Anna S.

Ranti

A local fat
accumulation
associated with
retention of water
and toxins and a
fibrous reaction of
the surrounding
conjunctive tissue
Anna S. Ranti

Gejala

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Keluhan
Timbunan Lemak
Efek kulit jeruk saat :
- Berdiri
- Berbaring
Tes Cubit
Anna S. Ranti

Stadium
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STAGE 1

Smooth skin surface. The mattress

phenomena is not produced in a pinch test

STAGE 2

The skin is smooth in standing and

lying position, but the mattress phenomena
is produced in a high pitch

STAGE 3

The skin surface appears smooth in a lying

position, when standing the mattress
phenomena occurs

STAGE 4

When standing or lying, symptoms are

clearly visible without a pinch test, partly
4
in disfiguring proportion

Anna S. Ranti

Types of Cellulite
Slight:
Visible when skin is pinched or when sitting
Compact:
Visible even when standing. Not painful when
pinched.
Loose:
Skin is quite loose when pinched. Not visible when
standing. This is due to water retention.
Painful:
Any type of cellulite with pain or discomfort when
pinched.
Anna S. Ranti

Types of Cellulite
When pinched, the fat is forced up
against the dermis, causing the
characteristic orange peel effect.
Much like how dough is pushed out
through a noodle making machine.
When they have grown very large, or the
connective tissues have weakened from
strain or age, as in the case of serious
cellulite problems, it would be visible
even without pinching.
Anna S. Ranti

 Cellulite appears less in males and more in

females
Female hormones affect cellulite formation
Female tissue has connective fibers that
connect from skin to fat in a vertical direction,
while males have it in a horizontal direction.
This leads to the 'orange peel' effect for
cellulite
Cellulite normally occurs in the overweight, but
those who are not may develop it too. Women
who are lean and fit can get cellulite too!

Anna S. Ranti

The connective tissues are constructed differently for

both genders. These walls are connective tissues
that are made up of collagen and elastin.
Men : have thicker skin, which is why fat doesnt
show up that well.
Men have connective tissues in such a way that
when the skin is pinched, the fat is angled
downward, women upward, thus hiding cellulite, if
there is any.
Women, have it worse.
Their connective tissues are constructed in a way
that shows cellulite more.
Anna S. Ranti

Contributing Causes to the

Onset of Cellulite
Poor lifestyle: Lack of exercise, not enough water causes
obesity and water retention, a contributing factor.
Obesity: Not a direct factor, but the increase in weight
tends to show cellulite in a worse light as opposed to a
leaner person
Hormonal changes: Cellulite occurs most often after
puberty, after pregnancy and before menopause.
It is related in some way to estrogen and Follicle
Stimulation Hormone (FSH).
Speculation is that cellulite binds with these chemical
receptors in some way.
Genetics: People whose parents have cellulite are more
prone to develop it.
9
Anna S. Ranti

Anna S. Ranti

10

FORMATION OF
CELLULITE
Cellulite also occurs regardless of the fitness of the person

involved.
Even the fittest and leanest of women have cellulite, though
it seems being fit delays the onset of it somewhat.
Three major theories as to how cellulite are formed are:
Adipocyte Hypertrophy: The enlargement of fat cells in the
body.
Adiposis: The clumping together of fat cells
Connective Tissue Problem: A breakdown and weakness of
connective tissues leading to cellulite.
Anna S. Ranti

11

LIPOLYSIS is mediated :
in part, the nervous system thru action on
the - and 2 adrenergic receptors on the
fat-cell surface
-adrenergic stimulators : theobromine,
thephylline, theophyllinacetic acid,
aminophylline, caffein, isopropylartenol,
epinephrine.
2 adrenergic inhibitors : yohimbine, alfayohimbine, piperoxan, phentolamine and
dihydroergotamine
12
Anna S. Ranti

in vitro shows that :

1. an agent activates the -adrenergic
receptor encourages lipolysis, or
reduction
in the fat cells size
2. an 2-adrenergic receptor
discourages
lipolysis by reducing blocking effects.
Additionally : 2-adrenergic inhibitor
may
allow lipolysis even in the presence
of an
13
Anna S. Rantiagent that stimulates both the - and

 In vitro studies :
An agent that activitates the adrenergic receptor:
Encourages lipolysis or reduction in the fats cellls size
An agent that activates alfa2 adrenergic receptor
discourages lipolysis by reducing blocking effect.
So, they all : can encourage lipolysis.

