What is the cellulite?
So-called cellulite is a clinical situation that is characterized by the presence of a cutaneous irregularity of the surface of the thighs caused by a fibrous thickening of the subcutaneous connective tissue of the adipose tissue (lipodystrophy or panniculopathy). From a clinical point of view it does not represent an outright medical problem but over the years has taken on a very important aesthetic and sociological connotation and is today considered to be one of the main blemishes of a female body. It is important to stress that cellulite is not a form of overweight, but that it can be worsened by this, because, in women, any excess fat is deposited in the areas that are typically affected by cellulite, and also because excess fat causes a general heaviness in the body and, in particular, the flow of blood and lymph to slow down. It is therefore useful and a priority in any cellulite treatment to reach one’s ideal weight with a suitable diet and to maintain it with adequate physical exercise.
Cellulite in medicine literally means “inflammation of the cells of the subcutaneous connective tissue”. But, actually, the common condition know by this name is not an inflammatory process but represents a whole group of clinical situations which are not pathological and are different from one another. The term cellulite has now become of common usage, even scientifically and groups together various clinical conditions that recognize different causes and consequently require different therapeutic and corrective treatments. Then, sometimes, the different clinical pictures can appear together, and it is therefore important, to distinguish precisely the various clinical situations in order to ensure the correct diagnosis and therapy. Today, the diagnosis is possible thanks to objective instrumental methods, which are not invasive and repeatable, like ultrasound scans, and it is for this reason that there is no sense in tackling a treatment without a previous diagnostic assessment.
Accentuation of the normal female habitus
It is a situation that we notice in people with a generally normal weight, without any particular alterations of a metabolic or circulatory type, but who, instead, have a skeletal constitution with an accentuation of the diameter of the pelvis compared with that of the thorax. Therefore it is a non-pathological hereditary family condition, which is the expression of a lack of harmony in the figure, that it is not accepted by the aesthetic standards of today’s fashion. In this case it is obviously impossible to modify the structure of the person’s skeleton. If instead we undertake the correct development of the muscles of the upper part of the trunk we manage to achieve a partial re-harmonization of the silhouette.
Fatty tissue represents a normal presence in our bodies, which plays the role of an energy reserve. The presence of adipose tissue in the subcutaneous tissue also has the role of being a cushion between the muscular-skeletal adipose tissue in the subcutaneous layer and the skin. In this case its role can also be of an aesthetic nature, as it is able to attenuate any bony protrusion and muscular protuberances. Normally, the subcutaneous fatty cushion in the external region of the thighs in a thin woman is between 7 and 12 mm. In some areas of the body, however, the fatty tissue can be in excess (as much as several cms.) and be resistant to dieting, because it is composed of low density cells of lipolytic receptors, but which are absolutely normal as regards their function. Whenever, in normal weight conditions, there is a localized adiposity, the fat in excess needs to be treated surgically by liposculpture, or, non-surgically with the local subcutaneous introduction of active ingredients that are able to destroy the adipose cells directly, or with ultrasound therapy, that has the ability to break down the cellular membranes of the adipose cells.
Hypotonia of glutes
The gluteal muscle, if not stimulated by physical exercise, tends to diminish in volume and to sag downwards through gravity, pulling with it the underlying tissues (rear portion of the thigh), which will move laterally originating in an apparent accumulation of tissues. In this case, the treatment prescribes the anatomical reharmonization of the muscles with physical exercises and selective muscular stimulation, which are able to give tone back to the muscle, which, in recovering its original position, will take with it the excess lateral volume. A food supplement based on branched chain aminoacids will make it easier to recover muscular tone and, consequently, the pleasing aesthetic appearance of the buttocks.
Water retention, or hydropsy, is a condition that can develop in some women, particularly for causes of a dietary or hormonal nature. The exchanges of liquids between the blood vessels and the tissues are very active and complex and therefore it is easy to understand how, even a slight alteration, can interrupt this balance and thus give rise to an edema, that is, to a swelling of the tissue. The edema can be accentuated and become chronic through the effect of a sedentary life style and prolonged standing. It is, then, necessary to intervene with a diet that reduces the introduction of salt in the diet, corrects any hormone alterations that are present and leads to the elimination of the water retention in the lower limbs by the systemic introduction and deep dermis or subdermis introduction of drugs that are able to reactivate the altered micro-circulatory capacity, and by sessions of lymph drainage and/or pressotherapy.
his is a condition (it is the real cellulite) that develops for a series of predisposing basic factors, which are essentially anatomical, due to the distinctive architectural characteristics of women’s subcutaneous tissue, and to some motivating and aggravating factors, of an essentially hormonal type, but also ones of posture, circulation and diet, with an out-and-out suffering of the subcutaneous tissues. In its advanced phases we get to the stage of the formation of sclerotic fibrous tissue which appears on the surface of the skin, with hollows and bumps that give the skin that typical bumpy look that is typical of this condition (“mattress” or “orange peel” skin) It is evident from what we have just said that it is necessary to be able to diagnose the pannicolopaty in its initial phases. From the point of view of a clinical examination this can be difficult, but the medical history of the patient and her family, and diagnostic tests can help the physician in formulating a precise diagnosis. So the diagnosis is the fundamental moment for the therapeutic programme and is carried out via an ultrasound assessment. The treatment is complex, and, considering that the two main determining factors (the anatomical predisposition and the hormones) cannot be modified, requires the correction of the causative factors that can be corrected, the activation of the vein-lymphatic and capillary circulation in the lower limbs, the reduction of the volume of liquids stagnating in the tissues using manual lymphatic drainage or pneumatic (pressotherapy), the increase of the resistance of the walls of the micro and lymphatic vessels using drugs introduced into the deep dermis or subdermis, the reduction of any adipose excess using the subcutaneous introduction of ingredients that are active on the fat and the micro-massaging of the skin and connective tissue with suction. (Endermology) In the more advanced phases, in which the fibrosis is significant and the dimpling evident, a dermatological mini-surgical procedure called subcision may be useful.
The treatment of cellulite is therefore complex and, both from the functional and from the aesthetic point of view, requires a series of integrated methods, which often produce an improvement in the patient’s aesthetic appearance, but require constant application so as not to lose the benefits obtained.
Useless cellulite treatment
Anti-cellulite creams: no cream massaged on to the skin can reach the area of the cellulite which is deep, nor can it modify the anatomy of the subcutaneous layer. There are no scientific works that show a lasting clinical effectiveness of any product in the form of a cream.
Drastic diets: although it helps to maintain one’s ideal weight, to slim below one’s ideal weight is harmful, it does not diminish the cellulite or rather it makes it more evident, and creates aesthetic imbalances with other areas of the body.
Liposuction: the surgical technique of liposuction is a useful operation only in those cases in which there is a localized adiposity in excess in patients of a normal weight. It is not a slimming method and does not, in any way, modify the aspect of the cellulite; in fact sometimes it can worsen it.
Aesthetic treatments: Many anticellulite treatments have a merely temporary aim, and, taking into account some immediate benefits, even of a psychological nature that certain treatments doubtless offer, they do involve the need to be maintained indefinitely.
Birth control pills: The pill increases the level of hormones and generally increases the aspect of cellulite in subjects with a predisposition. Any anticellulite treatment requires the immediate interruption of the pill.