What Causes Cellulite?
One theory has to do with swelling within localized fatty areas. This can be accentuated by increases in lymphatic pressure or venous blood pressure.
For some, excess fat, loose skin, or a combination of the two additionally contribute to the problem. Stress, trauma, diet, medications, and pregnancy have also been listed as possible contributing factors.
Dr. Yates believes the two main causes of cellulite are:
- Fat and swelling which is accentuated by adjacent tight supportive connective tissue of the skin (think button on a pillow)
- Loose skin causing a traction on this connective tissue, leaving the cellulite depressions on the skin.
- Often a combination of both come into play for a particular patient
What treatment options are available for cellulite?
Every year it seems that there is a new “hot” treatment for cellulite. The problem is that most do not do what they claim. The results are much less than advertised, if at all, leaving many patients unhappy. Here is a brief list of popular therapies at this time:
Mesotherapy (lipodissolve) – Highly advertised and hyped. Basically the injection of a non standardized mixture of chemicals intended to dissolve fat painlessly without surgery. Not generally supported by plastic surgeons. Unbiased, comparative studies reveal no measurable effect (Plastic and Reconstructive Surgery, April 2008). Dr. Yates has actually seen a few patients who claim that this increased fat. Very low satisfaction rate, about 25%.
Cellulite creams – There are no valid studies or even anecdotal evidence that these show any improvement, There are studies that show no improvement (Plastic and Reconstructive Surgery, Sept 1999).
Body wraps – See creams
Endermologie– An external machine is used to roll and suck the skin which claims to reduce the appearance of cellulite. Studies have not demonstrated that this lives up to the hype.
Ultrashape – Not FDA approved. Non-thermal ultrasound energy to break up the fat which is resorbed by the body. Promising in theory, needs the benefit of more time and research to know for sure. One concern is where does the fat and cholesterol go. The coronary arteries increasing the risk of heart disease? Currently patient satisfaction rated very low, about 30%.
Velasmooth – Combination of RF and light energy applied like Ultrashape externally to break up fat cells. Again, promising but needs more time and where does the fat go? Satisfaction about 30%
Velashape – Basically Endermologie plus Velasmooth, Low satisfaction rate.
Tumescent liposuction – This is what Dr. Yates uses for body contouring. Although liposuction can improve cellulite, this is minimal and cellulite can even be made worse with liposuction. With release of the cellulite depressions with a V shaped cannula and a little fat grafting this can be improved somewhat more. I would estimate about a 50% improvement at best.
Laser liposuction (smartlipo) – Highly advertised and hyped. Burn the tissue with a laser prior to removing it with liposuction (or leave it to be resorbed by the body). Most surgeons (or non-surgeons) using this technology are not plastic surgeons at this point. The danger is that a patient can focus on the technology rather than the experience and artistry of the surgeon which is vastly more important. There may be a benefit of this technology in the treatment of cellulite if skin tightening is really occurring (time will tell).
Ultrasound liposuction (Vaser liposuction) – Ultrasound assisted liposuction. Limited in treatment of cellulite similar to tumescent liposuction.
It is easy to see why there is so much confusion about the treatment of cellulite. First, no one, and I mean no one really knows all of the causes for cellulite. Second, proponents of each method of treatment will try to sell their own technique in favor of others. The truth is, there is little scientific support for any of these methods for the treatment of cellulite. Even in the best cases the benefit is minor.
It would be great for patients and surgeons alike if one of these treatments or something on the horizon could treat cellulite consistently and effectively. In the meantime, Dr. Yates won’t buy the hype of current methods or experiment on his patients with new technology until it is proven. For fatty bulges liposuction does very well but for cellulite don’t expect too much. Dr Yates is very experienced in body contouring providing service to the Salt Lake City metro area in Utah.