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Cellulite
Not excess fat: it is how the fat is arranged beneath the skin.
The most useful thing to know about cellulite is that it is not a question of how much fat there is, but of how it is arranged. Beneath the skin, adipose tissue is divided into lobules by fibrous septa connecting the skin to the deeper planes. When the lobules increase in volume and the septa stay rigid, the surface is pulled down in some places and pushed up in others: hence the irregular, orange-peel appearance.
This explains the observation that confuses most people: cellulite appears on lean, athletic bodies too. It is not an indicator of weight, nor of a sedentary life. What matters far more is tissue structure — in women the septa run perpendicular to the skin, and are therefore more likely to produce the effect — together with hormonal, circulatory and familial components.
From this follows something worth saying plainly: losing weight can reduce it but does not necessarily eliminate it, and in some cases significant weight loss makes it even more visible, because the skin loses tone while the septa stay where they were. It is why many people arrive frustrated after months of well-executed diet and training.
On treatments, the same honesty used for stretch marks is needed, because this is another area where advertising promises what the tissue does not do. The appearance of the surface can be improved, the circulatory component and tissue quality can be addressed, a localised accumulation can be reduced where there is one. An anatomical structure cannot be erased, and a serious pathway starts from there rather than promising otherwise.
Why it appears even on lean bodies
Because it does not depend on the amount of adipose tissue but on how it is organised. The fibrous septa connecting skin to the deeper planes pull the surface down at specific points: if the lobules between one septum and the next are even slightly raised, the effect shows. This is why diet and training improve many things but may not touch this one — and why being told "you need to lose weight" not only fails to help, it is often not even the right assessment.
How it shows
- Irregular, orange-peel skin surface
- Typical sites: thighs, buttocks, hips, sometimes arms and abdomen
- More evident when standing or when pinching the skin
- Present in lean, athletic people too
- Sometimes associated with heaviness or swelling in the legs
- Worsening with prolonged standing and in premenstrual periods
How we proceed
- 1Assessment of the picture: tissue structure, circulatory component, localised accumulations
- 2Distinction between cellulite, localised adiposity and skin laxity, which often coexist
- 3Definition of realistic goals before choosing the treatment
- 4Definition of the pathway and the sessions required
- 5Maintenance: without it, the result is lost over time
Available treatments
- First aesthetic medicine visit
- Carboxytherapy
- Biostimulation
- Scheduled follow-up
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Frequently asked questions
If I lose weight will it go away?+
It may reduce, but it will not necessarily disappear, because the mechanism is not the amount of fat but how it is organised between the fibrous septa. In some cases significant weight loss makes it more visible, because the skin loses tone while the underlying structure remains. This is why many people arrive after months of good dieting wondering why nothing has changed.
Are cellulite and localised fat the same thing?+
No, and confusing them leads to choosing the wrong treatment. Localised adiposity is an accumulation of fat in a specific area: it shows as added volume. Cellulite is a surface problem, of how the tissue is organised beneath the skin. They often coexist in the same person and the same area, and in that case the two components need different approaches.
Do creams work?+
They can affect hydration and the surface appearance of the skin, which is not nothing, but they do not reach the structure producing the irregularity: the fibrous septa and lobules lie beneath, where a cream does not reach. They are support, not treatment, and it is right to use them knowing what they can and cannot do.
How much improvement can I expect?+
An improvement in the appearance of the surface, often appreciable, but partial and requiring maintenance. Not elimination: the anatomical structure producing it remains. We prefer to say so beforehand rather than let it be discovered afterwards that expectations were badly built — on this subject exaggerated promises are the industry norm, and they are why so many arrive already disappointed by previous courses.
Related reading
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