Cellulite is a problem that plagues many women and increasingly also affects men. Although it is considered a cosmetic problem, it is a true medical condition that affects the subcutaneous tissue of certain areas of the body, in particular the thighs.
Poor circulation, both vascular and lymphatic, causes poor oxygenation and accumulation of waste products locally. With time, this induces tissue inflammation and oedema which underlie the typical orange peel appearance of cellulite.
The oedema causes a chronic inflammatory process. Physicians classify cellulite in stages; the first stage in the classification of cellulite (oedematous) is followed by the second (fibrous), the third (sclerotic) and finally, the fourth (fibrosclerotic).
Over time, the fat transforms into fibrous tissue (cellulite), which compresses the capillaries in the connective tissue, worsening the problems underlying the imperfection. This also explains the onset of pain and circulatory disorders.
More correctly called oedematous fibro-sclerotic panniculopathy (EFSP), cellulite has a multifactorial origin. Indeed, it may be due to hormonal disorders, eating habits, sedentary lifestyle, tight clothing, high-heeled shoes, overweight, stress, chronic anaemia and other causes that can, alone or in combination, affect the capillary wall and determine the pathological changes underlying EFSP.
The aesthetic physician is an ally in managing the problem. He or she can in fact identify the causes that have facilitated the condition and establish a personalised intervention strategy based on lifestyle advice according to the type of physical constitution and select the most suitable food supplements and cosmeceuticals, as well as targeted medical treatments. Among these, icoone®, biological mesotherapy and needling are worth mentioning.
Indeed, cellulite should also be fought “from within” with the correct diet. It is beneficial to drink water that is low in sodium and high in potassium. Potassium is contained in various foods, mainly fruit and vegetables. Drinking herbal teas containing horsetail, green tea, cranberry and other plants that help drain or strengthen capillaries is beneficial.
Further help can be provided by gemmotherapy or supplements, which should always only be taken on medical advice.
Among these, bromelain, cranberry, horsetail, grape seed extract, and vitamins C and E (useful for the formation of collagen), are beneficial.
For second and third-stage cellulite, there are specific supplements such as maritime pine bark extract, marine glucosamine and others that require a thorough medical history in order to be recommended.
Manual massage has always been an effective weapon in the fight against cellulite. Today this tool has been reproduced using a medical instrument, icoone, which is able to perform deep tissue massage.
This device provides treatment that never damages the capillaries, which, as mentioned previously, are particularly vulnerable in panniculopathy.
Icoone® is ideal for treating E.F.S.P. and imperfections such as cellulite, oedema, tissue laxity, flaccidity of the inner thigh, abdominal and inner arm sagging, localized fat, jodhpur thighs, remodelling the figure.
Treatment with icoone® generates an increase in the micro-circulatory blood flow and lymph flow and stimulates fibroblasts. The results are visible from the first sessions in which tissue fibrosis is reduced, lipolysis stimulated and collagen production increased. The skin regenerates, appearing firmer and more toned. The treatment is non-invasive and gives a deep sense of wellbeing.
A study conducted by researchers at McMaster University reveals that exercise also helps to keep our organism’s skin younger. At least three sessions of aerobic exercise a week can bring the clock back as much as twenty years. In fact, the skin will be healthier, thicker and firmer. The merit seems to be attributable to the lifting effect exerted by myokines, substances produced by the muscles during movement. icoone®, included as a substitute for one or more weekly exercise sessions, could help us to look younger and healthier, as well as combat cellulite.
Homotoxicological or biological mesotherapy is another effective weapon to fight cellulite and, like icoone®, in expert hands it is virtually free of side effects. It involves subcutaneously inserting, through the use of small needles, a mixture of substances that act on multiple levels and have the function of reducing cellulite. The technique is the same as for traditional mesotherapy with the difference that a mix of homeopathic and / or herbal remedies are inserted subcutaneously, while in traditional mesotherapy, drugs such as diuretics or phosphatidylcholine are used. Traditional mesotherapy has the advantage of acting more quickly but the disadvantage of greater side effects. Diuretics, much used in the past, are now much less used and in any case they are used at much lower dilutions because they can induce fibrosis in the tissue. Since the drugs are used not at homeopathic but allopathic concentrations, it is always wise to test for any allergies, as is also the case for herbs used in allopathic concentrations.
Mesotherapy is contraindicated if the patient is suffering from leukaemia or cancer, diabetes, infections of the blood or HIV. It should be avoided during pregnancy and breastfeeding.
The remedies used in biological mesotherapy are chosen depending on the type of cellulite to be treated and the patient’s constitution with the result of curing the problem and not merely reducing it from a cosmetic point of view.
There are remedies that serve to strengthen the microcirculation such as witch hazel, horse chestnut, grape vine, others that improve lymphatic drainage, others with revitalizing properties such as procainum, others that are lipolytic such as coffea cruda, acidum dehydrocolicum, and others such as olibanum that work by stimulating the fibroblasts. These remedies, alone or in combination and at different dilutions, perform a full-spectrum action on the problem and its more acute or more chronic components.
In addition to these, herbal extracts, such as Cynara scolymus extract and sweet clover extract, complete the job. Finally, mesotherapy agents such as trace elements, vitamins, coenzymes, free hyaluronic acid, DMAE, organic silicone, carnitine and sodium deoxyribonucleic acid, act as true bio-revitalizers.
The points selected to inject substances are not only those where the problem is located but also acupuncture points that give maximum results, both therapeutically and cosmetically, once an energy diagnosis has been performed and a treatment program set up.
Another effective medical weapon against cellulite is needling. This is also a biological technique. Indeed, it exploits the activation of the mechanisms of self healing of the skin by stimulating the production of collagen; needling is based on the action of controlled micro-trauma produced by the penetration of microscopic 1-millimetre needles arranged on a cylindrical roll. The regenerating effect starts to be seen after 2-3 months and reaches a peak after 6-8 months. Four sessions are required, a distance of one month apart.
Each of these techniques is effective alone but synergy maximizes the results. There are also mini-invasive surgical options to remove small localized fat deposits, which may be combined with these medical techniques. These include regional liposuction, a surgical but minimally-invasive technique, also called liposculpture, that eliminates localized excess fat.
Another popular treatment to aesthetically improve cellulite consists of treatments using ultrasound. The high-frequency sound waves that are produced by the ultrasound machine can reach deep into the area affected by cellulite. This action is targeted to heat the area in question, so that our body can direct a larger amount of blood there, thus allowing the flow of lymphatic fluids. The ultrasound waves attack the adipocytes and transform them into waste. To prevent this waste being reabsorbed by the adipocytes themselves, it is necessary to then perform drainage to allow it to be eliminated naturally.
Ultrasound waves, high-frequency sound waves, are imperceptible. In cosmetic cellulite treatment, a frequency of 3MHz is used to obtain penetration of approximately 2-3 cm. The drawback of this method, albeit rather rare, is the risk of small burns due to the heating of the plaques or thin, sensitive skin types. Generally, comprehensive treatment requires 8 – 10 sessions and can even be repeated twice a year for the most severe cases.
By Dr. Roberta Perna