Accent XL has two treatment heads, producing radiofrequency waves which are absorbed at different depths in the skin; the bipolar head delivers energy to the second layer of the skin, the dermis, at a depth of about 2mm- which is used to induce skin tightening; and the unipolar head, which diffuses thermal energy through the subcutaneous fat layer, resulting in a shrinking and smoothing effect. (Unlike HIFU, eg Liposonix, Radiofrequency does not permanently destroy fat cells)

CELLULITE is a term used to describe lumpy, bumpy fat usually seen in the thighs, buttocks and occasionally abdomen and upper arms; it almost always affects women, and may occur regardless of whether the person is of a normal weight, or overweight. Oftentimes it may be accompanied by large dimples, or depressions in the skin. It may also present as peau d ‘orange, with smaller dimples that resemble the pores on the surface of an orange, indicative of lymphedema, or trapping of lymphatic fluid.

It is a disorder of the collagenous supportive matrix*, where disordered collagen fibres allow fingers of fat cells to poke out causing palpable lumps, while tethering of the skin by other collagen fibres causes hollows , or dimples .

*Think of the fat cells as eggs in an egg box; the egg box would be the collagen fibres

Large dimples can be improved by cutting the fibres of collagen which tether the skin with a scalpel or needle tip, a process called subcision, which is done under local anaesthesia; or by injecting the area with an enzyme called collagenase, which dissolves the tethering fibres (chemical subcision – a form of mesotherapy).

Accent XL Laser - Shrinks, Firms and Smooths Fatty Tissue
Lazer Room Patient : Accent XL & Mesotherapy

Lazer Room Patient : Accent XL & Mesotherapy

The Accent XL laser emits radiofrequency waves which are converted into thermal energy in the subcutaneous fatty tissue, resulting in

  • Shrinkage of fat cells – volume loss of the fatty layer
  • Remodelling of the storage matrix for the fat cells – collagen. This is an especially important aspect of the treatment of cellulite- the abnormally lumpy/bumpy fatty tissue that often is seen in the buttock/thigh areas of women. One of the key histological features of cellulite on microscopic examination is disrupted collagen fibres – some fibres may remain intact, pulling on the upper layers of the skin, causing dimpling, while broken collagen fibres allow out pouching of fingers of fatty cells, appearing as lumps, or rolls, under the skin.
  • Improved microcirculation to the fat cells – this allows the drainage of toxins and excess fluids through the lymphatic channels, thus further relieving congestion and orange-peel texture in the cellulitic areas.
Virtually Painfree Treatments, Ongoing Improvements, Long-lasting Effects

This remodeling of fatty tissue occurs over time with a series of Accent treatments; with ongoing improvements occurring up to 6 months after a course of therapy, as subsequent renewal of healthy collagen fibers add to the smoothing and firming effect of the initial treatments. By drinking plenty of water to ensure adequate hydration, and thus continued flushing of toxins, in addition to establishing and maintaining healthy eating patterns and regular exercise , one can expect to maintain these improvements for a considerable period of time.

Depending on the degree of cellulite, or the volume of fatty tissue to be reduced, an initial series of 4-8 treatments performed at 2-weekly intervals may be recommended. The area treated at a given session would generally not exceed the size of a dinner plate for maximum effectiveness; for larger volumes of fat or stubborn deposits, the treatments may be combined with mesotherapy, for its synergistic effect (see section on Injectables – Mesotherapy).

What to Expect During Treatments?


Accent treatments are generally well tolerated- often described “like getting a hot stone massage”- skin temperature is monitored with an infrared sensor to ensure that it remains in a safe and therapeutic range. No analgesia is required, and there is no downtime following treatments- the skin may appear red immediately following a session, but this will quickly fade, and there are no restrictions on activity. All skin types can be treated, and the Accent laser is not photosensitizing- thus treatment can be undertaken before or immediately after, sun or UV exposure.

Contra-indications to treatment

  • Pregnancy
  • The presence of cancer or undiagnosed tumour
  • Uncontrolled hypertension
  • Electrical devices – pacemaker, implanted defibrillator, or other devices implanted in the body
  • Metal plates in the proximity of the area to be treated – eg extensive dental implants,(face), metal hip replacement (buttock) plate for repair of fractured bone (thighs)
  • Severe multiorgan disease – eg renal impairment, advanced circulatory problems
  • History of thrombo-embolic disease
  • Active auto-immune disease

Additional applications of Accent XL Laser

  • Shrinking  lipomas – benign fatty tumours found in  the thighs, arms and abdomen
  • Jaw contouring: i.e. reduction of  fatty deposits under chin and sides of face
  • Following surgical liposuction, to smooth  tethered or irregular ski
  • Skin tightening – of loose skin of face, neck, upper arms, abdomen
  • Body after Baby- treatment of  loose skin, stretch marks and  localized fat in abdomen


SKIN TIGHTENING : Accent XL Bipolar head

Accent XL Bipolar treatment head delivers energy to the lower dermis, about 2 millimeters below the surface of the skin, stimulating collagen formation, and resulting over a course of 4-6 treatments in SKIN TIGHTENING – above the layer of shrunken or removed fatty tissue.

  • Accent can be used to tighten overlying skin after fat reduction (post Liposonix , post liposuction, following weight loss)
    If we did not employ this dual approach to treatment, shrinkage or removal of fat could result in wrinkling and folds of the overlying skin – as sometimes happens after surgical removal of adipose tissue. The Accent laser can be employed to smooth tissue irregularities post liposuction
  • Body After Baby- Accent  Skin tightening, reduction of stretch marks
    Lazer Room Patient - Body after Baby - skin tightening and roller therapy

    Lazer Room Patient – Body after Baby – skin tightening and roller therapy

  • Tightening of loose skin of upper arms, neck


Note: some patients with excessive folds of skin may be more suited to surgical interventions eg brachioplasty (upper arms), abdomen (tummy tuck) or neck (lift): patients should be aware that laser treatments of these areas may result in  modest improvements only and are not a substitute for surgery.