Understanding Cellulite: Overview, Causes and Treatments

Cellulite is certainly a common cosmetic concern shared by many of our clients. It can have a significant impact on body confidence and self-esteem, but which treatments work and which treatments are just mythical fads?

Well let’s start here:

What is cellulite exactly?

Cellulite appears as uneven textural dimples in certain areas of the body, particularly on the thighs, hips, buttocks, and abdomen. It’s generally referred to as the cottage cheese or orange peel effect. Cellulite most commonly appears in women, and this can be somewhat attributed to the vertical structural formation of fat cells, collagen and connective tissue which differs from men who have stronger crosslinked arrangements of these components.

How does cellulite form?

There are many myths and mistruths about how cellulite develops. If we are sticking to the facts then cellulite is most closely linked to hormones, genetics, age, and physical activity. It occurs when fibrous connective cords called septae, that tether the skin to the underlying muscle facia, tighten and become inflexible causing the skin to pull down and dimple in certain areas.

Cellulite is often misconstrued as a ‘fat’ problem, when in fact it is actually a ‘skin structure’ problem, which can occur in individuals of varying physical descriptions. In saying that, fat cells which are housed within the pockets between the septaecan still impact the appearance of cellulite. This is because as the fat cells expand and have nowhere to go, they begin to put pressure on the skins surface in an attempt to expand upwards. However, where we have these inflexible rigid septae the skin cannot expand upwards and will therefore dimple.

The ageing process can also contribute to the worsening appearance of cellulite. This is because as we age our skin loses its ability to produce healthy collagen and elastin fibres and is therefore weaker, thinner, and less able to resist the tension caused by the septae.

This brings us to the solution…

When we talk about treating cellulite, we are not talking about completely removing it, instead what we really mean is how can we improve its appearance. If we are going to correct the appearance of cellulite, we need to tackle two issues, one being the achievement of some fat reduction and two being the successful relaxation of the fibrous septae.

What about topical treatments?

There is always a ‘miracle’ cream on the market which makes bold accusations about erasing cellulite. The truth however, as we know, is that cellulite is a subdermal issue which cannot be correct with topical remedies. Many of these topical ointments contain caffeine and retinoids, which can work as a diuretic to drain the water content in the area and also thicken the epidermis, but at best they can provide a very minimal and temporary improvement to cellulite.

So, what works?

Like we said earlier cellulite is not exclusively a fat problem, it requires a combination of fat reduction but also skin tightening modalities, and therefore a multi technology approach is required. A combination of Fat Freezing, Radio Frequency, Ultrasound, and certain types of Lasers can be used to address cellulite from the inside out.

Fat Freezing

Fat Freezing or Cryolipolysis works to selectively cool down fat cells at extreme temperatures, this results in a number of fat cells within the area (normally 20-20%) crystalising and undergoing a process of cell death. Once these cells die, they are metabolised by the body and carried out by the lymphatic system as waste. The overall result of this treatment is a minimisation in the number of fat cells in an area. As we mentioned earlier cellulite is worsened by an exorbitant amount of swollen fat cells pushing upwards into the epidermis. Therefore, Cryolipolysis works to minimise the content of cells present between the septae and thus minimise the pressure placed on the surface of the skin. 

Radio Frequency

Many Radio Frequency devices on the market utilise a combination of massage, vacuum, rotational suction and light therapy, to liquify and destroy fat, loosen the fibrous septae, reduce fluid retention and
also stimulate collagen and elastin to enhance skin strength and firmness. Overall radio frequency devices provide a very effective solution for the minimisation of cellulite through the application of heat to minimise fat cells and rejuvenate the skins structure.

Ultrasound

Ultrasound technologies employ high frequencies of ultrasonic waves to thermally destroy fat cells but also create pinpoint damage within the dermal layer of the skin where collagen and elastin fibers reside. This damage encourages collagen and elastin to remodel and re-densify the skins texture. Again, this is an effective treatment to address excess fat content and skin laxity.

Laser and Microblade Treatments

There are also a number of treatments that work to specifically release the tightly strung septae, which is the primary structural cause of cellulite. Specialised laser treatments use a small probe, which is injected just beneath the skins surface. This probe emits a laser beam that works to release some of the fibrous septae tension, stimulate collagen and elastin and reduce the thickness of fat within the area. Cellfina treatments also work to cut the fibrous septae anchoring the skin into the dimpled position by using a microblade to sever the band. Once the band is cut the skin will bounce back into position and the dimple will have disappeared.

Overall, we see that cellulite is a complex skin concern which requires a multi-modality and treatment approach to achieve the visible results our clients desire.