What causes cellulite?
Cellulite is most prevalent in individuals with excess body fat, particularly those over 25 years old. It can still, however, affect young and fit individuals, with it occurring in 80% to 90% of women and 10% of men.
Cellulite is usually most noticeable on the thighs, butt, and occasionally the arms or stomach, appearing as dimples.
Contrary to popular belief, cellulite is not caused by excess fat. The American Academy of Dermatology states that fat removal procedures such as liposuction will rarely affect cellulite. While a healthy lifestyle and weight loss can improve the appearance of cellulite, it is not necessarily a cure in most instances.
The real cause of cellulite is due to the structure of the subcutaneous fibrous tissue, specifically how the layer of fat that rests over the fascia, surrounds the muscles.
The female connective tissue between the skin and fascia is composed of vertical fibrous bands known as septa, these structures divide fat into honeycomb-shaped groups. In contrast, male tissue has a tighter structure, crisscrossing as opposed to vertical bands, where fat is less likely to bulge.
Hormonal changes such as those experienced during pregnancy and aging can cause these septa to harden, pulling the skin down, and compacting the fat until it protrudes from the compartments.
The onset of menopause can also cause cellulite to begin appearing or worsen. Declining estrogen levels will result in a drop in collagen production, causing the skin to become thinner and less pliable while expanding the size of fat cells, making dimples more noticeable.
Lastly, a slowing metabolism with less blood circulation, as well as hereditary factors, can contribute to cellulite formation.
The severity of cellulite is often rated as follows:
- Level 1: Mild cellulite, often referred to as "orange-peel texture," exhibits a few shallow indentations and slightly loose skin.
- Level 2: Moderate cellulite, frequently known as "cottage cheese cellulite," shows 5 to 9 deeper dimples and more pronounced skin sagging.
- Level 3: Severe cellulite has a distinctive "mattress-like" appearance with 10 or more deep dimples, and is generally seen with significant skin sagging.
Can you get rid of cellulite?
Unfortunately, there is currently no permanent fix for cellulite. There are, however, cellulite reduction treatments available that can moderately improve its appearance.
The latest cellulite therapies include injectable enzymes and radio waves that can help soften the fibrous bands, or even subcision surgery to sever them. Other alternatives aim to increase collagen production, resulting in firmer thicker skin that will reduce the appearance of indents.
Generally, treatment sessions will be ongoing if you want to maintain the desired effects and keep the lumps under control.
The best ways to treat cellulite
The following treatments are the most effective at reducing cellulite according to doctors and patients.
Cellfina is a minimally invasive procedure that reduces cellulite on the buttocks and thighs through precision vacuum-aided tissue release. It is considered to be the most popular method for combating cellulite as it targets the root cause of the problem by severing the fibrous bands responsible for the dimpled appearance. According to studies, the effects of Cellfina can last up to three years.
The procedure starts with the surgeon labelling the targeted dimples and afterwards local anesthesia is administered through a vacuum-assisted applicator. The doctor then utilises the suction device along with an electric microblade to sever the septal fibres. The recovery period is usually one day of intense soreness and then swelling and bruising for up to 4 weeks.
Dermal fillers are TGA-approved to reduce the visibility of facial wrinkles, however, some practitioners also use these injectables off-label to fill in cellulite dimples. Collagen-boosting fillers can provide continual improvement after the initial injection. Typically, multiple sessions are required to achieve the desired look. The effects will fully realise after 4 to 6 months and can last for up to 3 years.
A combination of subcision and a dermal filler is recommended by some doctors. Subcision can be used initially to treat the cellulite, and then a dermal filler injection can follow, this enhances skin texture, increases volume, and effectively addresses skin laxity.
BodyFX is a medical device, approved by the TGA for temporary cellulite reduction and body contouring. Clinical trials have shown a 68% decrease in cellulite among patients after treatment.
BodyFX uses a combination of deep tissue heating, radiofrequency energy and suction-assisted negative pressure to disperse heat across the skin and underlying fat, leading to tissue contraction.
8 weekly sessions are suggested for cellulite reduction and the final results should be visible 6 months after treatment.
Subcision, which is primarily used to treat acne scars, is another well-known cellulite surgery. This technique utilises a needle to sever the fibrous tissue bands under the skin, reducing the tension that causes cellulite. This procedure is only suitable for cellulite dimples that are visible while sitting or standing, not during muscle contraction.
Through studies, subcision has been proven to be a safe and effective cellulite reduction treatment. However, the procedure is accompanied by some mild side effects such as swelling, tenderness and bruising. Unfortunately, subcision is not a long-term fix for cellulite, patients usually see dimples reappear a few years after the operation.
More cellulite reduction treatments to consider
Emtone, brought to you by the creators of the muscle-toning device Emsculpt, is TGA-approved for reducing the appearance of cellulite using radiofrequency (RF) and precisely directed acoustic sound waves.
The heat generated by the radiofrequency waves rearranges existing collagen fibres and stimulates the production of new collagen, resulting in thicker more pliable skin. Meanwhile, the pressure from the sound waves enhances circulation and helps drain fluid, which can cause indentations. Results become noticeable 3 months after undergoing 4 to 6 Emtone treatment sessions.
