Cellulite Pathophysiology and Psychosocial Implications

Bass, Lawrence S.; Hibler, Brian P.; Khalifian, Saami; Shridharani, Sachin M.; Klibanov, Olga M.; Moradi, Amir

doi:10.1097/dss.0000000000003745

Cited by 5 publications

(2 citation statements)

References 38 publications

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“…The elusive nature of cellulite pathogenesis has resulted in a wide range of clinical therapeutic approaches aimed at improving the cosmetic appearance of all areas where cellulite may precipitate. 33 Given this plethora of overlapping information and approaches, there is clear value in attempting to form consensus on the relative efficacy and safety of contemporary cellulite treatment approaches. In this systematic review, we focus on the management of thigh and buttocks cellulite, with TS and CCH collagenase protocols.…”

Section: Discussionmentioning

confidence: 99%

Comparing Collagenase and Tissue Subcision for Cellulite Treatment of the Buttock and Thigh Regions: A Systematic Review and Meta-analysis

Foppiani,

Raska,

Galinaud

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: In this systematic review, we assessed the therapeutic efficacy and safety of Clostridium histolyticum collagenase (CCH) and tissue subcision (TS) for treating cellulite, which ranges from subtle to pronounced lesions. Methods: A systematic review was performed following PRISMA guidelines for CCH and TS treatment to the thigh and gluteal regions. A proportion meta-analysis was then conducted using Stata statistical software. Results: A total of 14 studies were incorporated into the final analysis. Nine focused on TS and five on CCH injection, collectively reporting outcomes for 1254 patients. Of these, 465 received CCH injection and 789 underwent subcision. For bruising, rates were 89% [95% confidence interval (CI), 71%–96%] with CCH injection and 99% (95% CI, 85%–99%) for subcision; pain requiring analgesic was reported at 74% (95% CI, 55%–87%) for CCH and 60% (95% CI, 43%–76%) for subcision; both showed induration at 7% (95% CI, 5%–11% for CCH, 95% CI, 2%–25% for subcision), whereas skin discoloration was higher post-CCH injection at 16% (95% CI, 10%–26%) compared with 7% (95% CI, 5%–10%) postsubcision. Conclusions: Both CCH and TS seem effective treatments for cellulite. However, upon evaluating the adverse outcomes between the two modalities, subcision demonstrated a higher incidence of bruising, albeit similar rates of induration compared with CCH injection. Conversely, the CCH injection group manifested a higher propensity for pain requiring analgesia and notably exhibited increased instances of skin discoloration compared with their subcision patient group. Further standardized research is crucial for more informed cellulite treatment decisions and for comparing efficacy, safety, and cost-effectiveness between TS and CCH.

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Section: Discussionmentioning

confidence: 99%

Comparing Collagenase and Tissue Subcision for Cellulite Treatment of the Buttock and Thigh Regions: A Systematic Review and Meta-analysis

Foppiani,

Raska,

Galinaud

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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“…Although cellulite is an aesthetic condition with no known adverse impact on health, it does have a profound psychological impact on those women suffering from it, many of whom go to extraordinary lengths to try to improve it. 8 As the majority of post-pubertal females have cellulite to a greater of lesser extent, it would seem sensible to prioritise the subjective feelings of the participants undergoing the treatment rather than rely on whether any objective test is capable of noting an improvement.…”

Section: Discussionmentioning

confidence: 99%

Participant Reported Improvement in Cellulite by Vari-Pad Apparel and Objective Measurements – A “First Use” Pilot Study

