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Cellulite Treatment  (Skin Dimples, Adiposis Edematosa and gynoid lipodystrophy) Cellulite

What is Cellulite?cellulite like skin of orange

Cellulite is a skin change that is claimed to occur in most (80-90%) women. It presents as a modification of skin appearance evident by skin dimpling and nodularity (like peau de orange) that occurs mainly in women on the pelvic region, lower limbs, and abdomen and is caused by the herniation of subcutaneous fat within fibrous connective tissue, leading to a padded or orange peel-like appearance. Cellulite is a description rather than a physical object. The term was first used in the 1920s.

Its existence as a real disorder has been questioned, and the prevailing medical opinion is that it is merely the "normal condition of many women and some men". It is rarely seen in males, but is more common in males with androgen-deficient states such as Klinefelter's syndrome, hypogonadism, post-castration states and in those patients receiving estrogen therapy for prostate cancer. The cellulite becomes more severe as the androgen deficiency worsens in these males.

Medically, this condition also called:
Adiposis Edematosa, Dermopanniculosis Deformans, and Gynoid Lipodystrophy.


Causes of Cellulite:

The causes of cellulite are poorly understood and may involve changes in metabolism and physiology such as gender specific dimorphic skin architecture, alteration of connective tissue structure, hormonal factors, genetic factors, the microcirculatory system, the extracellular matrix, and subtle inflammatory alterations:

pathology of cellulite formation



A- Hormonal factors: Hormones play a dominant role in the formation of cellulite. Estrogen may be the important hormone and initiate and aggravate cellulite. However, there has been no reliable clinical evidence to support such a claim. Other hormones including insulin, the catecholamine adrenaline and nor-adrenaline, thyroid hormones, and prolactin are all believed to participate in the development of cellulite.
B- Genetic factors: There is a genetic element in individual susceptibility to cellulite. Researchers have traced the genetic component of cellulite to particular polymorphisms in the angiotensin converting enzyme (ACE) and hypoxia-inducible factor 1A (HIF1a) genes.
C- Predisposing factors: Several factors have been shown to affect the development of cellulite. Gender, race, biotype, distribution of subcutaneous fat, and predisposition to lymphatic and circulatory insufficiency have all been shown to contribute to cellulite.
D- Diet: Dieting has shown to have variable effects on improving or worsening the appearance of cellulite.
E- Lifestyle: A high stress lifestyle will cause an increase in the level of catecholamine, which have also been associated with the evolution of cellulite.
F- Clothing: Wearing tight underwear enhances cellulite formation by impeding the flow of lymphatic fluid in the hips and thighs.


Treatment of Cellulite:

Numerous therapies for the treatment of cellulite are available, but the empirical evidence for the efficacy of these strategies is limited. i.e. “At this point, there is no outstanding treatment for cellulite.”

Some of these therapies include: cellulite

1.Methylxanthines: are a group of chemicals that include aminophylline, caffeine, and theophyilline. These chemicals are present in many cellulite creams and are promoted as treatments for cellulite because of their known ability to break down fat stores.
However, skin creams cannot deliver the required concentration of these chemicals for the length of time required for significant fat breakdown.

2.Dietary supplements: Several of these products have been marketed and contain a variety of ingredients such as ginkgo biloba, sweet clover, grape-seed bioflavonoid, bladder wrack extract, oil of evening primrose, fish oil, and soy lecithin.
These preparations have positive effects on the body such as boosting metabolism, improving circulation, protecting against cell damage, and breaking down fats. Because these products are sold as dietary supplements and not as drugs, they are not subject to the jurisdiction of the U.S. Food and Drug Administration (FDA). They are therefore exempt from meeting the scientific standards for both safety and effectiveness that are applied to drugs.
Furthermore, there are no valid clinical studies to support the use of these dietary supplements for the treatment of cellulite.

3.Massage treatments: Several machines have been introduced that massage the areas affected by cellulite. These machines use rolling cylinders to gather areas of skin and massage them inside a chamber. One example of massage treatments is Endermologie, which was developed in France and has been used for cellulite treatment. This technique uses an electrically powered device that suctions, pulls, and squeezes affected areas. Treatments are expensive and typically last for 30-45 minutes, and 10-12 treatments are typically required before results are noticeable. While a temporary decrease in the appearance of cellulite may occur, the technique appears to redistribute fat rather than permanently alter its configuration under the skin. Regular maintenance treatments are required after the initial effect has been achieved or the appearance of cellulite will return. Endermologie has been approved by the U.S. FDA for temporary reduction in the appearance of cellulite. LPG is also an ideal device to treat cellulite.

