with another procedure though, right?
Dr. G (37:26):
Yeah. So Aveli is done under local anesthetic. You can take an oral sedative, just need a ride home, you can use our pronox. So laughing gas, very well tolerated. Very few patients are like, oh, this was way worse than I thought. But if you’re doing another surgical procedure, then yes, you’re going to want to be under anesthesia. Then it just drags everything out. So it’s a great add-on if you’re already doing something.
Bri (37:53):
Yeah, I feel like when we first started, I think we have it down to a science now. She is very, I think taking the oral sedative, I highly suggest I even put it in the email I send you just suggest taking it to be comfortable. And then when she first started, she numbed both sides at one time and that did not work out as well. And now she does one side and then goes to another. And I feel like now, between everything, people are super comfortable. I don’t even think people even use the pronox when it’s out.
Dr. G (38:22):
Yeah, it just there to make them feel better that it’s there if they need it. I agree. Yeah, there were a couple little tricks. And then just the more we know, the more we can prep our patients for what to expect. And so I think that helps a lot too. But as soon as the bruising goes away within a couple of weeks, you’re good to go. Sometimes people will feel a little bit lumpy, but you won’t see it. So that can take a month to six weeks. And so I usually see my patients back at a week to two weeks and then again in a month, and then again at three months if we need to.
Bri (38:57):
Yeah,
Dr. G (38:57):
One and done.
Bri (38:59):
Is it the only current surgical cellulite treatment available?
Dr. G (39:04):
Yeah, I think Cellulase and Cellfina were the other cellulite adjacent things. Which
Bri (39:10):
Were they Lasers?
Dr. G (39:11):
No, there’s no laser. They’re just different versions of, they’re like a Walmart Aveli. I mean, they’re prototypes. They’re just not as precise. I mean, it still might be around just because people probably have those machines. You can see with that little wand, it’s a one time consumable. And then the treatment can range,
Bri (39:35):
So don’t drop it.
Dr. G (39:36):
Yeah, for reals. I know that little wand is over a thousand dollars a pop, but at least I’m not buying a hundred thousand dollars machine. We’re not reusing these. This is the demo. And it can be anywhere if you just have a couple of dimples, $3,000 to $6,000 depending on how many, it’s really, we kind of judge it based on how many areas we’re treating, how many dimples I’m attacking, and then if you want to add a Radiesse is a great add-on for that. So that’s a bio stimulator. It’s a filler that functions as a bio stimulator and we can put that in to kind of help improve laxity, smooth out some areas of irregularities and add a little bit of volume. It’s not a huge volumizer. If you want to fill out hip dips or something like that, then
Bri (40:27):
You’re going to fill out my dimple with that, right?
Dr. G (40:29):
Yes, we are.
Bri (40:30):
Yeah,
Dr. G (40:30):
I know.
Bri (40:31):
So we’ll document my dimple journey so I can go to our Instagram and watch my butt.
Dr. G (40:36):
Yeah, she wanted Aveli and so took her pants off at work and I said, no, that’s not a cellulite. You just have a little dent from surgery or something. I don’t know, just a dent. So we’re going to fill that out.
Bri (40:48):
I didn’t even notice the dent until she said something and now I can’t not see it.
Dr. G (40:54):
Just like piercing your one ear. We need to get on that.
Bri (40:57):
Oh yeah. She sewed up my ear hole and then we keep forgetting to pierce it. So I’ve been wearing clip on earrings. It’s crazy.
Dr. G (41:05):
I know those things take two minutes, but we’re always busy in the office, so Yeah. So patients are super excited about the results. They’re happy to have this. They’re more confident in either the white leggings or in their bikinis. And we’re in Southern California. That’s important.
Bri (41:24):
Right. Was it two girls in the office when we got it? They’re like, okay, two people can try it. Obviously I put my hand up and got denied. But the other girl that did it, it looked so good.
Dr. G (41:34):
Yes. Yeah, it definitely did.
Bri (41:36):
So good. I was like, dang.
Dr. G (41:38):
Yeah, and she came back to work the next day. There’s really no downtime. It’s just you want to take it easy with your workouts,
Bri (41:44):
Just take a couple days off or a day or so.
Dr. G (41:47):
Yep. Take it easy.
Bri (41:48):
Don’t expect to do it like lunchtime and go back to work after.
Dr. G (41:52):
Yeah, only if you work here.
Bri (41:55):
Yeah, exactly. I will gladly do lunchtime procedures.
Dr. G (42:00):
Alright. I mean, I think that’s it. That kind of sums up Aveli. It’s a great treatment to get now before the summer hits, especially in San Diego because we’re in May gray, June gloom, so our summer doesn’t really hit until July, August. So you have plenty of time to recover, not have any weird bruising. And look bikini ready for the summer.
Bri (42:22):
Yes. Bikini ready ladies. And is this only for ladies actually?
Dr. G (42:29):
I mean, we’ve had a couple men come in. Men really don’t get cellulite that often and I haven’t treated any, but it’s doable. It’s just nobody is bit yet not. And I prefer not to look at the male butt anyway, so it’s fine.
Bri (42:48):
I would also not like to massage the fluid out of a male butt.
Dr. G (42:51):
We’re a lady practice through and through to some degree.
Bri (42:56):
Yeah. Except for Dr. Chao.
Dr. G (43:00):
Yes. She does love that male rhinoplasty. She does. Alright.
Bri (43:05):
And facelift.
Dr. G (43:06):
Yes. And facelift. So yeah, I think that’s it. If you want to know more about Aveli, check out the information on our website. You can reach out to the office and chit chat with us. And Ava will be happy to give you more information, our coordinator or schedule a consult with me and then schedule your procedure. And you can hang out with me and Bri for a couple hours and talk about the Daily Mail.
Bri (43:26):
And if you want to see my Radiesse journey or you just want to see my butt go on our Instagram and you can watch her fill in my dimple.
Dr. G (43:34):
Yeah. Coming soon.
Bri (43:36):
Coming soon. Okay. We are scrubbed in.
Dr. G (43:41):
And scrubbing out. Catch you later.
Bri (43:44):
Slay.
Dr. G (43:49):
If you’re listening today and have questions, need info about scheduling, financing, reviews, or photos, check out the show notes for links. Restore SD Plastic Surgery is located in La Jolla, California. To learn more about us go to restoresdplasticsurgery.com or follow us on Instagram @restoreSDplasticsurgery. If you enjoyed this episode, please share it and subscribe to All the B’s on YouTube, apple Podcasts, Spotify, or wherever you like to listen to podcasts.
About Restore SD & Dr. Katerina Gallus
As the Director of Restore SD Plastic Surgery, board certified female San Diego plastic surgeon Dr. Katerina Gallus has over 20 years of experience helping patients enjoy head to toe rejuvenation with face, breast and body procedures. After a successful career as a Navy plastic surgeon, Dr. Gallus founded her San Diego plastic surgery center, Restore SD Plastic Surgery, with the intention of creating a welcoming space for anyone seeking cosmetic enhancement.
Restore SD Plastic Surgery offers popular facial rejuvenation procedures like facelift & neck lift, facial fat transfer, nanofat grafting and rhinoplasty; breast augmentation with implants, breast lifts or breast reduction; body contouring procedures such as tummy tuck, liposuction, mommy makeover, and Brazilian butt lift (BBL), as well as non-surgical aesthetician services, BOTOX, dermal fillers, laser treatments, and weight loss injections.
Dr. Gallus and her highly-experienced aesthetics team are here to help you look and feel your best! To schedule a personal consultation, please contact us online or call our office at (858) 224-2281 today. We proudly serve the San Diego and La Jolla areas.
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