Studies of fat cells have shown that ADRENERGIC

Agonist can directly increase intracellular cAMP levels and
stimulates lipolysis by releasing cAMP thru inhibiting
phosphodiesterase.
In the adipocyte, cAMP triggers triglyceride hydrolysis.
Anna S. Ranti

14

1.
2.
3.
4.
5.

Methylxanthines
: inhibit phosphodiesterase
Silanols
: protect connective tissue
Silanols
: help tissue drainage
CoA + L-carnitine :
Herbal treatments for local edema :
venotonic activity

Anna S. Ranti

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Agent
Aminophylline
Aminophylline
Aminophylline
Aminophylline
Aminophylline/Yohimbin
Caffeine/Theophyllin/
Herbal
Caffeine/L-carnitine/coA
Theophyllineacetic acid/
methylsilanetriol
Mannuronic acid/
methylsilanetriol

% agent

5 obese
5 (27-47)
28 obese
23 obese

Length of
treatment
28
28
49
42

3-10
control
10
10

Girth reduction
(inches)
0.75(ave)
0.50-1.25
0.25
0.50-0.75

5 obese

28

N/A

0.50-1.75

20 normal

30

1.0(ave 5%)

25 normal
9 normal
15 normal

28
30
60

5
6
6

1.64(ave.8.2%)
0.75-1.25
1.25-2.75

10 normal

50

0.25-1.25

Subjects

Obese : more than 20% overweight

Anna S. Ranti

29

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30

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31

No increase in theophylline serum measurements

were noted with the 10% aminophylline over the use
periods. (A spectrophotometric method was used to
measure theophylline levels; coffee, tea, chocolate,
and acetaminophen can give falsely high values.) No
significant changes were seen in blood pressure,
pulse or chemistry results except for a reduction in
triglycerides and an increase in FFAs.
Anna S. Ranti

32

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36

2-adrenergic receptors stimulate the hydrolysis to

FFAs and glycerol (lypolisis) of fat that has been stored as
triglycerides.
- adrenergic agonists or -/ 2-adrenergic
antagonists at the adipocyte surface stimulate lipolysis.
2-adrenergic stimulators primarily
methylxanthine derivatives promote lipolysis by inhibiting
phosphodiesterase, which transforms cAMP into AMP.
At cellular levels, silanols (monomethylsilanetriol,
for instance) combined with a phosphodiesterase inhibitor
(such as theophyllineacetic acid) have 7 times greater
lipolysis stimulating activity than do common, reference
lipolytic compounds (such as theophylline).
Anna S. Ranti

37

Silanols also normalize water mobility through

cellullar membrane by increasing the amount of polar
amino acids, particularly in elastic fibers.
CoA and L-carnitne assist in transporting resultant
FFAs to mitochondria to hasten oxidative degradation.
Silanols bound to othe rmoieties as
theophyllineacetic acid have been shown to inhibit freeradicals and to stimulate fibroblasts, leading to the
regeneration of connective tissues.

Anna S. Ranti

38

Before and
after
treatment
with the
anticellulite
cream and
anticellulite
shorts.

