Cellulite is the skin visibility of underlying globules of fatty tissue sandwiched between normal fibrous bands of tissue (septae). It occurs both in thin or fat individuals, and women more than men. Why some people have cellulite and others do not is both anatomical (simply the way your subcutaneous fatty layer is arranged over your muscles and under your skin) and multifactorial. Etiologies can include genetics, skin thickness, skin tone, diet, hormones, physical activity level, ethnicity, and age.
There are many potential treatments for cellulite out there, but unfortunately most are ineffective.
Cellulite creams. Many creams are advertised and on the market claiming to improve the appearance of cellulite. Most of these creams contain ingredients such as aminophylline, caffeine, theophylline, urea, and various herbal additives. First of all, topical skin creams are physically unable to traverse the skin barrier, and deliver any ingredient in an effective concentration to target underlying fat or connective tissue. There is no scientific evidence that these creams are effective against cellulite. However, keeping the skin hydrated, avoiding environmental damage, and using sunscreen regularly keeps skin quality as good as it can be.
Liposuction. This is a great surgical procedure to remove disproportionate and localized fatty deposits from the body. It does not smooth skin or affect the appearance of cellulite. Cellulite usually stays the same after the procedure, with risks of it even looking worse.
Mesotherapy. Mesotherapy is the injections of fatty dissolving enzymes under the skin. Multiple injections and multiple sessions are required followed by a week of pain and swelling. Scientific studies evaluating the safety and efficacy of Mesotherapy are few and far between. Mesotherapy supposedly breaks down fat and may slightly improve the appearance of cellulite. The scary thing about Mesotherapy is that you don’t always know what combination of drugs is in the “cocktail” being injected. Serious risks and side effects have been reported including life-threatening systemic illness, and also localized swelling, skin loss, open wounds, infection, and irregular contours.
Collagenase, Hyaluronidase: These are naturally occurring enzymes in the body that break down connective tissue (the tissues that bind our cells together). The long-term effects of these injections are unknown, and studies have not yet been carried out to determine the extent and duration of the improvements, if any. The treatment is considered experimental and is not yet routinely available, but research is underway to determine if collagenase or hyaluronidase injections may become an option for the treatment of cellulite.
Massage and spa treatments. Massage and other spa treatments like wraps may have a temporary effect on the appearance of cellulite, but only as a result of temporary swelling or removal of retained fluid. They do not remove cellulite.
Cellulaze is a newer FDA-approved cellulite treatment. Although it is advertized as “non-invasive”, it is invasive, labor intensive, and requires anesthesia. Small access incisions are made and a laser cannula is inserted under the skin. Three passes are made per area, one to liquefy fat, one to release septae, and another to heat the undersurface of the skin. Although Cellulaze promises a 70 to 80 percent improvement in cellulite, results are quite variable and are more along the lines of a 50% improvement at best. Because the treatments are so time consuming, the Cellulaze laser is so expensive, and the treatment needs to be performed by a Board Certified Physician, the treatment areas tend to be small and expensive. For example, an 8 by 8 inch area of cellulite on the outer thighs may take hours to treat, and can cost around $5000 or more. Expect downtime, swelling, bruising, and discomfort quite similar to a Liposuction surgery.
Stay tuned for part II of Treatments for Cellulite…
Dr. Hayley Brown MD, FACS
Board Certified Plastic Surgeon
Desert Hills Plastic Surgery Center serving Henderson and Las Vegas, Nevada