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The search for an effective treatment for cellulite is ongoing and is far from reaching a consistent solution. Various methods of treating cellulite have been espoused including liposuction, fat injections, endermologie and other mechanical disruption methods, injection lipolysis, subcutaneous carbon dioxide infusions,  herbal and dietary supplements, and numerous creams and lotions. While some of these do have a mild beneficial effect, none work consistently or have scientific data supporting their long-term efficacy. Some of these treatments, such as liposuction, can even make cellulite appear worse.

Cellulite is caused by bands of fibrous tissue that connect the skin down to the muscle from the skin. Because the bands are tight, the fat between the skin and the muscle bulges out between them creating dimpling around each band. Women are much more predisposed to cellulite due to genetic predisposition, hormonal changes and weight gain although some men can get it too.

A new study published in the November/December 2008 issue of Aesthetic Surgery Journal shows that a combination treatment of laser energy and fat injections improves cellulite. The treatment uses a 1064-nm Nd:YAG laser passed underneath the skin to help melt fat and tighten the overlying skin. The laser treatment is followed by spot injections of the patient’s own fat into the depressed cellulite dimples. In the study, 52 women between the ages of 18 to 47 with severe cellulite were treated. After the laser tightening and fat injections, the women had weekly massage therapy treatments to help evenly distribute the fat. Patients were followed for at least one year or longer and nearly 85% of the patients rated their results as good or excellent.

While this studied treatment was not non-invasive (it was actually surgery), it does appear to offer some real effectiveness in cases of severe cellulite. I am not surprised that this approach worked as it disrupts the contracting bands from the heat of the laser probe (e.g. smart lipo) and adds select areas of fat to fill in the dimples. The postoperative massage  therapy helps smooth out the injected fat which may help the cellulite from reforming. For milder cases of cellulite, which makes up many cellulite problems, this approach is not appropriate and is too invasive. Milder cases of cellulite must rely on non-invasive external treatment methods of which none have shown significant effectiveness.

Dr. Barry Eppley

Indianapolis, Indiana

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