Cellulite consists of surface relief alterations resulting in depressions and raised areas and thus irregular appearance, such as an orange peel, cottage cheese or mattress-like appearance of the skin, located mainly on the thighs and buttocks but also on the arms, abdomen, legs, and other areas. Depressed lesions are due to the presence of fibrous septa that pull the skin surface down; raised areas result from the projection of underlying fat to the skin surface as shown on anatomical and imaging studies. Women are most frequently affected by this condition; this is due to the structure and anatomy of the subcutaneous septa compared to the structure of men. In addition, cellulite is aggravated by progressive skin laxity or flaccidity, localized fat deposition and obesity. Furthermore, other factors have been implicated in the pathogenesis of cellulite, such as hormonal, biochemical, inflammatory and circulatory factors.
A new photonumeric severity quantitative and qualitative scale was developed and validated; five key morphological aspects of cellulite were identified for comparison. Each item was graded from 0 to 3, allowing final classification of cellulite as mild, moderate, and severe, according to the sum of the scores of the CSS.
Subcision: uma alternativa cirúrgica para a lipodistrofia ginóide (‘celulite’) e outras alterações do relevo corporal.
Based on clinical assessment of pre- and post-treatment standardized photographs on 232 patients, subcision was shown to be efficacious in the treatment of high-grade cellulite. Targeted specifically for the treatment of major cellulite depressions on the skin surface of patients with cellulite through three action mechanisms: sectioning the connective tissue septa responsible for the depressions; provoking the formation of new connective tissue from blood components; and redistributing the adipose tissue and the mechanical forces between the adipose lobules.