Cellulite

Cellulite is not a disease, but an anatomical variation due to the arrangement of fat cells within a fibrous framework. As such it cannot be cured by medicines. Only changing the physical anatomy has any hope of changing the appearance and that too is difficult.

The tough fibrous framework is arranged as vertical compartments in women and more horizontally in men. Cellulite occurs in the thighs and buttocks, areas where there is more fat, the female secondary characteristics, pushing upwards against the restraining framework.

This produces the mattress or orange-peel appearance as the fat cells expand with weight gain. It mostly affects the hips, thighs and buttocks. About 8 in every 10 women experience this condition. It is much less common in men because of the different architecture of the fat cells and the lack of fat in these areas.

Many factors influence the onset of cellulite, which tends to first present itself around puberty, including genetics and hormones and to a much lesser extent, diet, exercise and metabolic change.

If cellulite is not a disease then how do we treat it?

We can consider that fat is arranged like ice cubes in a freezing tray, the dividers are fibrous bands or septae. As the fat expands it bulges out, restrained by septae producing the quilting effect. Therefore strengthening the skin or releasing the septae can be expected to improve the appearance.

 We can strengthen the skin by tightening it or by inducing fibrosis or scarring within it either from the outside (radiofrequency or laser) or from below the skin (by radiofrequency or Laser). We at the Cadogan Clinic obtain the best results using the laser, Cellulase, from below. We can also release the fibrous septae with a fine blade (Subcision) or again with the same Cellulase laser.

There are three degrees of cellulite, based on how noticeable it is. The cellulite level of a patient determines which treatments will be the most effective to address it.

• Level 1: can only be seen when flexing muscles in the affected area.
• Level 2: can be seen when muscles are at rest.
• Level 3: the skin has dents, cobblestones, and hills that are visible at all times

The apparent cause of cellulite is the interaction between the connective tissue beneath the skin surface and the underlying layer of fat. The connective tissues and fat cells have a vertical arrangement in women. Cellulite appears if the fat layers protrude into the skin layer.

Cellulite development also depends on the hormones and age of the individual. The flow of blood to connective tissues beneath the skin decreases in women due to the action of the estrogen hormone. This lowers the supply of oxygen and as a result, less collagen is produced. A combination of these factors increases the visibility of fat deposits. Ageing makes the skin to become less elastic and this accelerates the rate of cellulite development.