This we denominate as the cellulite complex. Slimming or reducing the edema in isolation improves this cellulite complex; however, this is not the correct way to treat cellulite. Thus, an accurate diagnosis and specific treatment for each disease is crucial; a mistake that repeatedly occurs in the evaluation of these patients.
The technique employed in this work aims at physiologically stimulating the lymphatic system; this difference, compared to other therapies, allows the results to be maintained for years. To achieve reductions in size is simple but increases are normally seen soon after ceasing treatment. This intensive method revolutionizes the treatment of cellulite.
The technique was conceived after developing new procedures to improve lymphedema. Patients under treatment for lymphedema observed that the cellulite was also improving. From these observations and a review of the literature about the subject, we came up with a physiopathological hypothesis about this condition. Our hypothesis is that lymphatic stasis results in an accumulation of all the substances drained by the lymphatic system [ 17 ].
In the initial phase of cellulite, an accumulation of fluids and other substances is identified in the interstitial space. Progression to the clinical condition is related to the concentration of these substances associated with local reactions due to this buildup. Thus, cellulite is a disease caused by accumulation. The hypothesis explains that the main cause of lymphostasis is related to the action of female hormones on the contraction of the lymphatics and the tonus of the vessels as well as exacerbation of substances in the interstitial space.
The therapeutic proposal is different to the majority of the published reports as it approaches the condition of restoring the pathophysiology involved in alterations to the interstitial space.
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It does not cure cellulite when there are triggering stimuli, though improvement of the physiology allows a balance of the hemostasis of the interstitial space and control of the cellulite. The important thing is not to injure the subcutaneous tissues during treatment as this may further aggravate the cellulite. Many methods aim at destroying the adipose cells and surrounding tissue, which can result in reduced volume by an inflammatory mechanism with lesions of the vessels thereby causing flaccidity as is observed with many of these treatments.
Another aspect to be considered is that this form of treatment does not lead to any weight loss. One hypothesis that explains these great reductions in size without weight loss is redistribution throughout the entire organism. This surprised her friends who thought she had lost weight and not gained weight. According to this hypothesis, the main substance mobilized is hyaluronic acid. This is compatible with the experience of patients with very dry skin who report a great improvement after treatment. Hence, this technique promises to revolutionize the treatment of cellulite.
A series of investigations are being carried out by the authors aiming at providing more data; one book is already available with further information about the different aspects of this approach [ 11 ]. We have been researching this technique for 10 years and have observed that several factors interfere in the results, and so the correct use of the method is crucial. Currently, we have more than patients evaluated using different forms of this method and of the results and failings that it presented and how the difficulties were solved.
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The difficulties found in relation to the evaluation of these patients are related to a reliable method of evaluation before and after treatment. Thus, a cheap method that provides more precise measurements is necessary to help to evaluate these patients. The form of intensive treatment of cellulite proposed in this study allows significant reductions of this disease. National Center for Biotechnology Information , U.
Journal List Dermatol Res Pract v. Dermatol Res Pract. Published online May Author information Article notes Copyright and License information Disclaimer. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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This article has been cited by other articles in PMC. Abstract Aim. Introduction Gynoid lipodystrophy cellulite can be regarded as the most investigated nondisease, because, from the cosmetic viewpoint, most women desire a reduction in the severity of cellulite [ 1 ]. Method A novel form of cellulite therapy was evaluated in ten patients with ages ranging between 25 and 59 years mean Patient no.
Open in a separate window. Table 4 Measurements before and after treatment at the gluteal fold region. Patient Right leg Left leg Before treatment cm After treatment cm Before treatment cm After treatment cm 1 57 55 57 55 2 Table 5 Measurements at the navel before and after treatment. Patient Before treatment cm After treatment cm Difference cm 1 Discussion The current study shows a novel intensive therapy for cellulite based on a new physiopathological concept.
Conclusions The form of intensive treatment of cellulite proposed in this study allows significant reductions of this disease.
References 1. Non-invasive evaluation techniques to quantify the efficacy of cosmetic anti-cellulite products. Skin Research and Technology. Cellulite: a new treatment approach combining subdermal Nd: YAG laser lipolysis and autologous fat transplantation. Aesthetic Surgery Journal. Rawlings AV.
