how-to-treat

Cellulite Reduction Tools

Cellulite structure and physiology

 

Cellulite is a condition that affects 80-90% of  women in the Western World who are over the age of 20. Men also have cellulite but in very low incidence rates, which is due to a fundamentally different structure of the subcutaneous (under the skin) fat layer−a result of gender differences between male and female hormone levels.

Cellulite is caused due to a combination of conditions that are typical to women post puberty. These conditions include enlargement of the fat cells in the adipose (fat) layer of the hypodermis, weakening of the dermis layer of the skin and hardening of the connective tissue in the adipose layer. In addition, areas infested with cellulite tend to have a lower circulation and metabolism rate, inducing water retention in the area which worsens the cellulite appearance.

The subcutaneous adipose layer in females is composed of fat cells enclosed in between columns of connective tissue on two sides, the dermis from above and muscle below. After puberty these fat cells grow in size while at the same time the connective tissue becomes less flexible. In addition, the dermis layer of the skin becomes weaker due to reduction in collagen and elastin production, causing the skin to become lax. 
Enlargement of the fat cells and hardening of connective tissue that surrounds them, forces the fat to push up against the weakened dermis, causing the uneven, dimpled texture typical to cellulite.
In men, the fat cells in the subcutaneous adipose tissue are organized between connective tissue in a crisscross pattern; hence the fat is not pushed up against the dermis but is locked between strands of connective tissue, preventing the formation of cellulite.

Technologies that tackle cellulite

It is important to emphasize that none of the technologies mentioned below actually eliminate cellulite. Cellulite cannot be removed, but can only be reduced or its appearance improved. Furthermore, the best results are obtained from combining several technologies. 
To effectively reduce the appearance of cellulite, changes need to occur on a few levels. The size of the fat cells in the subcutaneous adipose layer should be reduced in size, and the dermis should be strengthened and thickened to reduce the effect of the bulging fat cells. It also helps if the connective tissue in the adipose layer becomes more flexible, which enables the compartments that store the fat in the adipose layer to expand rather than push up against the dermis. This article will evaluate the main technologies available on the market for cellulite reduction. It will not cover such methods as creams, wraps, exercise diets, etc.’

Endermologie

Endermologie technology, developed by LPG France, was the first treatment approved by the FDA for “temporary reduction of cellulite”. The Endermologie technology was introduced in the 1980’s as a non-surgical method to treat scars of burn victims. The treated patients noticed an improvement in skin texture and cellulite reduction, which led to an additional indication for use of this technology. 

Cellu M6, the device that utilizes this technology, is a massage device comprised of 2 rollers and a gentle suction action that deploys mechanical stimulation. According to the manufacture, the device activates natural processes in the treated area, including the stimulation of new collagen and elastin production, along with induced lipolysis in the subcutaneous adipose tissue. The company claims that this deep massage action also stretches the strands of connective tissue in the adipose tissue below the skin, causing them to stretch and soften, resulting in the reduction of compression in the chambers that box the fat cells, and thereby reducing the effect of bulging, bumpy skin typical to cellulite. Treatment involves 14-28 sessions once or twice a week followed by a monthly maintenance treatment. 

LPG has also developed a home use device, the Wellbox, for use by the client in the comfort of their own home. The Wellbox−to ensure patient safety− uses less suction power than the professional devices, therefore delivering less results. Nevertheless, patients can use the device as often as desired. Another downfall of the Wellbox is its high price, given the temporary results it delivers.

Ultrasound

Ultrasound cellulite treatment involves emitting high-frequency sound waves from a transducer. These waves vibrate the tissue, penetrating deep into the dermis and subcutaneous fat areas of the skin. This vibration creates heat in the affected tissue which increases blood circulation. In addition, the vibration causes pockets of low-pressure and high-pressure waves in liquids, leading to the formation of small bubbles with lower internal pressure (vacuum). When the bubbles collide with fat cells in the adipose tissue they collapse and cause the fat cells to break, due to the large difference between the pressure in the fat cells which is much higher than that in the vacuum bubbles (cavitation). This causes destruction of fat cells and release of their content into the extra cellular matrix. The released fat is then reabsorbed into the body via the lymph and vascular system.

