Physiology of Cellulite - Causes, Myths

Cellulite affects many women and yet there is little information concerning the real causes of cellulite and prevention of cellulite. As part of Empire Medical Training’s Mesotherapy Course and Certification, we discuss these topics but for many physicians, they do not fully understand the development of cellulite and effective treatments for this condition. There are (3) layers of fat in association with our skin; adipose layer, deep reserve fat layers, and subcutaneous layer (4-6mm deep). Cellulite and the origins of cellulite reside in the subcutaneous fat chambers and these chambers tend to be regulated by hormones, not diet and exercise. Contrary to belief, cellulite is not caused by or is more prevalent in obese or overweight individuals. Hormone imbalances are the main cause of cellulitic changes in the subcutaneous fat layer over time and contribute to hormonal changes within the body. The hormone factors associated with cellulite development refer to excess estrogen levels at varying intervals which inhibit catecholamine-mediated lipolysis at the cellular level. This is why the incidence of cellulite is much greater with women rather than men besides the fact that women have fewer beta receptors in problem areas as well as having fewer chambers within the subcutaneous layers to store fat. Though hormones are the main cause of cellulite in women (85-90% incidence), vascular perfusion challenges, impaired venous and lymphatic drainage contribute to cellulite formation. Other contributory factors include smoking, poor diet, and genetic disposition to smaller subcutaneous fat chambers. Similar to acne, the cellulitic process is progressive and is not a condition that presents itself fully in a short period of time. Fat in the subcutaneous chambers become engorged (venous and hormone mediated), increased capillary permeability causes leakage of fluid and edema occurs within the chambers. The result is decreased lymphatic drainage of the area as the elastin fibers which make up these chambers become inelastic. Eventually, proteinaceous deposits cause stiffening of the septae of the elastin vertical fibers with possible permanent scarring and painful nodule formation.

However, there are preventative measures for younger people to delay or defer the development of cellulite. Diet, including natural estrogen blockers, does not allow for the large swing of estrogen levels. Educating patients and clinically grading cellulite for patients bring to light the need for intervention. Intervention can take on many roles including hormone balancing after child bearing years, estrogen blockers, mechanical treatments (i.e. Injections, RF, LLT, Ultrasound), and combination therapies. If you are interested in fully understanding your patient needs and be able to treat cellulite effectively for this condition as well as small fat pocket formation, Empire’s Mesotherapy Course and Certification will train you in the latest protocols and treatment options available.