Cellulite is created by the fibrous connections from the skin to the subcutaneous fascia and can worsen with weight gain and weight loss in some patients. The fact that cellulite can worsen and improve in certain patients with weight fluctuations it indicates there is no quick fix. Liposuction can help improve cellulite in some patients, usually those that cellulite worsens with weight gain. Skin quality is also a factor at cellulite treatment and some skin toners can help. Liposuction can help in the majority of patients because it helps to break up those fibrous bands.

Dear “Cellulite”:

Cellulite is nothing more than a superficial layer of normal fat cells beneath the skin. The fat appears bumpy and irregular because it is trapped between a skin ceiling, a tough unyielding fibrous floor and thin fiber walls. Any swelling or reduction in the metabolic fat will inflate or deflate its appearance on the skin. Like a parachute, more or less air will create dimples and pulls on the silk chute. A thicker skin such as those of black, Mediterranean, Asian, Indian and other origins will resist the irregularities of the skin. A thinner northern European skin will more easily show the pucker, dimpling, hollows and bulges.

Any factor that causes the fat cells within its confined space to bulge or contract; or the walls, ceiling and floor of the fat compartment to loosen or tighten will affect cellulite.

Your lifestyle is the most adjustable factor in controlling cellulite. The basics include: exercise and proper weight control including a diet rich in fruits, vegetables, and fiber. Hydration and vigorous massage will help too.

Other factors include your metabolism and hormone balance, the thickness of your skin and pregnancy.

Unfortunately, Cellulite is not “curable” but there are improving steps beyond the lifestyle controls above to improve its appearance.

There are many cellulite treatment available. These include massages, cellulite creams, lasers and light therapies. Advertisers promise remarkable results but most of these products and services don't live up to their claims.

• Liposuction. This is a surgical procedure to remove fat deposits from the body. Liposuction, though, removes deep fat, not cellulite, which is just beneath the skin. Liposuction may actually worsen the appearance of cellulite by creating more depressions and laxity by deflating the volume of the skin.

• Mesotherapy. Mesotherapy involves injecting a cocktail of vitamins, minerals, amino acids, and enzymes into the fat layers. Mesotherapy has been banned in much of the US due to improper use and non-FDA approval. It may also create more problems than it solves due to swelling, infection, and irregular contours.

• Massage and Suction / Roller Therapies. These treatments may have a short-lived effect on the dimpling appearance of skin. They do not remove cellulite. They act by increasing circulation and massaging out fluid excess. It may be similar to a vigorous massage.

• Laser, Light, Radio Frequency and Ultrasound treatments. Many generations of devices have been FDA approved for use in skin conditioning. Those that pass through the skin, focus on different layers of the tissues to cause heat and or inflammation. This “controlled inflammation” “heals” by producing scar, ie. collagen to plump, shrink and otherwise improve the deficiencies we perceive in our skin and fat.

• Cellulaze. The latest minimally invasive procedures will pass under the skin to divide the fiber walls and destroy the superficial fat cells. Results will last as long as it takes for the inflammation and scar to soften; ie, 3 to 6 months.

• Topical Retin-A, retinols: Topical treatments: These products directly stimulate skin cell activity, function and productivity of a more youthful and more resistant skin structure. More collagen, more elastin, more GAG’s (the protein-sugar molecules) useful in a smoother textured skin. With the combination of mid-depth dermal lasers, we are visualizing greater improvements.

I hope this is helpful! Please choose an experienced, board certified plastic surgeon for your consultation.

All the best,

Dean Kane, MD, FACS

Temporary results are achievable using non-invasive devices like Velashape or SmoothShapes.

As far as long term results, Cellulase or ThermiRF are slightly invasive treatments that give better long term results.

Thermage body is the only results that are noticeable but even those results can be underwhelming. Lipo doesn't address cellulite.

"Get rid of cellulite".... Non-invasive treatments can start with the use of a tretinoin cream 1-2X day. It has been shown to increase collagen and elastin formation which lends support the the "walls" holding the fat "dimples." Also, regular massage and compression have been shown to temporarily ease the appearance of Cellulite. I would try starting a regular regimen of both these before spending big bucks. if you want to go further with lasers and more expensive treatments you could consider some Skin Tightening therapy (Ultherapy or yag Laser) along with a fat reduction treatment such as Zeltiq Machine treatments or Vanquish. GOOD LUCK! Dr Nick

I have not seen significant improvement in cellulite via any specific plastic surgical modality. Some practitioners recommend Cellulaze. But I have not been impressed with any long term outcomes. Every few years, a new option presents itself to the marketplace. Endermologie was previously popular, but was/is expensive and temporary.

I would recommend saving your money and practicing good diet and exercise for now. This may not be the answer you are looking for, but it is an honest answer

Liposuction can make cellulite worse-don't do it. All cellulite therapy produces only temporary results with machines like Velashape and Venus Freeze-so you have to keep having treatments to maintain results.

Surgical procedures like laser and surgical subscision can be more effective but leave scars and the cellulite can still come back. Don't be misled and spend a lot of money on falsely advertised cellulite cures. Significant weight loss can help.

I can give you a response for temporary cellulite reduction. Usually a light assisted heat device like Velashape, like Venus freeze can assist. There is some debate about a permanent solution with Cellulaze however the results have been mixed.

Superficial liposuction with an Ultrasound sound based device. Go to the Smart Beauty Guide for more information.