Cellulite is a herniation of subcutaneous fat within fibrous connective tissue. It manifests itself as dimpling and modularity in the skin particularly in the abdomen and lower body, particularly the thighs and buttocks. Cellulite is more prevalent in women than men and is estimated to affect about 80-90% of post-adolescent women to some degree.
The uppermost layer of subcutaneous tissue (hypodermis) consists of freestanding fat cell chambers filled with fat cells. These are separated by vertical walls of connective tissue called septa. Fibrous connective cords tether the skin to the underlying muscle, with the fat lying between. As fat cells accumulate, they push up against the skin, while the long, tough cords pull down. This creates an uneven surface or dimpling.
The apex of the upright fat chambers are in the form of an arc-like dome that can be prone to collapse under pressure from factors such as excess weight or fluid retention. These larger chambers generate smaller compartments of fat cells (known as papillae adipose) that cluster tightly under the skin. This combination of freestanding fat cell chambers and compartmentalized clusters of fat cells are the elements that create the change in appearance in the skin's surface known as cellulite. As fat cells accumulate, they push up against the skin, while the long, tough cords pull down. This creates an uneven surface or dimpling.
There is a decrease in the number of elastin and collagen fibers in cellulite tissue. It is believed that, as people age, these structural proteins generally begin to stiffen and lose their flexibility. Enlarged fat cells, accumulated fluids and toxins, and poor circulation (both blood and lymphatic flow) can exacerbate the loss of firmness. All of these factors are believed to contribute to the formation of cellulite.
Though excess fat does play a role in the formation of cellulite, reducing cellulite is not merely a matter of losing weight. The disruptions in the connective tissue of the skin that contribute to cellulite's unique appearance must also be addressed. Various forms of treatment for cellulite have been developed including cryolipolysis, massage, ultrasound, radiofrequency irradiation, and lasers, all with varying degrees of success.
Current laser treatments for cellulite involve inserting a laser cannula under a patient's skin and are therefore invasive procedures. The laser light melts the lumpy fat pockets and softens the fiber bands of connective tissue that hold them together. Non-invasive topical laser treatments have also been developed but do not produce photon pulse capable of going deep enough into the skin to stimulate cellular change.