Cellulite and methods for its correction

Svetlana Yudina, dermatovenerologist, Honored Doctor of Ukraine, chief physician of the Doctor Yudina clinic

The concept of “cellulite” dates back to the early 70s of the last century. Thanks to the close attention to this problem in aesthetic medicine, the impression of a cellulite pandemic in the world has been created.

Pathogenesis of cellulite

Adipose tissue is the most important organ of our body, with multiple functions: thermal insulation and mechanical protection of external and internal organs. It consists of fat cells, fibroblasts, macrophages, preadipocytes, and loose fibrous connective tissue. Adipose tissue develops from the moment a person is born and stops developing at puberty. A person lives with a constant number of fat cells determined genetically. A person’s weight fluctuations in the direction of decrease or increase are not associated with a change in the number of adipocytes, but with a decrease or increase in each adipocyte individually. The adipocyte is a unique cell that can accumulate fat and will increase in volume by 30-40 times.

Fat cells are metabolically extremely active, capable of synthesizing fatty acids from carbohydrates, and during periods of dietary restriction, supplying them to the body. This ability of adipose tissue is regulated by two processes: lipogenesis and lipolysis.

Lipogenesis is the synthesis of fats, which are synthesized by carbohydrate metabolism reactions; the process is regulated by carbohydrate metabolism reactions. Improper nutrition leads to increased formation of fats and fat depots.

Lipolysis is the reverse process of lipogenesis and is regulated by adrenaline, norepinephrine, insulin, glucagon, thyroid hormone and growth hormone.

The amount of energy a person expends has a significant impact on the volume of fat cells. Increasing activity reduces the volume of fat reserves, but only under the condition that significantly more energy is expended than is received. Otherwise, the fat cell - adipocyte reaches a large size, and since adipocytes are located in the cells of loose connective tissue, the simultaneous increase in adipocytes leads to compaction of the intercellular partitions. This impairs the blood supply to adipose tissue and interstitial pressure is formed - “stagnation”. This condition is reflected in the skin texture. This is how cellulite appears.

Cellulite can affect both fat and thin people, men and women, young and mature people. As a pathology, it begins when hypertrophy of adipocytes joins a disruption of microcirculation and metabolism of adipose tissue. The location of cellulite is different in men and women, as their fat is distributed differently. For women, these are the hips, buttocks and chest; for men, these are the abdomen, ribs, and shoulders. In women, fat mass makes up 20-25% of total body weight, and in men it is only 10-15%. It has already been proven that the rate of cellulite development directly depends on lifestyle. The provoking factor is poor nutrition (carbohydrate, fatty, smoked, fried, sweet drinks). Smoking also contributes to the development of pathology, since nicotine destroys vitamin C, on which the condition of the skin and connective tissues depends, and also causes a narrowing of capillaries and thereby worsens metabolism at the cellular level. Stress and a sedentary lifestyle increase cellulite.

For convenience, the following classification of the stages of cellulite development was adopted.

Stage I is a slight edema or swelling, the skin at this stage is even and smooth, but the body is already beginning to slow down venous blood flow and lymph circulation, the process of fluid retention in the subcutaneous fatty tissue, and waste products gradually accumulate in the intercellular fluid.

Stage II - swelling increases, slight lumpiness appears. The venous system can no longer cope with the amount of fluid that needs to be removed from the body. In this regard, the pressure inside the tissues increases, fat deposits become dense.

Stage III - orange peel is clearly visible. Connective tissue develops in the form of a mesh, similar to a honeycomb, superficial veins do not cope with their work, and blood stagnates in the capillaries. The walls of the capillaries weaken, the permeability of the walls of blood vessels increases. Some veins and capillaries weaken so much that they burst, causing permanent bruises to appear on the skin.

Stage IV - cellulite is clearly visible. The tuberosity is pronounced. Due to insufficient blood supply, the skin in cellulite areas is cold and has a bluish tint.

Cosmetology care

For more effective cosmetological care, an individual comprehensive program is developed, which includes: dietetics, psychophysiological and sports correction, the use of natural and medicinal products, cosmetic and hardware correction. Methods are selected individually for each patient.

Dietetics: an individual dietary table and lifestyle is developed, adapted to the specific rhythm of life of a particular patient.

Psychophysiological correction: the patient is consulted by a psychologist to bring the body’s state into mental balance.

