What is Cellulite?
Medically Reviewed by Arash Akhavan, MD, FAAD
Cellulite is a common, harmless skin condition characterized by a lumpy, dimpled appearance, often compared to the texture of an orange peel. It predominantly affects women, with studies indicating that between 80% and 90% of post-pubertal females experience cellulite at some point in their lives.
The condition most commonly appears on the posterior and lateral thighs, buttocks, and hips. Despite its prevalence, cellulite can lead to significant negative psychosocial effects, including body dissatisfaction and decreased quality of life. The demand for cellulite treatment is substantial, with the global cellulite treatment market valued at approximately $1.75 billion in 2022 and projected to reach $4.44 billion by 2031.
Cellulite manifests primarily in two forms on the buttocks and thighs:
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Dimples: Small, localized indentations in the skin.
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Rippled or Textured Skin: A wavy, uneven skin surface.
Understanding these variations is essential for selecting appropriate cellulite treatment options and managing expectations effectively.
What Are Cellulite Dimples?
Cellulite dimples are small, deep depressions that appear on the skin, giving it a pitted or dimpled texture, similar to the surface of a golf ball. Unlike the broader waves or ripples seen with other types of cellulite, these dimples are more localized and defined, often appearing on the buttocks and thighs.
What Causes Cellulite Dimples?
The primary cause of cellulite dimples lies beneath the skin, in the fibrous collagen bands called septa that connect the skin to underlying muscle. Over time, these bands can:
- Tighten or thicken abnormally due to genetics, hormonal changes, or aging.
- Pull the skin downward, creating visible dimples
This tethering effect is what gives cellulite dimples their characteristic sunken appearance, distinct from the looser, wavy texture of other cellulite types.
Treating Cellulite Dimples
Because cellulite dimples are caused by fibrous bands pulling the skin down, the only effective way to treat them is by releasing or eliminating these bands.
Outdated Treatments (Less Effective):
- Cellulaze: A laser-based treatment that attempted to break the bands but often resulted in prolonged downtime and inconsistent results.
- Qwo: An injectable treatment that chemically dissolved the bands but was discontinued due to side effects like bruising and skin discoloration.
- Cellfina: A mechanical, needle-based treatment that cut the bands. This was a great treatment but was replaced by the newer Avéli technology.
New and More Effective Treatment:
- Avéli: The latest and most advanced cellulite treatment, Avéli offers a highly targeted approach to cutting the collagen bands that cause dimples. Using a minimally invasive, single-treatment procedure, Avéli provides immediate and long-lasting improvement in dimpled cellulite with less downtime and more predictable results than older methods. For patients seeking smoother, more even skin, targeting the fibrous bands directly with modern treatments like Avéli is the most effective solution for eliminating cellulite dimples.
What Are Cellulite Ripples?
Cellulite ripples, also called cellulite texturing or wavy cellulite, describes the uneven, wavy appearance of the skin, often compared to the texture of cottage cheese or an orange peel. Unlike cellulite dimples, which are deep and localized, cellulite texturing appears as a broader, shallow undulation across larger areas of the buttocks and thighs.
What Causes Cellulite Texturing?
Cellulite texturing is caused by a combination of:
- Loss of skin elasticity – As collagen and elastin production slows with age, the skin becomes thinner and less firm.
- Enlarged fat lobules – Fat cells push up against the skin, creating a wavy, uneven texture.
- Poor lymphatic drainage – Fluid buildup beneath the skin can contribute to puffiness and uneven skin tone.
Unlike cellulite dimples, which are caused by fibrous bands, textured cellulite results from fat pressing against weakened, less elastic skin, making it ideal to address both the skin and underlying fat layers for improvement.
Treating Cellulite Texturing
Because this type of cellulite results from loss of collagen, skin laxity, and fat bulging, the most effective treatments focus on:
- Strengthening and firming the skin to improve its elasticity.
- Smoothing the underlying fat layers to reduce unevenness.
Ineffective Treatments for Textured Cellulite:
- Cellulite Creams: Despite marketing claims, creams cannot penetrate deeply enough to repair collagen or reduce fat.
- Endermologie: A mechanical massage technique that temporarily improves circulation but fails to address the underlying skin structure.
- Shockwave Therapy: A treatment using acoustic waves to break up fat deposits, which often provides only temporary results and is inconsistent for textured cellulite.
Effective Treatments for Textured Cellulite:
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Emtone: The most advanced treatment for cellulite texturing, Emtone combines radiofrequency (RF) and targeted pressure energy to:
- Boost collagen and elastin production for firmer, smoother skin.
- Improve lymphatic drainage to reduce fluid buildup.
- Smooth out fat lobules beneath the skin’s surface.
Emtone is non-invasive, requires no downtime, and is highly effective in reducing cellulite texturing on the buttocks, thighs, and abdomen.
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Biostimulatory Fillers (e.g., Sculptra or Radiesse): Injectable treatments that:
- Stimulate natural collagen production, thickening and firming the skin.
- Reduce the appearance of waves and ripples by improving skin structure and support.
Biostimulatory fillers are especially effective for mature skin with noticeable laxity and can be combined with Emtone for even greater results.
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Combining Treatments for the Best Results: Since textured cellulite is a result of both skin laxity and fat distribution, a combination approach is often the most effective. Many patients benefit from Emtone to tighten skin and improve texture, followed by biostimulatory fillers to restore volume and firmness.
By addressing both the surface skin and deeper layers, modern treatments can dramatically reduce the appearance of cellulite texturing, creating smoother, firmer, and more youthful-looking skin.
Arash Akhavan, MD is founder and owner of The Dermatology and Laser Group, one of the top centers for cosmetic procedures in New York City for over a decade. Arash Akhavan, MD, FAAD is a Board Certified Dermatologist and an Associate Professor at The Mount Sinai School of Medicine. Dr. Akhavan is a Castle Connolly Top Doc, New York Magazine Best Doctor, and Super Doctor featured in The New York Times. Dr. Akhavan is a key opinion leader that has been featured on hundreds of media publications including The New York Times, Allure, Marie Claire, Women’s Health, Cosmopolitan, ABC News, Fox News, Fox 5, NY1, WPIX, and more. He has been featured on nationally syndicated television programs such as The Doctors.
Dr. Akhavan serves as an educator and lecturer for multiple aesthetic device and injectable companies. This allows his office access to newer technologies at an earlier date than other offices, as well as a higher level of expertise in the use of these devices. This, in turn, translates to more effective and safer treatments for our patients.
By Arash Akhavan, MD, FAAD | | Categories: Body, Cellulite Treatment
