The Skinny on Cellulite

If you don't love the look of the back of your legs, thighs or butt because of the appearance of cellulite, - take some comfort in knowing that you are not alone. Not by a long shot... Despite what the computer-altered backsides of models in magazines look like, that fact is The American Society of Plastic Surgeons estimates that at least 85% of all women have at least some "cellulite", somewhere on their bodies. For women over 40, that number is thought to be more like 90%.

The term "cellulite" has actually been around for over 150 years, it was first coined in France. The word was used to describe the dimpled, mattress-like or orange-peely appearance of body fat often seen on a woman's thighs or buttocks - and sometimes seen on the abdomen or the back of the upper arms. The term was first crossed the Atlantic in a Vogue article published back in the 1960s. And a national obsession began. Today, cellulite treatments represent a 97 million dollar industry.

But what exactly is cellulite? What causes it? And of greatest interest to many women - what (if anything) can be done to get rid of it?

Most women mistakenly believe that there is something unique about this type of body fat, because of its distinctive appearance. But the truth is, scientists have analyzed cellulite using needle biopsies and found it to be no different in anyway to fat found in other areas of the body. It's really just plain old body fat.

So why then does it look the way it does?

The reason for cellulite's distinctive appearance is due to the nature of the structure of the skin and the connective tissue in areas where most body fat is stored.

Those lumpy, bumpy areas are caused by regular body fat pushing up against the upper layers of the skin from inside of cylindrical-shaped pockets of connective tissue below the skin's surface. The more that collagen fibers stretch, break down or even pull too tight, the more that fat cells will tend to bulge out towards the skin's surface, causing a rippled or dimpling effect which we term, "cellulite".

Cellulite can be "consistent feature cellulite", meaning that it is visible at all times, regardless of body position. Or it can be "pinch" or "compression cellulite" meaning that it is seen only when a women sits or moves in a certain position.

Unfortunately, (and file this one under "Life's not fair, Ladies, right next to "PMS" and "labor pains") the fact is that women are much more prone to cellulite than men: 1) because we have more subcutaneous (below the skin) fat and 2) because our skin is thinner.

Also, the structure of the connective tissue surrounding the fat cells in men is actually of a completely different shape. Men's connective tissue forms a criss-cross pattern, rather than a cylindrical one. This tends to press the fat down rather than push it up towards the skin's surface. That is why you rarely see cellulite in men, even very overweight men. However, it is seen in men who are deficient in certain male hormones such as androgen.

Moreover, importantly despite the vast amount of money spent on cellulite treatments, the truth is there is no reliable, proven way to permanently remove cellulite.

Certainly liposuction can remove body fat - but because cellulite is largely a function of the structure of connective tissue which supports and houses the body fat, liposuction typically does not improve the appearance of cellulite - and often actually makes its appearance worse.

Other treatments, such as creams, herbal wrapping, massage and endomologie (a vacuum suction with two rollers on either side) may remove fluid in the dermis area of skin - temporarily reducing the appearance of cellulite. However, this change in appearance stops as soon as the treatments do.

Another treatment is, Restylane. Restalyne is used by plastic surgeons to fill in depressions (such as smile lines) in the face. This treatment is much less effective in improving the appearance of cellulite and any effects are temporary and must be repeated regularly for continued results.

One dangerous (and dubious) cellulite treatment is "mesotherapy". In mesotherapy, an injection of a soy lecithin derivative which is supposed to dissolve fat is injected directly into affected areas. This is usually not recommended because the results are usually not very impressive and the treatment is associated with serious risk of bleeding, ulcers or drug interactions. Yikes!!

Another frightening therapy is called "subcision" in which a doctor uses a needle to break up connective tissue and fat. Not surprisingly, this technique is very painful, damages the skin - and even after all that is still not very effective.

TriActive is another technology, in which "cool lasers" using infared technology are rolled over the skin. The lasers are supposed to heat the collagen bands causing them to tighten, thereby hopefully smoothing out the appearance of the skin. However, both medical experts (and patients) have varied opinions about how successful this treatment is. And at an average of $2400, it doesn't come cheap.

VelaSmooth is yet another device, which has the same technology as TriActive - plus the addition of radio frequency energy. Supposedly, the radio frequency adds additional heat to tighten bands and break up fat cells. Again, results are very limited at best.

So the million dollar (actually ,97 million dollar) question is, "So, how do you get rid of cellulite? The most honest answer is - YOU DON'T.

But there ARE ways of reducing its appearance. Specifically:

Start with good "skin structure" genes - so choose your parents well.
Maintain lower levels of body fat (the recommended levels for women are usually between 18-25%, levels below 15-16% may be associated with menstrual dysfunction). Female athletes with low body fat usually have far less cellulite than sedentary women.
Avoid rapid fluctuations in weight, yo-yo dieting and extensive exposure to the sun - all of which can effects skin's elasticity and can worsen the appearance of cellulite
Have good muscle tone - when muscle tissue is firm below the subcutaneous fat layer - the appearance of the fat layer is usually smoother. Exercises such as squats, lunges and step-ups are great for toning all of the areas of the hip, butt and thighs, improving muscle tone and making legs firmer.

Also, keep in mind that cellulite is:

Not a disease
Not caused by poor circulation or damaged blood vessels
Not a hormonal or lymphatic condition

Even models, who are often thin (but frequently not athletic) often have cellulite. The reason that you don't see it - is that it is removed through the miracle of digital imaging. It used to be done with airbrush techniques, but now a few moments on the computer and all "imperfections" are erased.

To my mind this is really unfortunate, because it makes women some how feel like freaks. We've all been to the beach and taken a look around. You see that most women, even fit ones, have at least a little something visible on the thighs.

But, usually we forget what women's bodies really look like and continue to compare ourselves to altered images of models. My suggestion to my clients...workout...eat right...be sure to engage in resistance training with challenging weights two to three times per week...and find a healthy body weight that can be maintained, without going to extremes.

Also, I suggest not starring at your butt in the mirror (unless you are looking to admire how awesome you look - in which case by all means!!!) and just focus on being healthy - not "perfect"! It's a normal part of being a woman and you have plenty of company. Remember, 85% of women have at least some cellulite, somewhere - and the last time I checked 85% was a majority.