Cellulite Dclinic
A M o d e r n A p p ro a c h t o t h e
Tre a t m e n t o f C e l l u l i t e
Anthony M. Rossi, MDa,b, Bruce E. Katz, MDb,c,*
KEYWORDS
Cellulite Laser lipolysis Skin laxity Nd: YAG laser for cellulite
KEY POINTS
Cellulite is a well-documented condition and, although many treatment options have been purported, few have lasting clinical results.
The use of laser and light-based devices, in both a noninvasive and a minimally invasive fashion, has augmented the understanding and approach to the treatment of cellulite.
Understanding the structural components that underpin cellulite anatomy allows for a more specific targeting approach.
Cellulite is a topographic alteration of the skin and subcutaneous adipose that has been reported as early as 150 years ago but yet still affects patients today. It is quite prevalent, almost ubiquitous in postpubertal women and can be thought of as a female secondary sex characteristic.1 Cellulite formation has a complex pathophysiology that includes expansion of subcutaneous fat, fibrotic dermal septae, as well as dermal laxity and atrophy. Many factors are also thought to influence the formation of cellulite; a genetic predisposition, along with hormonal influences, structural adipose differences, and inflammation may all contribute. It is thought that in cellulite the adipose cells are arranged in chambers surrounded by bands of connective tissue called septae, which span to connect muscle to the inferior portion of the dermis. The adipose cells that are encased within the perimeters of this area expand with water absorption, thereby stretching the connective tissue.
This connective tissue can contract and thicken, holding the skin at a nonflexible length, while the surrounding tissue continues to expand with weight, or water gain. This expansion results in skin dimpling and an orange peel appearance, mainly in the pelvis, thighs, and abdominal areas.2
Many devices and treatments have focused on these purported
Tre a t m e n t o f C e l l u l i t e
Anthony M. Rossi, MDa,b, Bruce E. Katz, MDb,c,*
KEYWORDS
Cellulite Laser lipolysis Skin laxity Nd: YAG laser for cellulite
KEY POINTS
Cellulite is a well-documented condition and, although many treatment options have been purported, few have lasting clinical results.
The use of laser and light-based devices, in both a noninvasive and a minimally invasive fashion, has augmented the understanding and approach to the treatment of cellulite.
Understanding the structural components that underpin cellulite anatomy allows for a more specific targeting approach.
Cellulite is a topographic alteration of the skin and subcutaneous adipose that has been reported as early as 150 years ago but yet still affects patients today. It is quite prevalent, almost ubiquitous in postpubertal women and can be thought of as a female secondary sex characteristic.1 Cellulite formation has a complex pathophysiology that includes expansion of subcutaneous fat, fibrotic dermal septae, as well as dermal laxity and atrophy. Many factors are also thought to influence the formation of cellulite; a genetic predisposition, along with hormonal influences, structural adipose differences, and inflammation may all contribute. It is thought that in cellulite the adipose cells are arranged in chambers surrounded by bands of connective tissue called septae, which span to connect muscle to the inferior portion of the dermis. The adipose cells that are encased within the perimeters of this area expand with water absorption, thereby stretching the connective tissue.
This connective tissue can contract and thicken, holding the skin at a nonflexible length, while the surrounding tissue continues to expand with weight, or water gain. This expansion results in skin dimpling and an orange peel appearance, mainly in the pelvis, thighs, and abdominal areas.2
Many devices and treatments have focused on these purported