Cellulite is the term used to describe an uneven, dimpled, bumpy appearance to the tissues over areas like the buttocks, thighs and sometimes other locations of the body. Over the last many years this appearance has been attributed to many things, and people are often under the mistaken impression that it is due to excess fat. This has led many patients to seek treatments to reduce fat, like liposuction, or non invasive fat reducing treatments like Liposonix®, or CoolSculpting®, in order to get rid of cellulite. Doctors now recognize that cellulite occurs even in thin people who do not have excessive amounts of fat, and often fat reducing treatments do not improve the appearance of cellulite, and can sometimes make the “orange skin “or “lumpy mattress” appearance even worse.
Cellulite is now thought to be age and gender related, and almost all women, and a small proportion of men, will develop it over years. The reason women have a higher incidence of cellulite is the composition of their fat tissue differs from that of men in that it is arranged in “chambers” separated by fibrous bands, and with age the fat is thought to bulge between lax bands whereas men have a more crisscrossed fibrous band arrangement within their fatty tissue. Fluctuations in weight are also thought to be associated, so maintenance of a steady weight may minimize its appearance.
Topical creams and rolling and massage devices that are touted to reduce cellulite are considered to be mostly useless by medical personnel. There are some medical devices that thus far appear to be of some modest benefit, and these are worthy of more study. However, a simple technique that has been used for some years to treat cellulite, has re-emerged and is gaining recognition as a successful treatment, especially since MRI imaging has demonstrated a fibrous band in association with each indented dimple of cellulite. This essentially pulls the skin inward, relative to the surrounding fat. In subcision, a needle is inserted into the dimple to cut the fibrous band thus allowing the tissue to lie more flat. This treatment is done under local anesthetic and pressure is applied to the area afterward. It has been shown to improve the type of cellulite associated with indented dimples at rest, i.e. those who only have indentations when they tense their muscles, or those whose main issue is bumps as opposed to dimples will not benefit from subcision. Side effects of subcision include bruising.