Ultrasound treatments can be dangerous if performed by unprofessional practitioners. When a device emits focused ultrasound, it can easily damage blood vessels and bone.

Acoustic Wave Therapy (AWT)

AWT is characterized by the application of acoustic sound waves to the affected body regions. The sound waves cause vibration in the treated area which penetrates the skin and subcutaneous fat layer, causing an increase in temperature and in metabolism rate. In addition, according to device manufacturers, the vibration causes softening of the connective tissue columns in the subcutaneous fat layer, providing them with greater flexibility, hence enabling the subcutaneous fat compartments to expand, which reduces the pressure of the fat cells on the dermis above. The sound waves cause a vibration that induces the process of lipolysis (break down of fat) in the fat cells. In addition, the vibration changes the permeability of the fat cells, increasing the secretion of lipolysis bi-products from the fat cells into the area surrounding the cells. From there the bi products are cleared via the lymphatic and vascular systems to the liver or urine. The heat generated by the vibration induces heat in the dermis, causing the collagen to tighten.

Treatment protocol consists of about 30 minute sessions and, depending on the degree of cellulite, 6 to 10 sessions at 3 to 4 day intervals. Treatments should be accompanied by 30 minutes of physical exercise per day, a low-fat diet and drinking 2 to 3 liters of liquid per day to ensure rapid elimination of waste products.

Radio Frequency

Radio Frequency treatments for reduction of cellulite are very popular and effective. Radio Frequency induces an increase of temperature in the treated tissue. This temperature increase prompts the release of fatty acids from the fat cells in the adipose layer, causing them to shrink. In addition, the thermal effect achieved in the dermis causes tightening of existing collagen and stimulation of new collagen formation in the dermis. The combination of fat cell size reduction along with the tightening of the dermis leads to an improvement in the appearance of cellulite and in skin texture. There are many radio frequency (RF) technologies available: Mono polar RF is the first generation of RF, whereby the treatment area is less controlled and the energy applied is very high, which may cause some discomfort. Bi polar RF is the second generation of RF. It is more focused but the penetration depth of the energy is limited, and therefore most Bi Polar devices add suction to the treatment to enable working on a larger volume. This suction can be very painful, especially on the inner thigh area. TriPollar RF is the 3rd generation RF technology. TriPollar RF uses 3 electrodes inducing very focused and effective energy to the treated area, hence enabling good thermal heating without the need of suction or high power, resulting in an RF treatment that is very pleasant and effective.

It is also possible to perform TriPollar treatments in the comfort of your own home using the TriPollar Pose device. 
The protocol of TriPollar RF calls for 6-8 weekly treatments followed by monthly or Bi monthly maintenance treatments.

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TriLipo

The TriLipo technology combines TriPollar RF with Dynamic Muscle Activation simultaneously. TriLipo technology affects three layers: Muscles, subcutaneous fat, and the dermis. Combining the RF effect with muscle activation enhances fat drainage from the fat cells, as a result of contracting muscles pushing up against the fat cells, thereby inducing a squeezing the fat tissue. In addition, the muscle activation enhances the circulation in the treated area, improving the drainage of the bi products of the fat release. The muscle activation in the TriLipo technology adds an additional benefit of toning of the muscles below the fat tissue affected by cellulite. Improving the tone of these muscles helps with improving cellulite appearance as well.
TriLipo protocol calls for about 6 treatments that can be performed on a weekly or bi-weekly schedule.

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Summary

There are a few technologies that claim to target cellulite. None of the technologies mentioned above eliminate cellulite completely. When searching for cellulite treatments it is important to keep your expectations closer to reality and also to combine the treatment with lifestyle changes that include exercise and healthier food.

Cellulite Reduction Tools