Cellulite Treatment

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The Secret to Treating Cellulite is Below the Skin’s Surface

By Richard Buckley, M.D. – Connections Magazine: October 2012

There are countless cellulite treatments — most failing to live up to their claim to smooth the unsightly lumps and bumps. Today, there is a treatment that works. It addresses the roots of the problem, for dramatic, long-lasting results.

First, you have to understand the problem

Cellulite is the lumpy, bumpy, cottage cheese appearance often seen on women’s outer thighs and buttocks. It affects between 80% and 90% of women after puberty.

Heredity plays a role, but the cause goes beyond genetics. In fact, there are three things that occur, which result in the appearance of cellulite. Once you understand those, treating it becomes clear.

No. 1: Compartmentalized fat.

We hold fat under our skin in compartments. These compartments are far different for women than for men. In men, they’re somewhat diamond shaped; in women, they’re parallel. Women are more likely to have cellulite than men because of that parallel structure, which makes it easy for the fat in these chambers to push up on the skin above (called herniation).

No. 2: Fibrous bands.

The walls of these containers are fibrous bands, called septae. Cellulite is associated with an increased body mass index (BMI). If you’ve gained any weight at all, the fibrous bands can’t stretch out, and the fat between the bands pushes up against the skin. The lower parts of the cellulite are where the fibrous bands won’t allow the skin to go up. The parts that are bumped up, pushing up against the underside of the skin, are herniated.

No. 3: Thin skin.

Skin thickness is a complicating factor. Whether or not your skin is thin or thick
depends, for the most part, on genetics and age. Unfortunately, skin thins as we age, which can make cellulite worse.

Smoothing the surface

The way we successfully approach cellulite is to address the three issues with tools, including lasers and radiofrequency devices. The reason many of the lotions, potions, above-the-surface suctioning and massaging don’t work is because they don’t treat what’s going on below the skin.

Now that the FDA has approved lasers that treat the fat layer under the skin, we have real options in the war against cellulite. Using these lasers, I work on the fat causing the elevated portion of cellulite. This is while patients are wide awake, under local anesthesia. I melt the fat, tailor the area, and smooth it with the laser.

And remember those septal fibers that are tethered down. They, too, can be released and separated with the laser or by using cannulas.

So, now we have a level surface, but still might have thin skin. The thinner the skin, the more likely it is that you’ll see bulges or herniations. There are various ways of helping to restore healthy skin thickness, by stimulating new collagen. We do that with lasers and various radiofrequency devices, which stimulate the body’s fibroblast cells to make new collagen.

What can you expect?

We perform these procedures on an outpatient basis while patients are comfortable and awake. I address the fat smoothing portion and septae release of cellulite treatment in one appointment. The skin tightening and thickening, however, is more of a process. One would want to stimulate the processes that will cause an increase in elastin fibers and new collagen multiple times. Just how many times would depend on the cellulite’s severity and patient’s age and ethnicity.