Endermologie is a therapeutic massage that combats cellulite by using a vacuum device to disrupt and release trapped pockets of fat from fibrous connective tissue. The procedure typically requires 8 to 10 treatments to see the best results. There is limited scientific research investigating edermologie's effectiveness and the published studies that exist show varying results. A 2009 study saw significant decreases in body circumference for participants, though only 15% experienced an improvement in their cellulite symptoms. On the other hand, a more extensive study in 2013 reported that 99% of patients experienced a decrease in body circumference and 69% rated being highly satisfied with the procedure.
Venus Legacy pairs radiofrequency waves with electromagnetic energy to increase collagen production, resulting in a reduction of cellulite, tighter skin, and fewer wrinkles. An initial block of 6 to 8 weekly treatments is required to achieve noticeable effects, and results should be visible 3 to 4 months after the final session. To sustain the benefits, 3 to 4 touch-up appointments per year are recommended.
Cellulaze is a minimally invasive surgical procedure that uses lasers to combat cellulite by restoring the skin and underlying connective tissue to its original state. The procedure involves the use of a small fibre-optic laser that accesses under the skin via tiny incisions, allowing for delicate treatment of structural skin issues.
Cellulaze works by breaking up accumulated pockets of fat and severing fibrous bands that pull the skin downward. The process also promotes collagen growth for healthier, firmer, and more elastic skin.
Do cellulite creams work?
Topical cellulite creams can only provide temporary smoothing effects on mild cellulite, as they are unable to reach the underlying tissue.
Retinol-based creams can increase skin firmness over time, reducing the prominence of cellulite. Consistent daily use for at least half a year is required before you can see any results.
Skin creams containing caffeine, such as Brazilian Bum Bum Cream, work by dehydrating fat cells and improving circulation, leading to a temporary smoothing of the skin. The cream must be used regularly for noticeable improvements, and the effects will not be as pronounced as in-clinic procedures.
Studies & Sources
American Academy of Dermatology Association n.d., Cellulite treatments: What really works?, www.aad.org, viewed 4 February 2023, <https://www.aad.org/public/cosmetic/fat-removal/cellulite-treatments-what-really-works>.
Friedmann, D, Vick, G & Mishra, V 2017, ‘Cellulite: a review with a focus on subcision’, Clinical, Cosmetic and Investigational Dermatology, vol. Volume 10, pp. 17–23, viewed 4 February 2023, <https://www.dovepress.com/cellulite-a-review-with-a-focus-on-subcision-peer-reviewed-fulltext-article-CCID>.
Kaminer, MS, Coleman, WP, Weiss, RA, Robinson, DM & Grossman, J 2017, ‘A Multicenter Pivotal Study to Evaluate Tissue Stabilized—Guided Subcision Using the Cellfina Device for the Treatment of Cellulite With 3-Year Follow-Up’, Dermatologic Surgery, vol. 43, no. 10, pp. 1240–1248, viewed 4 February 2023, <https://journals.lww.com/dermatologicsurgery/Abstract/2017/10000/A_Multicenter_Pivotal_Study_to_Evaluate_Tissue.7.aspx>.
Kennedy, J, Verne, S, Griffith, R, Falto-Aizpurua, L & Nouri, K 2015, ‘Non-invasive subcutaneous fat reduction: a review’, Journal of the European Academy of Dermatology and Venereology, vol. 29, no. 9, pp. 1679–1688, viewed 4 February 2023, <https://onlinelibrary.wiley.com/doi/10.1111/jdv.12994>.
Kutlubay, Z, Songur, A, Engіn, B, Khatіb, R, Calay, Ö & Serdaroğlu, S 2013, ‘An alternative treatment modality for cellulite: LPG endermologie’, Journal of Cosmetic and Laser Therapy, vol. 15, no. 5, pp. 266–270, viewed 4 February 2023, <https://www.tandfonline.com/doi/abs/10.3109/14764172.2013.787801?journalCode=ijcl20>.
Luebberding, S, Krueger, N & Sadick, NS 2015, ‘Cellulite: An Evidence-Based Review’, American Journal of Clinical Dermatology, vol. 16, no. 4, pp. 243–256, viewed 4 February 2023, <https://link.springer.com/article/10.1007/s40257-015-0129-5>.
Therapeutic Goods Administration 2015, InMode Australia Pty Ltd - Multi-modality skin surface treatment system (238736), Therapeutic Goods Administration (TGA), viewed 4 February 2023, <https://www.tga.gov.au/resources/artg/238736>.
― 2019, BTL Medical Technologies Pty Ltd - Skin contouring system, radio-frequency (319200), Therapeutic Goods Administration (TGA), viewed 4 February 2023, <https://www.tga.gov.au/resources/artg/319200>.
Tülin Güleç, A 2009, ‘Treatment of cellulite with LPG endermologie’, International Journal of Dermatology, vol. 48, no. 3, pp. 265–270, viewed 4 February 2023, <https://onlinelibrary.wiley.com/doi/10.1111/j.1365-4632.2009.03898.x>.