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Cellulite corresponds to a change in the skin that usually occurs in young adult women after puberty, where can be observed skin dimpling and nodularity, especially in the pelvic region, legs and abdomen.

Histological analysis of the skin shows that the fat tissue is located in small chambers of 0,5 to 1 cm surrounded by fibrous tissue (retinacula cutis). This fibrous tissue in the woman is arranged in arches with vertical or oblique direction and attaches the skin to deeper tissues and in spite of being elastic they have “memory” and try to come back to their original stretch. When an increase of the amount of fat tissue inside the chamber happens, naturally the skin tries to expand outside but the pull of the fibrous tissue causes the dimpling giving the aspect of orange skin (peau d’orange).

This condition is not a disease or inflammation but affects the skin esthetically as a result of the mechanical pull of the retinacula cutis after an increase of fat content in the chambers. It’s important to notice that cellulite occurs in almost 90% of women and is rarely seen in men because the distribution of the retinacula cutis is different.  Certain conditions can facilitate the appearance of cellulite due to retention of lymphatic fluid that increase the distention of the fat chambers, like the use of tight clothes and high stress lifestyle with an increase in catecholamine hormones for example.

The treatment for this condition is very discussed and you will see an impressive amount of different solutions that include exercises, cosmetic products, laser treatment and medication, none of which work in the practice because the problem is anatomic: You would have to cut each one of the retinacula cutis to solve it. Even dieting has mixed results, though in some cases diet can improve the look of the skin with cellulite.

Liposuction for the treatment of cellulite is a point in discussion, as the problem locates in the most superficial area of the fat compartment this is not the first tool in the treatment, some patients benefit of it when diminishing the deeper layers of fat tissue, achieving modeling of areas that are abnormally overstretched because of an increased deep component of fat, but the utility of the procedure must be evaluated case to case in a clinic evaluation and will be recommended when is thought to be useful due to added anatomic characteristics.

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