An Exploratory Investigation of the Morphology and Biochemistry of Cellulite

Abstract

Dimpling of the skin of the thighs and buttocks is commonly referred to as cellulite, and it afflicts women much more frequently than men. Whereas many therapies that presume cellulite is caused by an abnormality of adipose tissue have gained recent popularity, the basic pathophysiology of cellulite has not been clearly identified. Theoretically, cellulite could reflect differences in adipose tissue biochemistry or connective tissue structure of affected versus unaffected individuals and/or of affected versus unaffected regions within an individual. We report here on direct experimental examination of these possibilities. Seven healthy adult subjects (five women, two men; four affected, three unaffected) underwent sonography of the thigh, measurement of regional in vivo subcutaneous adipose tissue metabolism (catecholaminergic responsiveness and blood flow) by microdialysis probe studies of the abdomen and the thigh, and full-thickness wedge biopsy of the thigh under local anesthesia. The presence of cellulite was defined as evidence of dimpling of the skin of the posterolateral thigh when the subject stood with the affected leg flexed to 90 degrees at the hip and knee. Any continuous area of skin at least 3 cm in diameter in which no dimpling was evident was designated as "unaffected." In all affected individuals, studies were performed to include both affected and unaffected areas of the thigh. In vitro pathologic examination of wedge biopsies and in vivo sonographic examination of the thigh both showed a diffuse pattern of extrusion of underlying adipose tissue into the reticular dermis in affected, but not unaffected, individuals. In vitro and in vivo studies also demonstrated that women had a diffuse pattern of irregular and discontinuous connective tissue immediately below the dermis, but this same layer of connective tissue was smooth and continuous in men. This connective tissue layer was more irregular and discontinuous in affected versus unaffected individuals. No significant differences were noted in subcutaneous adipose tissue morphology, lipolytic responsiveness, or regional blood flow between affected and unaffected sites within individuals. There is a sexual dimorphism in the structural characteristics of subdermal connective tissue that predisposes women to develop the irregular extrusion of adipose tissue into the dermis, which characterizes cellulite. These gender-related differences are diffuse and not localized only to affected areas. There is no evidence of any primary role for adipose tissue physiology, blood flow, or biochemistry in the etiology of cellulite, although the connective tissue of the female thigh is structured to accentuate differences in small subdermal adipose tissue depots.

The High Frequency (HF) Ultrasound as a Useful Imaging Technique for the Efficacy Assessment of Different Anti-Cellulite Treatments

“…Among the assumed parameters, the measurement of the length and area of subcutaneous tissue bands growing into the dermis should be noted. In cellulite, the dermis-hypodermis junction has a characteristic serrated appearance, which was already mentioned by other researchers [7,12,14]. The area of these subcutaneous tissue bands is very important.…”

“…One of the key problems in aesthetic medicine is connective tissue fibrosis involving mainly the thighs, abdomen and buttocks [3][4][5][6] which is referred to as cellulite. It affects approximately 85% -90% of female population and increasingly affects the male population, as well [7]. Until present, the stage of cellulite development has been usually assessed using palpation (and specifically developed scales), macrophotography or termography [4,[8][9][10].…”

Correlação entre alinhamento pélvico e fibroedema geloide

“…The stretching weakens and thins out the base of the dermal connective tissue, allowing the protrusion of fat in the dermo-hypodermic interface, causing the appearance of wavy and irregular skin 6 . The herniations of fat in the dermis are a characteristic of female anatomy 7 . Subcutaneous tissue in men, on the other hand, is characterized by horizontal and diagonal fascial bands, preventing herniation of fat 8 .…”

The Effect of Combination of Red, Infrared and Blue Wavelengths of Low-Level Laser on Reduction of Abdominal Girth: A Before-After Case Series

“…LLLT was suggested to induce the formation of transitory micro-pores in the cell membrane of adipocytes, allowing intracellular lipids to leak out. [13][14][15][16] Though, the biochemical mechanism of action of LLLT on adipose tissue is still controversial, one possible explanation might be that, absorption of laser light by mitochondrial chromophores (particularly, cytochrome C oxidase) of the adipocytes leads to increase of cyclic adenosine monophosphate (cAMP) production. Elevated cAMP stimulates cytoplasmic lipase, an enzyme that converts triglycerides into fatty acids and glycerol which can both pass through transitory pores, thereby leading to shrinkage of the adipocytes.…”