Sports correction: it is necessary to activate the general tone of the body, enhance metabolic processes and sweating through physical exercise. Swimming, aerobics, shaping, sports equipment, and walking have proven themselves to be excellent.

Use of natural and medicinal products: additionally, natural special products, dietary supplements, metabolic “normalizers,” and fat burners may be recommended.

Cosmetic correction: manual procedures, general, medical and sports massages, lymphatic drainage massages, and spinal treatment are great help. In second place are wraps with professional medicinal cosmetics. Algal, hot, cold, cryogenic, medicinal, and compression treatments help remarkably. Thermal masks with the addition of two electrodes have proven themselves to be effective: electrical stimulation and electrophoresis.

The method of mesotherapy is actively used - the injection of active drugs into the middle and lower layers of the skin, where external agents usually do not reach. Accordingly, they act locally and solve two problems at once: they cope with cellulite and restore lost skin tone.

When correcting cellulite, cryotherapy (cryosauna) and cryomassage with liquid nitrogen are used. Short-term cooling to low temperatures causes a narrowing of blood vessels with a subsequent expansion of not only active but also reserve capillaries, which significantly increases blood flow and metabolism in the skin.

Ozone-oxygen therapy: the essence of the method is that a mixture of oxygen and ozone is injected into problem areas - without oxygen, fat breakdown is impossible. And with cellulite, due to poor circulation, adipocytes constantly lack oxygen. This method is good for hard cellulite, especially in the breeches area.

Hardware correction: it is better to use it in a combination of various techniques, which significantly increases the effectiveness of these methods.

Hardware lymphatic drainage is a method of rhythmic muscle stimulation that can effectively reduce the content of fluids and toxins in tissues and enhance lymph drainage. The basis of the method: low-frequency currents supplied to the patient’s body cause significant conduction currents in deep-lying skeletal muscles and nerves. Under their influence, metabolic processes in cell membranes are activated. Hardware lymphatic drainage has a myostimulating effect, which is why in cosmetic literature it is called myostimulation. Indications: nutritional-constitutional obesity, cellulite and diseases of the peripheral nervous system.

Ultrasound therapy: the method is based on a vibration-mechanical and thermal effect, used mainly for the treatment of fibrous cellulite. The effect is defibrosating, catabolic, reparative and regenerative. Indications: cellulite, hyperpigmentation, degenerative-dystrophic diseases of the joints, consequences of injuries, inflammatory diseases of the skin and muscles, atopic dermatitis, scleroderma, trophic ulcers.

Electrical stimulation is a treatment that uses pulsed currents to contract skeletal and smooth muscles. The method is based on the maximum sensitivity of the nerve fibers of the skin and skeletal muscles to pulsed current compared to other types of current. Therapeutic effect: lymphatic drainage, myostimulating, trophostimulating and vasodilating. Indications: severe swelling of soft tissues, cellulite, primary muscle atrophy, secondary muscle atrophy, nutritional-constitutional obesity.

Endermotherapy (synonyms endermotonia, dermotonia) is a combined effect on the patient of local vacuum decompression and roller massage. As a result of repeated movement of the skin, its blood flow increases and lipoliposis intensifies in the underlying layers of the dermis. As a result, muscle tone and muscle soreness progressively decrease, a feeling of lightness arises, and the functions of internal organs and systems are enhanced. It has a lipolytic, lymphatic drainage and vasodilating effect. Indications: nutritional-constitutional obesity, changes in skin texture, cellulite.

Microcurrent therapy: performed to strengthen connective tissue fibers and improve skin structure. The technique is good for small, dense volumes.

Pressotherapy is a dosed effect of compressed air pumped into corsets. This massage improves blood circulation and lymph flow, and accordingly, relieves swelling.

Finally

As a rule, women aged 25-50 years resort to cosmetic correction of cellulite, which, by the way, is expensive. A characteristic feature of people who have signs of cellulite and seek help is a high educational level - these are employees of financial institutions, creative intelligentsia, representatives of show business. They learn about the possibility of getting rid of cellulite from popular medical magazines and Internet portals. We have noticed that cellulite manifests itself most aggressively in people who smoke and lead a sedentary lifestyle. An associated risk factor is poor posture, prolonged immobility, crossing your legs when sitting, wearing tight clothes, high-heeled shoes for a long period - in 80% of women this leads to cellulite.

And one last thing. The possibilities of modern cosmetology, a healthy lifestyle and a person’s desire to get rid of this pathology can lead to a good result.

First published: "Cosmetologist" 2/2016