What is the best treatment for cellulite?

Cellulite affects up to 85% of adult women and can be extremely difficult to correct. Many treatments are ineffective or take multiple sessions to complete with very temporary results. "Orange peel skin" or "cottage cheese" affects all body shapes and sizes, from the slim to the full-figured.

It is common to confuse the concept of cellulite with that of normal fat and assume that cellulite is a direct response to overeating or lack of exercise. However, this is not the case. Normal fat and cellulite respond very differently to diet and/or exercise. When you diet, your body automatically burns its own reserves of stored fat. But cellulite is fat that is trapped in the dermal layer of skin and the body cannot effectively process it as fuel, so it remains.

Given the perplexing nature of cellulite, how can it be treated? Fortunately, there are a number of options available. Topical creams contain retinol or caffeine that can increase blood flow to the affected area, thus temporarily reducing the appearance of cellulite. Rollers (like Endermologie) can similarly reduce swelling and inflammation in the affected tissues and temporarily reduce the appearance of cellulite. Radiofrequency devices (e.g., BTL Vanquish, Thermi) can reduce the connective tissue in the affected area and increase blood flow to reduce the appearance of cellulite. However, each of these approaches is limited by the fact that the results are reversible and may only last weeks, days, or even hours. Similarly, they can only address relatively minor areas.

For more significant dimpling and for permanent results, patients require more intensive treatment. Liposuction and/or fat grafting can improve the appearance of cellulite in properly-selected patients. But for the best results, techniques that are specifically designed to treat cellulite are most often the best. Laser therapy (e.g., Cellulaze, CelluSmooth) works by placing a small laser probe under the skin through small stab incisions. The laser then specifically melts that fat and cuts through the fibrous bands that cause skin dimpling. These treatments require a single session and show immediate results. However, they do cause significant bruising and swelling, and can require touch-ups yearly.

Cellfina is the development for the treatment of cellulite. The treatment targets the fibrous bands which are the source of the dimpling in cellulite. It is most effective for the treatment of deep dimples and depressions of the buttocks and back of the thighs. It is less effective in the treatment of generalized waviness. To perform the procedure, a vacuum hand piece is placed over the dimpled tissue through which the surgeon will deliver a local anesthetic. Then a small, needle-like microblade is inserted to release the fibrous bands causing the cellulite. Investigational studies for Cellfina show a patient satisfaction rate of 85% at 3 months, 94% at one year and 96% at 2 years. This is a very exciting solution for the many women who suffer from the embarrassment of cellulite.

As always, it is essential that patients have an in-person consultation to develop a treatment plan that specifically addresses their personal surgical goals anatomy. I recommend that patients find a board-certified plastic surgeon with whom they are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your plastic surgeon and review before and after pictures of similar patients whom have had this procedure.


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