Harmless, but unpleasant
The first part of our article focused on the development and various degrees of severity of cellulite. Dr Christine Schrammek-Drusio and Christina Drusio will now examine cosmetic and medical treatment options.
Cellulite is not a disease. Rather, those affected suffer from the visual effects of the “orange peel skin”. Therefore, there are a variety of treatment options to reduce the unwanted dents.
Cosmetic treatments
Cosmetically, the visual appearance of cellulite can be improved, depending on the degree of severity. However, it is not possible without a healthy diet, abstaining from stimulants such as nicotine and alcohol and sufficient exercise. It is also important to combine the appropriate treatment method with highly concentrated active ingredients that stimulate the circulation and metabolism, regenerate, smooth and firm the skin – like biotin, guarana extract, ginkgo or sesame oil.
In addition to massages, peelings or manual lymph drainage, ultrasound can activate the microcirculation of the tissue and trigger the regeneration processes.
In problem zones, electroporation and micro needling may be used to strengthen the skin structure so that fat can press less against the skin from below. Other cosmetic treatments aim to strengthen the connective tissue and reduce fat mass, for example body wrapping (originally used in medical oedema therapy). Results will be visible after a few weeks. Compared to equipment-based procedures, wrapping is easy to implement and does not involve the purchase of expensive equipment. Intensive heat is generated under the foil and the blood circulation and metabolism are stimulated. The pressure and the applied ingredients activate the fat cells and push them together. At the same time, water and metabolic waste products escape from the cells and are drained away.
Leave that to a doctor
In recent years, new approaches have been developed for the treatment of cellulite, especially in the field of aesthetic medicine, with which good results can be achieved. However, just as in cosmetics, it should be a combination of treatment and a healthy lifestyle to achieve the best possible results.
Body wrapping generates heat and thus stimulates blood circulation and metabolism.
Local therapy: Locally applied active ingredients in combination with stimulating massages were the earliest attempts to get cellulite under control. The greatest challenge with these therapies is that the active ingredients reach their goal in sufficient concentration to achieve a therapeutic effect.
Active agents that have been tried and tested in application have above all a stimulating property (caffeine, theophylline), an effect that improves the skin structure (retinoids) or a hormonal effect (testosterone gels). Especially when using testosterone gels, which inhibit the breakdown of connective tissue, the doctor should check the hormone status in the blood prior to use.
Shock wave therapy (ESWT): In this gentle treatment method, a device generates shock waves that are transmitted to the tissue as intense mechanical pressure waves. The body responds with regeneration: stem cells are activated, blood circulation and lymph flow are improved, collagen formation is stimulated and the tissue becomes firmer. It usually takes several sessions to achieve a good result. The treatment can also be combined with other procedures such as (high-frequency) ultrasound, fat injection (injection lipolysis) or liposuction.
Fat removal injection (injection lipolysis): This method can be used to target fat in affected areas. It is used to reduce small, persistent fat deposits (e.g. double chin and under the belly button), but can also improve cellulite in the treated parts. A special active ingredient (phosphatidylcholine) is selectively injected into the fatty tissue and leads to the dissolution or melting of the fatty tissue. This triggers an inflammatory reaction in the tissue and the body then breaks down the fat on its own. The fat disappears and the overlying skin contracts slightly thanks to the elastic fibres.
Cryolipolysis: This is a non-invasive treatment that also aims to reduce fatty tissue and can consequently improve the appearance of cellulite. The fatty tissue is very sensitive to coldness and is being cooled to temperatures as low as minus eleven degrees Celsius. As a result, the fat cells are damaged or die. Within the natural healing process, the body then eliminates the fat cells in the following months and the tissue appears smoother and slimmer.
Liposuction: Since the 1970s, liposuction has been successfully performed to shape the silhouette of the body. It is obvious that by suctioning and removing fat cells in the affected areas, they are less able to press against the skin from below. However, there are no reliable studies that prove that cellulite can be successfully treated by liposuction alone. In fact, some studies have even shown that liposuction causes cellulite or even worsens it. Therefore, when it comes to fat reduction and cellulite treatment, combined procedures are used today, such as liposuction with laser lipolysis. This method is used for larger body areas and when skin sagging is the main concern. The laser is inserted into the subcutaneous fat tissue with the help of a cannula and causes the excess body fat to melt. In addition, the heat of the laser stimulates collagen synthesis, the skin is tightened and individual strands of connective tissue are loosened. Depending on the area, the treatment can take several hours and is therefore very expensive. The first results of this procedure can be seen immediately after the treatment. The final result of the treatment can be seen after about two to three months.
Subcision: The procedure describes the separation of the connective tissue strands (septa). The treatment is done on an out-patient basis and usually takes no longer than one hour. Beforehand, the doctor draws the dents in the skin while standing. Then, while lying down, he/she lifts the skin over the marked areas by means of a vacuum. Through a millimetre-sized skin incision, the device handpiece is brought into the tissue and a needle-like knife cuts through the strands of connective tissue. As a result, the skin is smoothed. This procedure is particularly suitable for individual dents. After a recovery period, the final result is visible in about six months.
