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If there is one body concern in plastic surgery that remains both ubiquitous in occurrence and refractory to treatment. is that of cellulite. So many women have it that the only comparable beauty affliction is that of stretch marks and wrinkles. Largely located on the thighs and buttocks, it interestingly affects almost no men. It is a true gender-biased concern.

Suffice it to say that there is no one definitive solution for the cellulite problem. The only thing we know for sure about it is its appearance can be lessened with weight loss and being very fit. Thin women tend to have less cellulite than those who are heavier.

But once one has it, it is basically impossible to get completely rid of it. The testament to its difficulty in treatment is the many topical products and even medical devices that purport to offer a solution to your cellulite concerns.

Because it is hard to treat, numerous fallacies and myths exist about cellulite. One of the most common is that it is composed of a different kind of fat. While its outer classic cottage cheese appearance on the skin may suggest otherwise, the fat in cellulite-afflicted areas is just plain fat. It is the surrounding fibrous bands that run between the underside of the skin to the deeper tissues that is the key anatomic difference. Like the quilted appearance of a spring mattress, the fat between these band is squeezed upward as the bands keep the skin where they attach pulled down. This is why it is important to keep one’s weight down if possible…increased fat deposits makes the appearance of cellulite worse.

Despite the many product and treatment claims, the myth (hope) of a cellulite cure persists. From massages and body wraps to topical creams and supplements, there are countless products promising to make your cellulite disappear. Quick fixes to cellulite are not reality. Surgical solutions have equally been unsatisfactory. While liposuction and the technique of pickling (a forked instrument that passes right under the skin) do disrupt the fibrous bands, the improvement in the appearance of cellulite is only short-term. The use of laser liposuction (Smartlipo), because of the heat generated in the fat along with fibrous band disruption, offers some theoretical improvement over traditional liposuction. Once can also use the small fiberoptic laser probe like a pickling instrument to disrupt the fibrous bands. I have see improvement in some of my Indianapolis liposuction patients but I certainly wouldn’t call it a cellulite cure.

The current use of the Zerona cold laser for body slimming says that it will also improve cellulite. But this treatment approach also employs intake of water, use of exercise, and oral supplements, all components of an active healthy lifestyle. Such a lifestyle combined with the inevitable weight loss which will occur makes the most sense in the battle against cellulite. Decreasing the fat between the bands and improving the lymphatic outflow of that same fat will improve its physical appearance.

Other medical devices employing external skin disruption and penetrating energies such as ultrasound, acoustic and infrared can also be of benefit. They have visible short-term improvement but they also require long-term maintenance treatments. Their adjunctive use  to lifestyle changes is a matter of a cost:benefit assessment. For the improvement seen are they worth the cost?

Dr. Barry Eppley

Indianapolis, Indiana

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