Cellulite Treatment- The Dermatology and Laser Group, NYC

Written by Arash Akhavan, MD, FAAD – Board Certified Dermatologist – Last Updated on February 1, 2023

What Is Cellulite?

Cellulite is dimples or depressions in the skin, most common on the buttock and thighs of women in their 20’s-50’s. It is estimated that as many as 9 in 10 women have cellulite. It is thus important to understand that cellulite is the norm and does not need to be treated. However, 85% of women with cellulite say that it negatively impacts their life and that is why we are proud to offer the most advanced options for the treatment of cellulite in NYC. We absolutely love treating cellulite. It is extremely fulfilling to see the joy on patients’ faces at their follow up visits when they see how much their cellulite is improved.

Anatomy of Cellulite

The main cause of cellulite is changes in fibrous bands called septa that tether the skin to structures below. When normal, these bands are necessary and good, keeping the skin smooth and attached to underlying structures. If we didn’t have enough tethering our skin and fat would actually sag. But some of these tethers can harden and shrink pulling down on the skin above and causing dimples.

Cellulite is not a condition caused by being unhealthy or overweight. Although fat can protrude around the septa worsening the appearance of cellulite, treating fat alone does not remove the cellulite. Similarly, a thinner dermis with less collagen can worse the appearance of cellulite allowing fat to protrude to a greater degree, but increasing skin thickness alone does little to improve the appearance of cellulite. Although changes in the dermis and adipose tissue are contributing factors, septa appear to be a substantial factor in the etiology of cellulite and are a key treatment target, particularly for sustained results.

Cellulite vs Loose Skin

Cellulite is a distinct condition from skin laxity although the issues can affect the same areas on women- the buttock and thighs. Skin laxity occurs with aging and weight loss and is a result of loss of collagen and elastic tissue. With a decrease in these structural proteins the skin is not able to support the weight of the fat and other tissues and loose, sagging skin becomes problematic.

Cellulite and skin laxity changes have a different appearance, as the edge of cellulite dimples are much more distinct. Another great way to differentiate between the two conditions is the lift test. When we are evaluating our cellulite treatment patients in our NYC office we alway perform a lift test, where you lift the skin superior to the area in question. If the area become smooth when you lift the skin, then you are most likely dealing with loose skin.

What Are The Treatments for Cellulite?

Understanding the causes of cellulite it becomes clear why creams, lotions, and massaging devices do not work as treatments for cellulite. We simply can’t effectively treat an internal condition like cellulite from the outside. Thankfully there a few minimally invasive options that are now available that are excellent options for the long term treatment of cellulite.

For true cellulite dimples caused by thickened and constricted septa there is an excellent device called Aveli. This device is far superior to previous treatments for cellulite tethers- Cellfina and Qwo. It will likely supplant them as the main treatment for long term improvement of cellulite dimples.

For patients suffering from skin laxity there is another device called Emtone that offers excellent results.

Introducing: Aveli

Aveli is a new device from a Silcon Valley technology company that selectively targets and releases the constricted septa that are causing cellulite. It does so without damaging the heathy septa supporting the skin.

Prior to the Aveli procedure patients are numbed with local anesthetic injections so that there is no pain during the procedure. The Aveli device is introduced under the cellulite dimple and the tethering bands are eliminated. This releases the cellulite depression. The procedure is safe and effective and minimally invasive.

Some Facts About Aveli Cellulite Treatment in our NYC Office

Aveli is a one time treatment and the cellulite dimples that are treated should be improved within months. As the procedure is only minimally invasive, most patients may resume normal day to day activity 24 hours after the procedure. Strenuous exercise should be avoided until any tenderness and swelling is resolved. This may take several days.

Cost

Aveli is a minimally procedure that should be performed by a Board Certified Dermatologist or Plastic Surgeon trained in Cosmetic Procedures. The cost for an Aveli procedure starts at $3,400. Our office may also offer discounts for sharing Before and After images. The exact cost can be determined at the time of consultation and will depend on the number of dimples being treated.

Before and After The Aveli Procedure

There is not much preparation necessary for this cellulite treatment. We ask our patients to avoid any optional blood thinning medications and alcohol for one week prior to the procedure. Medications prescribed or recommended by a physician, such as aspirin, should NOT be discontinued.

Remember to bring a dark pair of athletic compression pants (yoga pants) with you to wear after the procedure. Patients seeking Aveli cellulite treatment in our NYC office find treatments to be simple and easy to undergo.

When Do You See Results from Aveli?

The earliest results from Aveli are seen as soon as any bruising or swelling fades away. The dimples continue to improve with time with great results evident by 3 months.

Emtone

Some of our patients seeking treatment for cellulite are not candidates for Aveli. What some patients refer to as cellulite is not true cellulite dimples but is instead loose, hanging skin and lumpiness of fat. The best treatment for these patients is Emtone, a device that combines Radiofrequency (RF) and Targeted Pressure Energy (TPE) that smooths fat and improves collagen and elasticity in the skin.

Emtone is also great when combined with Aveli for the treatment of cellulite dimples that are combined with loose skin. Aveli would be completed first as a single treatment to improve the cellulite dimples. We would then begin Emtone treatments after a few weeks to help with skin tightening and smoothing. Treating both dimples and loose skin is a very popular cellulite treatment option in our NYC office.

Cellfina

Cellfina was a device we previously used for the treatment of cellulite dimples. It has now been replaced by the newer Aveli device. Cellfina uses a motorized blade to cut through cellulite bands from multiple angles.

Aveli is a superior device to Cellfina for multiple reasons. It is a much less traumatic procedure. Aveli is also a much more precise device for the treatment of cellulite as the physician is able to check that the septa being removed are the exact ones causing the cellulite dimple. With Aveli you can also confirm that the cellulite dimples have been treated before completing the procedure.

