Cellulite is a disorder of the skin structure, mainly of the subcutaneous tissue, which causes changed skin appearance, with nodules and cavities resembling orange peel appearing on the skin surface. Cellulite is a frequent ailment among women of all ages, developing in the following areas:
Cellulite constitutes a major aesthetic problem, which contributes to women’s lowered self-evaluation. Women suffering from cellulite do not like to show their imperfections, which makes them select masking clothes in summer, causes reduced comfort and the feeling of embarrassment at the swimming pool or at the beach. Some of them refrain from going to such places at all. The problem concerns app. 90% of women at post-menopausal age and may demonstrate varying severity, from changes visible only after the skin is pressed or stretched, to considerable and permanent unevenness.
What are the reasons of cellulite development?
The main role is played by genetic factors, but genetic predispositions alone will not cause appearance of symptoms. As a result of raised estrogen levels, cellulite develops mainly in women. Women of the white race are proven to suffer from cellulite more frequently than women in Asia. Another important factor is the lifestyle, which results in development of symptoms in predestined persons. High carbohydrate diets cause hyperinsulinemia that leads to increased lipogenesis, i.e. increased production of lipids in the body, which in turn causes higher storage of fat in the subcutaneous layer cells and makes cellulite more pronounced. Significant body mass fluctuations, gaining and losing weight in turns also strengthen the “orange peel” effect. A sitting lifestyle or, in contrast, work in the standing up position causes blood and lymph hypostasis in lower limbs as well as swelling of the subcutaneous tissue. Pregnancy also contributes to development of the discussed changes as a result of increased levels of hormones – estrogen, prolactin, insulin – and retention of water in the body during that period.
Nowadays, there are many methods of dealing with cellulite, from creams to laser liposuction. Therapies differ in terms of applied mechanism, duration, efficiency and invasiveness.
Treatments involving impact of physical factors onto the tissue are interesting treatment methods. One of them is endermologie, developed in France. Endermologie involves simultaneous massage and sucking in of tissue by the special LPG Endermologie device. The treatment improves lymph and blood circulation, which increases lipolysis and reduces water swelling. Endermologie is performed in series of app. 15 treatments of 35 minutes on average. The treatment is not painful; in fact, it is pleasant.
Ultrasounds are another idea for struggling with cellulite. The therapy involves emission of ultrasound waves by the head of a device placed on the skin. The waves break up and liquefy the fat tissue. Liquefied fat is transported by lymphatic vessels, and lymphatic massage is performed to strengthen this. The MedContour device, using a synergy of ultrasounds and lymphatic drainage, renders particularly good effects. One treatment already reduces the thigh circumference by 1-2 cm on average. The treatment is not painful and the patient experiences pleasant warmth. Effects are visible instantly. The number of treatments is determined by the severity of changes; from 4 to 6 treatments are usually required.
Cryptolysis is another physical method, involving removal of excess fat tissue under the influence of cold and, consequently, reduction of cellulite. The Coolsculpting (Zeltiq) device is used in areas resistant to lipolysis, such as the belly, trunk sides – so-called “love-handles” or inner thigh sides. The treatment involves application of the cooling head onto the skin and sucking in of the tissue which is cooled for app. 1 hour. During the treatment, the patient experiences intensive cold. Afterwards, slight reddening may remain in the area of application. The effect is visible after 2-4 months, when considerable fat tissue reduction is observed. The therapy must not be repeated sooner than after 3 months. Cryolipolysis is a non-invasive treatment method and the patient may return to regular activity immediately after the treatment.
The Thermage device uses radio waves, which cause heating up of the skin and subcutaneous tissue and, consequently, collagen shrinkage. In the partitions of fat tissue and dermis, the reaction causes smoothing and firming of the skin, which is followed by deposition of new collagen and strengthening of the skin structure. The treatment is dedicated to patients with cellulite and flaccid skin, e.g. during the loss weight process or in patients after pregnancy. The effect is visible immediately after the treatment, but the final results are achieved after 6 months. During the treatment, the patient experiences painfulness in the treated area, but the treatment does not require a convalescence period. Patients are not anaesthetised before the treatment in order to achieve cooperation between the sensation of warmth in the tissue and optimum device settings.
Mesotherapy and injection lipolysis are other forms of treatment aimed to stimulate lipolysis and reduce cellulite. These therapies involve injecting substances which enhance fat tissue breakup. Mesotherapy consists in injecting a solution containing such substances as caffeine, aminophylline, theophylline, causing lipolysis by hindering phosphodiesterase. The solutions are enriched with vitamins, herbal extracts, hormones and minerals. The treatment is not very painful; injections are performed at the distance of 0.5-1.5 cm and the treatment may be applied in any area. In order to achieve the expected results, the treatment needs to be repeated. The most frequent complication are small bruises at the place of injection. Injection lipolysis is another form of applying injections to tissues in order to reduce the fat tissue volume. The treatment involves application of injections of phosphatidylcholine obtained from soybean extract, into the target tissue. The substance damages fat cells. The process continues for app. 3 weeks after the injection. Phosphatidylcholine causes the sensation of itching and burning at the places where the injections are performed. The patient experiences slight pain, the skin becomes reddened and tender, bruises may develop. Swelling, maintained for 7 to 14 days, is a regular symptom after the treatment. A few days after the treatment, lymphatic drainage is recommended to assure removal of the decomposition process products. In some cases, a series of treatments needs to be performed.
Invasive forms of treatment are also used to fight cellulite. These include laser liposuction – Cellulaze, treatment characterised with low invasiveness, conducted in local anaesthesia or short intravenous anaesthesia. Painfulness is not experienced during the treatment. The procedure involves insertion of a narrow fibre optic cord into the subcutaneous tissue and, using a three-length laser beam, dissolution of the subcutaneous tissue, interruption of connective tissue partitions, which causes lifting and shrinkage of the skin. The treatment delivers very good results. Skin resilience increases gradually for up to 6 months after the treatment. If the patient’s lifestyle is proper, treatment effects are long-term. Effectiveness of classical liposuction in fighting cellulite is limited, as it removes deeper fat deposits. However, in order to achieve good cosmetic results, it may be combined with laser liposuction in patients with large volumes of fat tissue.
As you can see, there are many ways to fight cellulite. Yet, regular healthy lifestyle is extremely important, just as repeating and combining certain therapies depending on the severity and location of changes.
dr Michał Rożalski