Cellulite and its treatment. International Journal of Cosmetic Science. Cellulite: Nature and aetiopathogenesis. A multicenter study of cellulite treatment with a variable emission radio frequency system: Hottopics. Dermatologic Therapy. Lach E. Reduction of subcutaneous fat and improvement in cellulite appearance by dual-wavelength, low-level laser energy combined with vacuum and massage. Journal of Cosmetic and Laser Therapy.
We performed an analysis to estimate the overall effect of cellulite treatments from clinical studies. Medline library was screened up to December to identify eligible studies. We included 73 original studies in the present review. All of them were clinical studies, in most of them, only women were recruited. Above the studies searched up, 66 tested the effectiveness of an exclusive treatment performed without the association to other procedures: 11 topical agents, 10 shock-wave therapy, 10 radio frequency, eight laser therapy, five oral therapy, four manual massage therapy, three carbon dioxide therapy, two compressive therapy, two infrared therapy, one dermabrasion, and 11 devices that use an association of multiple treatments.
Seven papers tested a combination of two or more treatments. The mean difference of clinical morphologic features and ultrastructural changes between the treated group and the controlled showed significant heterogeneity between studies. It is still difficult to indicate an exclusive and effective single treatment for this condition. Our analysis purposed to obtain a complete overview of the available treatments in cellulite reduction. The cause of cellulite is still a matter of debate.
It is considered an endocrine-metabolic microcirculatory disorder that causes interstitial matrix alterations and structural changes in subcutaneous adipose tissue. However, its pathogenesis is not completely understood. Cellulite is a physiological phenomenon or at least, it has a physiological origin, which is characteristic of women, and multicausal, with the coexistence of a number of factors that trigger, perpetuate, or exacerbate it.
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The outstanding factors include, among others, connective tissue architecture, estrogen action, microvascular alterations, and certain genetic and hormonal characteristics. Cellulite treatment genesis of cellulite, it is considered that cellulite represents a condition in which fibrosis arises with the proliferation of fibroblasts around adipose cells in association with progressing peripheral circulatory failure and metabolic failure in normal tissue, thereby leading to progressively enhancing metabolic failure in adipose tissue and eventually to adipose tissue degeneration and advanced fibrosis in the surrounding tissues.
An efficacy testing of this variety of procedures is still missing, and there has been no large-scale study demonstrating their effectiveness. Z Irene et al. Disagreements of judgment were resolved by discussion between the review team members. All kinds of cellulite treatment were considered, including studies that used personal techniques.
The publications were screened manually and reviewed to identify reports for cellulite treatment. Three investigators independently reviewed and extracted data from the papers according to the predetermined criteria. Results We found references in PubMed. One hundred and sixty articles were excluded Fig.
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We finally collected 73 articles Table 1 , which satisfied our inclusion criteria: 70 were prospective studies, and 3 were retrospective studies. All of them were clinical studies. The first study was published in ,26 and most of the articles were published in the — period. Most of the studies recruited women only. The smallest trial27 enrolled 1 patient, and the biggest one enrolled subjects. The entire PubMed database was considered, until December Both English and not-English language papers were included.
No studies were excluded a priori because of weakness of design of data quality. The weight gain in both groups was apparent after the first 2 weeks Demographic data 42 patients 35 women 20 women 20 women 25— 57 years mean age Two-center, doubleblinded, randomized trial Retrospective study Prospective study Double-blinded, randomized trial Prospective two-center study Prospective comparative study Study design Anticellulite cream with occlusion by a bioceramic-coated neoprene garment Shock-wave therapy SWT Combination radiofrequency, infrared light, and mechanical suctionbased massage device An anticellulite cream was applied to the affected sites on a nightly basis.
Four blinded, independent dermatologist reviewers assessed the photographs for improvement. The results show a statistically significant improvement with regard to skin elasticity in group C, confirming the positive effect of treatment with CO2 alone on skin elasticity. In the other two groups, the results show that even if group A showed an improvement in skin elasticity.
Related Cellulite: Pathophysiology and Treatment (Basic and Clinical Dermatology)
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