Category: Cellulite

After the Weight Loss

scaleOne of the good things about our nation’s obesity epidemic is that there are so many people affected by it learning to reverse the weight gain. I often ask people what made them ready for change.  In my practice about half of the massive weight loss patients I see had bariatric surgery and half used diet and exercise alone. Make no mistake. Both are hard work.

The US population has obesity levels that are sky rocketing compared to our parent’s generation.  Theories abound about the cause of this unprecedented rise, but there is no doubt that it has become a serious public health problem. Health benefits of massive weight loss are large, but people often endure aesthetic and functional impairments that do not go away with weight loss alone.

Studies show that people are pleased with the changes in their appearance after massive weight loss, but their body image satisfaction decreases after 2-3 years.

The change comes from quality of life limitations created by the deflated hanging skin. They experience functional impairments including limited mobility from excess inner thigh skin, postural instability from abdominal skin excess, and increased hygiene demands from areas where the overhanging skin rubs.  16% report sores, rash and skin breakdown. 60% are dissatisfied with the appearance of their thighs.  Many continue to feel uncomfortable about their appearance which can have an impact on sexual and social interactions. The removal of excess skin by body contouring plastic surgery can contribute to better, physical, psychological, and social function. 

Studies have shown that 75-85% of those who have sustained massive weight loss desire body contouring surgery. The desire for plastic surgery after weight loss is twice as frequent in women and inversely related to age.

For more information refer to the December 2012 issue of Annals of Plastic Surgery.

Beauty, Body Contouring, Breast Augmentation, Breast health, Breast Implants, Breast Reduction, Cellulite, Mommy Makeover, Uncategorized, Weight loss

Cellulite: Any Treatment Options?

The term cellulite means different things to different people. Cellulite refers to an uneven texture of the skin that varies from skin dimpling to lumps and bumps. Eighty-five per cent of adult women have cellulite so it is an entirely normal finding, and probably under the influence of hormones. In some women the irregular contour is barely noticeable and in others quite extreme. It is most commonly located on the legs, abdomen and buttocks. The contour irregularity worsens with aging. Cellulite can be a source of significant body dissatisfaction.

Because the degree of cellulite changes can vary so much, a classification system was proposed by Curri in 1991. There are four grades in this classification system. Grade I has no noticeable changes to the observer, but under the microscope the tissues show typical signs. Grades II-IV show progressive loss of elasticity, dimpling, waviness and bumps of the surface.

The cause of cellulite has not been clearly shown but the interaction of genetics, hormones, inflammation and weight changes are all being investigated. Connective tissue that crisscrosses through fat is largely responsible. The fat cells bulge over these restraining bands into the deep dermal layer of the skin creating nodularity.

Many therapies have been proposed for cellulite. It has shown itself to be resistant to most. The ineffective treatment modalities include lasers, massage, contact cooling, radio frequency energy, ultrasound, infra red light, suction, topical creams, oral medications and iontophoresis. The long list of unrelated therapies speaks both to the appeal to find a treatment and to the lack of understating of its cause.

Mild cases of cellulite are not worth undertaking frustrating treatment attempts. More severe cellulite may respond to skin tightening surgical procedures, such as a body lift or thigh lift. Fat transfer can help to camouflage surface irregularities. The surface therapeutic tools such as lasers and light based therapies are likely to disappoint. Additional scientific studies are necessary to draw final conclusions.

Cellulite, Fat Transfer / Fat Grafting

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