The treatment for cellulite, if it is to be effective, needs to be specifically targeted at the all the underlying causes. But we need to firstly understand what cellulite is all about, what are the underlying causes, before we can go about treating cellulite.
WHAT ARE THE UNDERLYING CAUSES?
For cellulite to be apparent, there has to be a certain amount “swelling” in the skin, which doctors call edema. And this edema is often due to poor lymphatic or tissue circulation, but sometimes could also be due to excessive fat deposits. Regular exercise, watching one’s weight and the occasional “spa treatment” can help minimize the edema. These “spa treatments” may take the form of with or without mechanical message, or shockwave therapy. Or various combinations.
You may at this point brush off “spa treatments”, as you may have tied some of these non-invasive cellulite treatments, and found them to have very little benefit. The reason why may patients find them ineffective is because the other causal factors, which I will discussed below, which also contributes to the appearance of cellulite were not concurrently or adequately dealt with.
Uneven fat distribution is a contributing factor to cellulite. I’m not sure if you have noticed, cellulite tends to be more severe over the saddlebags, which is an area where fat accumulation tends to be more pronounced in many women.
Reducing the localized fat deposit is the aim here. And we can achieve this with non-invasive methods like Coolsculpting if small; or with Liposuction if there are other areas of disproportion that also needs smoothening out.
And oftentimes, there is some skin laxity which is contributing to the severity of the cellulite. Skin laxity itself may be due to poor tissue circulation, prolonged distension or just changes associated with aging skin.
For improving skin laxity, we advocate using the Radiesse Lift. This is an injection-based treatment where areas of skin laxity are injected subcutaneously with Radiesse. The calcium particles in Radiesse induces new collagen and elastin which then gradually improves skin elasticity.
We find skin tightening devices like Ultherapy and Thermage a bit too mild in terms of skin tightening particularly on the body. The Radiesse Lift has a slightly more visible outcome, although also mild.
Finally, but perhaps also most importantly, cellulite treatment needs to incorporate the release of the fibrous bands which tether the skin to the deep structures, which causes the dimples. But these fibrous bands are everywhere, and we cannot actually release all of the bands. Selectively releasing the tougher or denser fibrous bands is a procedure we call cellulite subcision.
The fibrous bands are very easy to spot as they the lie directly under the dimples with oblique lighting. Choosing 10-20 of the most severe dimples on each side, we through a minor surgical procedure, release (break from under the skin) the fibrous bands that tether the skin down. This procedure is called cellulite subcision.