Kiely,

Poulsen,

Muschamp

et al. 2023

CCID

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Background Cellulite affects 80–90% of post-pubertal females and, although cosmetic, has proven adverse psychological effects. A new compression garment with patented “vari-pad” technology has been developed, aiming to stimulate lymphatic return from the buttocks and thighs. The primary aim of this small pilot study was to assess participant satisfaction after using this garment in the short term and secondarily, to look for any objective improvements. Methods Eighteen female participants (mean 47.5y, range 26–60) completed the study. There were 2 weeks of “stabilisation”, 4 weeks of wearing the garment, and 2 weeks of further assessment. With the initial assessment, there were 9 visits for each participant. At each visit, weight, participant satisfaction (0–10), 3D images (Canfield, USA) and transcutaneous water content (LymphScanner, Delfin Technologies, Finland) and comfort (0–10) were recorded. Results There was no significant weight change in any of the participants during the trial period. After 4 weeks of wearing the garment, there was a significant improvement in participant satisfaction of their cellulite (n = 15, p = 0.0036) with a mean improvement of 18.5%. 3D image analysis of dimple volume showed no significant change in buttock cellulite, a significant decrease in left thigh cellulite (n = 17, p = 0.0123), but not on the right (n = 14, p = 0.6890). There was a significant decrease of localised water (n = 36, p = 0.0041). Comfort was 86% (range 40–100%) and there were no adverse reactions to the garment. Conclusion The vari-padded compression garment produced a significant improvement in participant satisfaction after just 4 weeks of treatment. Objective measurements failed to show a significant difference in cellulite on the buttocks but showed a significant improvement in the thighs by analysis of both dimple volumes and reduced transcutaneous water measurements. Further study is suggested to demonstrate if longer timeframes for use of the apparel will lead to further significant improvement in the appearance of cellulite. NCT Number NCT05748678.

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Cellulite & Skin Tightening: A Review of Pathophysiology and Topical Treatment

Castellanos‐García,

Ramírez‐Zuluaga,

Páez‐Cárdenas

et al. 2024

Dermatological Reviews

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BackgroundCellulite is a localized skin condition that affects many women, particularly after puberty. It results from a complex interplay of several factors that lead to the characteristic dimpled appearance of the skin. Cellulite may cause psychological stress and negatively impact quality of life. Additionally, body skin laxity may further exacerbate cosmetic concerns in these patients. Consequently, multiple therapeutic options, including topical treatments, have been explored to address both cellulite and skin laxity.ObjectivesTo review the pathophysiology of cellulite and skin laxity, as well as topical skincare options for their management.MethodsA literature search from 2000 to 2024 was conducted using the databases PubMed, EBSCOhost, Scopus, and Google Scholar, with the key terms “cellulite,” “cellulite management,” “cellulite topical treatment,” “skin sagging,” “skin laxity,” and “loose skin.” The search included clinical trials, observational studies, book chapters, and review articles in English and Spanish.ResultsThe pathophysiologic mechanisms underlying cellulite involve a combination of histological, hormonal, genetic, and lifestyle factors. Several topical agents, including retinoids and methylxanthines, have shown potential in improving the cosmetic appearance of cellulite and may contribute to localized fat reduction. Emerging botanical extracts hold promise as topical treatments for cellulite and skin tightening.ConclusionsCellulite and skin laxity are prevalent cosmetic concerns with multifactorial and complex pathophysiologic origins. Topical treatments for cellulite and skin tightening require further investigation. Although some studies have demonstrated positive outcomes with skincare products and topicals, robust evidence and studies with extended follow‐up are still lacking. Additional research is necessary to evaluate the long‐term efficacy of topical treatments as standalone therapies for cellulite and skin tightening.

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Cellulite Pathophysiology and Psychosocial Implications

Cited by 5 publications

References 38 publications

Comparing Collagenase and Tissue Subcision for Cellulite Treatment of the Buttock and Thigh Regions: A Systematic Review and Meta-analysis

Comparing Collagenase and Tissue Subcision for Cellulite Treatment of the Buttock and Thigh Regions: A Systematic Review and Meta-analysis

Participant Reported Improvement in Cellulite by Vari-Pad Apparel and Objective Measurements – A “First Use” Pilot Study

Cellulite & Skin Tightening: A Review of Pathophysiology and Topical Treatment

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