We have loved Cellfina cellulite treatment for our patients in our NYC office over the last 7 years. We are extremely excited to now be able to offer something even better to our patients.

QWO

Qwo was a product that was briefly available for the treatment of cellulite dimples. Qwo was an injectable medication called collagenase clostridium histolyticum that was injected into the collagen bundles that tethered the skin and dissolved them. Unfortunately treatments with Qwo also dissolves collagen in blood vessels causing massive bruising that can stain the skin. Although our patients all had amazing results with Qwo we discontinued treatment when other physicians began reporting issues with treatment.

Liposuction

Liposuction for cellulite treatment typically involves the use of a small cannula, or tube, that is inserted beneath the skin through a small incision. The cannula is then used to suction out the excess fat cells and reshape the area to create a smoother, more even appearance.

Liposuction can be an effective option for those seeking a more permanent solution to cellulite. By removing excess fat cells and reshaping the affected areas, liposuction can help to create a smoother, more even appearance. However, as with any surgical procedure, it is important to carefully weigh the potential benefits and risks before deciding to undergo treatment. Patients should consult with a qualified and experienced cosmetic surgeon to determine if liposuction is the right choice for their individual needs.

Mesotherapy

One benefit of mesotherapy is its versatility. The treatment can be customized to the individual needs of the patient, with the specific mixture of substances adjusted to target the unique characteristics of each patient’s cellulite. This can help to ensure that the treatment is as effective as possible for each individual.

However, the effectiveness of mesotherapy as a cellulite treatment is somewhat controversial. While some studies have shown that mesotherapy can improve the appearance of cellulite, others have found little to no benefit. One review of 13 studies on mesotherapy for cellulite found that while some patients experienced a reduction in the appearance of cellulite, the results were not statistically significant.

Endermologie

Endermologie is a non-invasive treatment that uses a specialized massage device to improve the appearance of cellulite. It has become a popular option for those seeking a non-surgical solution to this common condition. In this article, we will explore the effectiveness of endermologie as a cellulite treatment and discuss its potential benefits and risks.

Endermologie for cellulite treatment involves the use of a handheld device that uses suction and rollers to massage the affected areas. The massage action is intended to improve circulation, break down fat cells, and stimulate collagen production to improve the appearance of cellulite. The procedure can take anywhere from 30 minutes to an hour and is usually performed on an outpatient basis.

Cellulaze

Cellulaze is a minimally invasive laser treatment designed to reduce the appearance of cellulite. It uses laser energy to break down the fibrous bands that contribute to cellulite while also stimulating collagen production to improve skin texture and elasticity. In this article, we will explore the benefits of cellulite treatment with Cellulaze and discuss what patients can expect from the procedure.

One of the main benefits of Cellulaze as a cellulite treatment is its minimally invasive nature. Unlike traditional liposuction, which requires general anesthesia and a lengthy recovery period, Cellulaze can be performed under local anesthesia in a doctor’s office or outpatient setting. Patients can typically return to their normal activities within a few days of treatment.

Another benefit of Cellulaze is its ability to provide long-lasting results. Unlike other cellulite treatments, which may require ongoing maintenance to maintain the results, Cellulaze can provide improvements in cellulite that can last for up to three years or more.

Cellulaze also offers a high level of precision in treating cellulite. The laser energy can be targeted to specific areas of cellulite, allowing for a more customized treatment plan that can be tailored to the individual needs of each patient. The treatment can also be combined with other procedures, such as liposuction, to achieve a more comprehensive result.

Acoustic Wave Therapy

Acoustic wave therapy (AWT) is a non-invasive treatment that uses high-frequency sound waves to reduce the appearance of cellulite by stimulating collagen production. It works by stimulating blood flow, breaking down fat cells, and improving skin elasticity, resulting in a smoother, firmer appearance. One of the main advantages of AWT is its versatility. It can be used to treat cellulite on a variety of areas, including the thighs, buttocks, abdomen, and arms. Additionally, AWT can be used in combination with other treatments, such as radiofrequency or laser therapy, to achieve more comprehensive results.

Microdermabrasion

Microdermabrasion is a non-invasive cosmetic procedure that uses a special abrasive device to exfoliate and remove the outer layer of dead skin cells. This treatment can also be used to reduce the appearance of cellulite. Microdermabrasion has the ability to improve skin texture and tone. As the outer layer of dead skin cells is removed, the skin is stimulated to produce new cells, resulting in a smoother and more even skin texture. Additionally, the treatment can help to stimulate collagen production, which can improve skin elasticity and firmness.

References

Bass LS, Kaminer MS. Insights into the pathophysiology of cellulite: a review. Dermatol Surg. 2020;46:S77-S85.

Davis DS, Boen M, Fabi SG. Cellulite: patient selection and combination treatment for optimal results—a review and our experience. Dermatol Surg. 2019;45:1171-1184.

Brauer JA, Christman MP, Bae YSC, et al. Three-dimensional analysis of minimally invasive vacuum-assisted subcision treatment of cellulite. J Drugs Dermatol. 2018;17(9):960-965.

Young VL, DiBernardo BE. Comparison of cellulite severity scales and imaging methods. Aesth Surg J. 2021;41(6):NP521-NP537.

Stevens WG, Kaminer MS, Fabi SG, Fan L. Study of a new controlled focal septa release cellulite reduction method. Aesthet Surg J. 2022 Jan 28;sjac010.doi:10.1093/asj/sjac010.

Kaminer MS, Casabona G, Peeters W, et al. Validated assessment scales for skin laxity on the posterior thighs, buttocks, anterior thighs, and knees in female patients. Dermatol Surg. 2019;45:S12-S21.