A Possible Cure for Unsightly Cellulite?

Findings from a new study published in the November/December 2008 issue of Aesthetic Surgery Journal suggest that a combination treatment using laser energy and fat transplantation shows promise in significantly improving cellulite.  Cellulite is a common condition that gives the appearance of lumpiness and dimpling across the skin and is most prevalent in the thigh, hip, and buttock areas. Currently some treatments may provide temporary improvement in the dimpled appearance of cellulite, but to date there is no proven, permanent “cure” for cellulite.   “Cellulite is caused by bands of fibrous tissue that connect the muscle to the skin,” says Alan Gold, MD, President of the American Society for Aesthetic Plastic Surgery (ASAPS). “If these bands are tight and the fat between the muscle and the skin bulges out between them, there will be dimpling over each of those bands.  There is nothing otherwise special or unique about the fat itself in those areas.” Almost all women (and some men) have cellulite, stemming from genetic predisposition, hormonal changes and weight gain.

The treatment presented in the ASJ study first uses 1064-nm Nd:YAG laser energy conducted underneath the skin to stimulate collagen formation, skin tightening and, on a deeper level, to reduce fatty tissue.  Laser treatment is followed by injections of the patient’s own fat to fill in the depressed areas. Along with visible improvement, there are very few adverse effects, most of which are mild and temporary.

“The search for the cause of cellulite and effective treatments is ongoing, however, the combination of a minimally-invasive pulsed laser treatment and autologous fat transplantation represents a viable option for women who have severe cases of cellulite,” says Robert Gotkin, MD, a plastic surgeon in New York, NY and one of the authors of the study. “All treatments have limitations and since cellulite is a chronic condition, the patient must understand that there are no miracle procedures and multiple treatments may be necessary.”

The doctors treated 52 women between the ages of 18-47 with severe cases of cellulite who had not undergone previous surgical treatments such as lipoplasty or subcision (cutting scar tissue just below the surface of the skin). After the laser tightening and fat injections, patients received a massage to evenly distribute the fat and returned the next day for physiotherapeutic postoperative treatments. The follow-up period ranged from a year to almost 3 years, and nearly 85% of the patients rated their results as “good” or “excellent”.

Various methods of treating cellulite have been proposed including:

• Liposuction
• Fat Injections
• Lower Body Lift
• Endermologie
• Injection lipolysis
• Herbal and dietary supplements
• Creams and lotions

While some of these procedures, such as fat injections and lower body lift, have been shown to be beneficial in appropriately selected patients, others such as injection lipolysis and lotions do not have any scientific data supporting their efficacy.   Liposuction, while highly effective in reducing fat deposits and improving contour, sometimes makes cellulite appear worse.

Nd:YAG laser lipolysis and autologous fat transplantation are proven procedures for various aesthetic conditions, and, the use of these same modalities for cellulite treatment, may offer both a safe and effective new alternative. “Although there is currently no ‘cure’ for cellulite, this study provides hope for people who have the most severe cases,” says Foad Nahai, MD, Editor in Chief of ASJ.

About ASJ
Aesthetic Surgery Journal, owned by the American Society for Aesthetic Plastic Surgery and published by Elsevier Science, is a peer-reviewed international journal focusing on clinical and scientific developments in cosmetic surgery and cosmetic medicine.  The Journal has subscribers in more than 80 countries.  Besides its affiliation with ASAPS, the leading organization of board-certified plastic surgeons who specialize in aesthetic surgery, ASJ is also the official English-language journal of plastic surgery societies in Brazil, Israel, Mexico, Japan, Korea, Thailand, Costa Rica, Colombia, India and The Netherlands, and it is the official journal of the Rhinoplasty Society.   ASJ‘s Editorial Board includes plastic surgeons and Interspecialty Editors representing anesthesiology, dermatology, ophthalmology, otolaryngology and clinical psychology.  For information on the Journal, as well as subscriber and pay-per-view access to the Journal’s full text and graphics, go to www.aestheticsurgeryjournal.com.

About ASAPS
The American Society for Aesthetic Plastic Surgery, the leading organization of board-certified plastic surgeons specializing in cosmetic plastic surgery, includes Active-Member plastic surgeons certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada, as well as International Active Members who hold equivalent credentials in their own countries.  For information, visit www.surgery.org.