Cellulite Treatments

Cellulite Treatments; At A Glance

  • Best Results2-5 sessions
  • Treatment Recovery0-2 weeks
  • Procedure Time30 to 90 min
  • Skin SpecialistDavin Lim
  • Duration of Results5+ years
  • AnaestheticLocal, gas, sedation
  • Back to Work1-5 days
  • Cost$-$$$$

Cellulite Treatments

Predictable & effective cellulite treatments are now available. Current research has shown that results can extend beyond 5 years. I use a combination of collagen stimulation & surgical techniques to improve the appearance of cellulite. Devices including radiofrequency are useful adjunctive treatments to help with lymphatic flow & collagen stimulation.

FactsFacts on Cellulite Treatments

  • Over the past 3 years there has been a greater understanding of how to treat cellulite
  • The consensus is a multimodal approach to address the causes
  • Surgical subcision breaks thickened vertical bands
  • Collagen stimulating dermal fillers supports the overlying dermis
  • RF or radiofrequency, infrared & suction devices aids microcirculation
  • Electromagnetic field therapy can improve lymphatic drainage & decrease secondary inflammation
  • New FDA approved collagenase injections are novel treatments

What causes cellulite?

We now know how cellulite forms. In knowing so, we can have effective treatments that target one of the three factors.

  1. Thin dermal layer. People who are prone to cellulite will often have a thin dermal layer. This layer acts to compartmentalise the lower fat layer. A thin dermis does not support the extrusion forces that originate from the lower fat layer.
  2. Enlarged adipose network. Below the dermis lies the fat. People with cellulite have more volume. This increased volume pushes up, leading to herniation of pockets of fat.
  3. Thicker fibrous bands known as septae separate the pockets of fat. These bands attach to the dermis, leading to divots.

Secondary pathology includes altered lymphatic flow & inflammation of the fibrous compartments.

What is the truth behind cellulite treatments?

The most important aspect to understand is that multimodality treatments are required to effectively treat cellulite. The answer does not lie in a device, cream, nor injection but the combination of correct methods pertaining to the pattern of cellulite.

Let’s dispel some myths regarding cellulite treatments.

Fact 1. A cream for cellulite removal does not exist. Creams can be used as adjunctively to complement surgical & energy devices. The results from creams as monotherapy is marginal at best. Creams are best combined with deep tissue massage.

Fact 2. A predictable device for cellulite treatment does not exist. Devices including mono, bi, & multipolar RF, lasers & shock wave therapy can be used as adjunctive global treatment for cellulite improvement. Devices are best combined with surgical procedures & dermal fillers.

Fact 3. Diffuse cellulite is harder to treat than focal divots. The former requires remodelling of the fibrous bands, thickening of the dermal-epidermal junction to improve extrusion forces outwards, as well as reduction of adipose tissue.

Fact 4. Liposuction does not treat cellulite. However, if combined with subcision, lasers & dermal fillers, the appearance of cellulite can be improved.

What is the best way to approach cellulite?

A logical way to treat cellulite is to combine modalities that address the cause. I employ 3 methods as follows-

RF bipolar & multipolar devices. These machines are used to stimulate collagen in the deeper tissues. A thicker collagen layer in the dermal-fat junction is more resistant to extrusion forces, hence can reduce the out-pocketing of adipose tissue. Devices can also modulate blood & lymphatic flow, further reducing the appearance of cellulite.

Surgical breakage of fibro septal network with various devices & techniques. This is most useful for isolated divots. Breaking the bonds of collagen holding down the upper layers of skin results in ‘release’.

Dermal fillers can be used to stimulate collagen production to support the dermis. I use a variety of collagen stimulation techniques including hyper dilute PLLA & calcium hydroxyapatite fillers.

Which forms of cellulite responds best?

Localised cellulite is easier to treat compared to diffuse or general cellulite.

Localised or focal cellulite consists of discrete divots or depressions. These are treated with surgical subcision followed by stimulation of collagen using dermal fillers & RF devices.

Can liposuction treat cellulite?

Liposuction as a sole modality does not treat cellulite, however in combination with other modalities including Cellulaze, subcision, Cellfina, & laser assisted liposuction, it can help reduce the appearance of cellulite.

Davin’s Viewpoint on treating cellulite

Cellulite is seen in over 95% of women, & despite its prevalence & impact, it still remains challenging to treat. This is one of the most difficult conditions to treat well, even though billions have been spent on research over the past decade. Only recently has the anatomy & physiology of cellulite been understood, & hence directed treatments based upon clinical examination will give higher yields compared to a one size fits all device. The best results are achieved via manual methods, much like the surgical work I perform on acne scars. If one approaches cellulite analytically, the chance of success is infinitely higher.

There has been a dearth of reports on the use of magical cellulite creams with theoretical value. The usual list of ingredients includes caffeine or ground coffee to modulate blood flow (one of the causes of cellulite), peptides, retinoic acid, retinol to build up collagen in the fibroseptal network, niacinamide to reduce inflammation seen in the superficial fat layer, as well as a plethora of natural lipolytic topicals that claim to improve or accelerate fat breakdown. The reality is that there is no formulation that is the gold standard. If you are after a cost-effective method, you can try ground coffee, it has the highest concentration of caffeine, combine this with a retinol of your choice.

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