Cellulite, those unwanted irregularities in the skin that provide an appearance similar to orange peel, is called in medicine hydrolipodystrophy gynoid.
The term cellulite best suits hydrolipodystrophy gynoid since it suggests no inflammation of the subcutaneous tissue as the suffix "its". However, as the term is prescriptive and is much easier to be said and written, it will be used in this text. So from now on every time it is referred to cellulite, it will be told about aesthetics, known by everyone.
Cellulite is characterized by irregularities in the skin, like ripples caused by disorders in the subcutaneous tissue anatomy.
Under our skin there is always a sign of adipose tissue (fat), which can be larger or smaller depending on the region and nutritional status of the individual. Below the fat is the muscle which is connected to the skin by elastic fibrous tissue which crosses the fat tissue.
When these connective fibers have low elasticity and while there is an accumulation of fat in this region, the skin becomes irregular. This occurs because the fibers exert traction skin towards the muscle while the fat pushes up. See the illustration to better understand this mechanism. Cellulite is therefore a kind of herniation of fat toward the skin.
Cellulite occurs more often in regions that accumulate fat easily, such as hips, thighs, buttocks and stomach. Cellulite occurs more in obese or overweight, but can also occur in thin people. The lower elasticity of the subcutaneous tissue is, the lower will be the amount of fat which must accumulate to cause the corrugations. The accumulation of liquids and the way that fat is distributed in the tissue also influence the appearance of these irregularities.
Cellulite is much more common in women than in men, it is estimated that up to 90% of women suffer from this problem to some degree. Possibly this discrepancy between the sexes is caused by estrogen and the characteristics of the connective subcutaneous tissue in men, hindering herniation of fat. In addition to these factors, there are others that also increase the risk of cellulitis:
Cellulite grade 1: no irregularities visible when the patient is lying or standing, but the changes can be seen when you pinch the area with your fingers or under contraction of the local muscles.
Cellulite grade 2: Visible cellulite, looking as orange peel visible without compression of the skin. On palpation it is possible to note the presence of small nodules imperceptible to vision.
Cellulite grade 3: Visible cellulite, looking as orange peel and visible nodules.
As we have not yet fully understand all the mechanisms that cause the appearance of cellulite, there are hundreds on the market of ineffective treatments based on theories with no scientific basis. Furthermore, cellulite is not a disease, it is a normal change of subcutaneous tissue of females, which by widely imposing of a sexist society, became a nuisance for women. The fact is that until now there is no technology available that can correct the structural changes in the fatty tissue and deep dermis of females. In short: there is no 100% effective treatment against cellulite.
The aesthetic medicine is one of the fastest financial growing areas, which attracts groups that offer treatments without scientific evidence or based on studies of dubious quality. Currently there are many treatments for cellulite and it is impractical to discuss them all in this text. Let the next lines do a quick review of most common ones in the market.
The vast majority of cellulite creams will not work against it, and even those who have some effect, do so unobtrusive. The creams that show some evidence of results are those containing retinoids or methylxanthines. Alone, however, they hardly provide benefits.
There are hundreds of so-called natural products claiming to possess anti-cellulite substances. Usually these products help to remove toxins, reduce fluid retention, improve fat metabolism, enhance circulation, etc. The fact is that there are no supplements or products taken orally that are proven to have any effect on cellulite.
Also there is no specific diet for cellulite, with selected foods that supposedly would act directly against the problem. The diet recommended for cellulite is a healthy diet recommended for everyone: avoid excess sodium, saturated fats and carbohydrates.
The lymphatic drainage massage has little effect on cellulite. In the 90s a device called Endermologie was developed in France, aimed to perform a sort of massage to the areas affected by cellulite. The product was approved by the FDA as an option for the temporary relief of cellulite. The apparatus basically massages the skin to redistribute the fat, leading to a temporary improvement in the appearance of the skin. If dosing is discontinued, cellulite appears again as before.
The use of laser for the treatment of cellulite has gained attention in recent years. There is still controversy about its effectiveness because current scientific studies suffer many questions regarding its methodology. There are also techniques involving the use of laser with radiofrequency waves and massages. The fact is that, like the massages, the improvement is temporary and the treatment needs to be done regularly, which makes it very expensive and time-consuming.
Mesotherapy is a treatment that involves injecting substances directly into the affected tissue in order to "undo" cellulite by eliminating and localizing fat. This technique is controversial because it involves different methods and substances, none of which has been properly studied in major clinical trials. There is even the risk of side effects depending on the substance being administered. The lack of effective studies and, especially, the safety of the procedure are the main problems of this treatment.
Liposuction simply does not work for cellulite, and may even worsen it, increasing the irregularities on the skin. But the release of fibrous beams with special cannulas, followed by liposuction (removal of the fat from many different sites on the human body) shows good results, especially when combined with other therapeutic modalities. Like the other methods, it does not provide a cure for cellulite, but attenuates it enough. This technique should be done with a competent plastic surgeon. Avoid techniques that promise miracles, and especially avoid professionals not recognized by the Society of Plastic Surgery.
Unfortunately there is still no effective treatment to solve the problem of cellulite. Currently the best results are achieved with the combination of creams, massage and laser therapy. However, as have been already explained, are partial and temporary improvement, leading to a large consumption of time and money.
