Cellulite Treatments - Is A Permanent Solution Available?

Cellulite, also known as adiposis edematosa or orange peel syndrome, is a natural occurring condition that affects up to 90% of women, and can occur anywhere on the body from the arms, abdominal and back areas, but is most common on the buttock and thigh areas. Sedentary lifestyles combined with unhealthy diets as well as practices such as smoking and tanning can exacerbate the appearance of cellulite. Genetics and hormonal changes also appear to be an important factor, as healthy, fit and active women do report having cellulite even from ages as young as their 20s. 

There are many treatments that can, however, give on-going improvements and can potentially prevent a worsening of the existing condition. 

There is no treatment available that can cure cellulite permanently, as it is an on-going effect of the natural bodily processes. But there are treatments that can significantly improve it's appearance. 

Jennifer Love Hewitt is just one of the many celebrities who have been scrutinized for having cellulite

Why do we get cellulite?

Cellulite is often portrayed as caused by uneven layers of fat, but it is not solely the fat that creates this dimpling effect. Bands of fibrous tissue called septae connect the skin to the muscle layer. The dimples and bulges are an effect of the fat pushing up between the septae fibers, which are pulling down on the skin. Men rarely get cellulite, because their septae fibers are cross-hatched in a smooth and continuous pattern, whereas in women, the fibers are arranged vertically. 

Cellulite affected areas tend to be thinner-skinned, and with age, unhealthy practices and constant hormonal changes, the fibrous septae bands become tough and inelastic, while the dermis becomes thinner and less rigid. This allows fat cells to protrude into the spaces between the septae, and the 'cottage cheese' effect becomes more pronounced as the deterioration furthers. 
Under the surface of the skin, cellulite is revealed to be a series of bulges and dimples 
caused by the interaction of septae, fat cells and aging skin

How is cellulite severity measured?

The severity of cellulite is often measured according to a classification system called a Nurnberger-Mulller Cellulite Severity Scale. The type of cellulite is determined by a series of observational tests conducted while a patient is standing, supine (lying down) and when the area is pinched. 

The most severe type of cellulite, the kind that is observable even when a patient is supine, is the hardest to treat, as it shows that the underlying skin structures have deteriorated greatly and treatment results may be very limited. 

What treatments have been shown to improve cellulite?

Most creams and lotions are not able to address this deterioration of the skin, as their key ingredients, caffeine and retinol, are only designed to increase tissue swelling and exfoliation for a temporary action that dissipates very quickly. While cellulite creams have the advantage of ease of application and are generally affordable, proven formulas are few and far in between, and may offer only limited results, and once usage is discontinued, the condition will recur.

Massage regiments are helpful up to a point, as they help to increase blood circulation and promote fat redistribution, but cannot restore skin suppleness or elasticity for permanent results. Most salon cellulite treatments cannot improve the underlying structural problems caused by fatty bulges and tightened fibrous septae, but may be conservatively useful if used early enough as a means of prevention against the aging of the skin. 

Thermage is a popular treatment that uses radiofrequency wavelengths to stimulate collagen remodelling and improve skin laxity and tone. This treatment can also improve the appearance of cellulite dimpling.  Cellulite improvement from a single treatment can be seen over the next 3 – 6 months post treatment, with results lasting from 6 to 12 months. Some patients also find the Exilis treatment module effective for cellulite. Exilis uses radiofrequency to stimulate fat loss as well as tighten and smooth the skin. Exilis treatments need to be repeated on a weekly basis, and will give noticeable results in as few as four to five treatments.

 Other similar treatments available on the market include Velasmooth and Velashape, which combine massage with infra-red and radio-frequency technologies. Some doctors also suggest Ultherapy, which uses ultrasound technology for skin tightening, collagen remodelling and cellulite treatment. 

Endermologie and Lipomassage are other examples of non-surgical treatments that use suction and rollers to stimulate microcirculation and deep tissue massage. These procedures are reasonably effective on lower grade cellulite and must be continually maintained for long-term cellulite control. 

Mesotherapy and carboxytherapy, are techniques that are very popular in European countries such as France and Italy but are not considered medically safe treatments in Malaysia. Mesotherapy involves the use of specific pharmacological substances that are micro-injected in treatment areas, whereas carboxytherapy uses carbon dioxide infusion to break up and flush out fatty deposits and improve blood circulation to the affected areas. 

All these methods have been shown to have varying degrees of effectiveness against cellulite, but no "cure" has been shown that can give permanent improvement. One treatment that is not yet available in Asia is Cellulaze. This procedure involves a laser probe inserted into the skin to provide a three way effect - fatty bulges are liquefied, fibrous septae are cut, and the dermis is treated to remodel collagen content for thicker, more elastic skin. This is considered a minimally-invasive procedure, and does involve some healing time, but it is a promising treatment, having received a "worth it" rating of 73% on RealSelf.com. Cellulaze has not been US FDA cleared for permanent cellulite removal, but many doctors have reported results that last for up to a year. 

Have you had any experience with similar, or other cellulite therapies? How successful have you been in your battle with cellulite? Leave us a note in the comments section!

- Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email

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