4.Laser or light therapy: The FDA has approved low-level laser (Diode LASER) or light-therapy devices that combine suction or massage with light therapy for the temporary reduction of the appearance of cellulite. Like Endermologie, these treatments require multiple treatment sessions and maintenance treatments to keep up the improved appearance.

5.Mesotherapy: Mesotherapy is a controversial treatment for cellulite that involves injecting drugs or other substances directly into affected tissue. Herbs and vitamins are often used as well in the injection cocktails. Multiple injections over multiple (typically 10 or more) sessions are administered.

6.Collagenase: Collagenase is a naturally-occurring enzyme in the body that breaks down collagen, a component of connective tissue (the tissues that bind our cells together). A study in 2006 suggested that injections with this enzyme may be beneficial in improving the appearance of cellulite. The long-term effects of these injections are still unknown, and studies have not yet been carried out to determine the extent and duration of the improvements, if any.

7.Cellulite diets: Special "cellulite diets" have been proposed that claim to be effective in treating cellulite. Arguments for these diets claim that the combination of foods in the diet can reduce inflammation and improve circulation in affected areas and diminish cellulite.

8.Wraps: Many spa centers offer herbal or other types of body wraps as treatments for cellulite. Like cellulite diets, their effects have not been proven or reported in controlled studies in the medical literature. While wraps may decrease fluid retention and improve the overall appearance of skin, these effects are temporary.


How Much Do Cellulite Treatment Typically Cost?

Although price is a factor when deciding on surgery, the most important factor is that you feel you are getting a good quality, natural-looking result from the procedure.

Cellulite treatment costs are variable according to the deformity and the used technique. Usually the cost is ranging from 500 to 1500 U.S. dollars. When dealing with costs, you also need to take into consideration the fact that the procedure may need to be repeated. Most medical insurance providers do not cover the procedure.


FAQ from patients when considering undergoing Cellulite Treatment?


Q - What is the type of anesthesia, and when I can return to normal life?
A - Local anesthesia, and you can practice your normal life within 2 hours.

Q - What are the symptoms that may occur in the first five days after Cellulite injection or LASER procedures?
A - Soreness which could be managed by pain killer’s medications and there may be edema or swelling.

Q - What are the guarantees that the success of the process?
A - There is no doubt that the followers of the medical instructions and close follow up visits are the main factors for the success of any surgical procedure.

Q - When can we get the final results?
A - The final results is achieved after the first three weeks.

Q - What is ideal age for Cellulite Management?
A - It could be done at any age.

Q - If you are not Egyptian, What is the minimum period for follow up?
A - One day for each session.

Q - What are the contraindications of Cellulite treatment procedures?
A - There are no absolute contraindications but the patients should inform their surgeons about any allergies, serious medical conditions, and medications they may be taking.

Q - Where will the Cellulite treatment procedures be performed?
A - In hospital or may be in outpatient bases (clinic).

Q - In my case, what amount is most appropriate in helping me achieve my cosmetic goal?
A - It depend on the your age, Cellulite features and your preference.

Q - How much does Cellulite treatment procedure cost and what elements factor into that cost like hospital fees, anesthesia, and so on?
A - Ranging from 500 to 1500 U.S. dollars. Medical insurance dose not cover these procedures.

Q - What is the surgeon’s level of experience in performing Cellulite treatment procedures?
A - Consultant or Doctoral in Plastic surgery.

Q - What percentage of patients experience complications with Cellulite treatment procedures?
A - 1 - 5%


Summary of Cellulite treatment (Adiposis Edematosa) Procedures:

The time of the procedure:
from half to two hours.
Type of anesthesia: No or
local anesthesia +/- sedation.
Location:
hospital or clinic without postoperative hospital stay.
Expected Side effects:
Temporary swelling and pain.
Recovery time:
return to work after 2 hours and the final outcome within 3 weeks.
Cost:
according to procedure ranging from 500 to 1500 U.S. dollars.
Results: usually permanent results.