Anna S. Ranti

39

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46

Cellulite

Anna S. Ranti

47

The Bare Facts

The bane of bikini lines everywhere, cellulite is
a rather embarrassing problem.
The problem is almost exclusively isolated to
the fairer sex, though men are prone to it.
In addition, women of Caucasian and
Mediterranean descent are more susceptible to
it, though those of other ethnic groups are not
spared.
It is immediately recognizable, looking as if the
skin is crinkling or dimpled like orange peel.
Sometimes, when pinched, it could be painful.
48
Anna S. Ranti

The Bare Facts

Cellulite, after all the hype, is still fat.
Under a microscope, cellulite looks like fat cells
clumped together.
As it gets bigger, it displaces, and bends collagen
and elastin fibres around it.
These displaced fibres now cannot perform their
function: supporting the skin, and thus the skin
ends up with the characteristic orange peel look of
cellulite.
It is most often found on the hips, abdomen, thigh
and buttocks of women
Anna S. Ranti

49

The Bare Facts

Do you have cellulite?
Gently pinch an area between your thumb
and forefinger.
Check if the flesh dimples between your
fingers like an orange peel.
Stand and sit while looking at yourself in
the mirror.
If the flesh crinkles like orange peel, that is
cellulite!

Anna S. Ranti

50

The Bare Facts

The Bare Facts
In a section of skin, there is an epidermis,
the outermost layer of skin that acts as both
insulation and a protective covering against
the outside environment.
Below that is the dermis.
Underneath the dermis, are two layers of
subcutaneous fat and then the muscles of the
body.
Interlaced with the first layer of fat and the
skin are nerve endings and blood vessels.
51
Anna S. Ranti

Cellulite Fast Facts

Exercise, dieting and liposuction don't affect cellulite
directly. They all help but don't solve the problem.
Liposuction does not remove cellulite; it only makes it less
obvious.

Anna S. Ranti

52

Why does it happen to

me?
The exact reasons for cellulite formation are
unknown.
There is still speculation , but some facts are quite
apparent.
It happens in women more than men because of
female hormones such as estrogen.
It also tends to happen mostly after puberty, after
pregnancy and before menopause, the three times in a
womans life where their hormones reach a peak.

Anna S. Ranti

53

Why does it happen to

me?
After extensive research on both male and female
subjects, and cadavers, doctors also determined that,
contrary to popular opinion, cellulite is not caused by the
popular perception of damaged blood vessels, decreased
blood circulation, a weakening of capillaries or an enlarged
lymphatic condition.
Currently, the process of how it occurs is still not fully
understood, though things are going through an
elimination process to determine how it actually works.
Researchers are, however able to determine what
contributes to the problem.
Anna S. Ranti

54

What does work on cellulite?

Current solutions that various beauty companies and
medical bodies comprise intense exercise, cellulite creams
that promise to reduce or eliminate cellulite or slimming
drugs.
Research is still inconclusive as to the possible
benefits of such compounds.
Some people find one compound effective, others do
not.
There are various possible solutions for cellulite,
though there is no sure fire method, barring liponic
sculpturing.
Anna S. Ranti

55

What does work on cellulite?

Liposuction does not directly help cellulite. It only
works on the underlying body fat.
Before one gets any ideas, surgeons would avoid the
layer where cellulite resides, it is full of nerve and blood
vessels, making permanent damage likely.
There are some new surgical techniques that inject a
persons own body fat into the layer where cellulite resides
to even out the orange peel effect, but the problem remains
in that the fat would be reabsorbed by the body.

Anna S. Ranti

56

CELLULITE TREATMENT
Tri-Active LaserDermology (SM) is the result of the
newest FDA-approved technology incorporating tripleaction methodology for restoring a normal balance to the
skin and outer layers, including smoothing and tightening.
The treatment reduces the appearance of cellulite
through the combined action of mechanical massage,
localized cooling, and deep laser stimulation.
The Cellulite Endermologie Center in Manhattan is
one of the first facilities to possess the treatment in the
U.S., and the only center in New York City with the
technology.
Anna S. Ranti

57

CELLULITE TREATMENT
The triple-action technology employs deep laser
action from six diode lasers that enhance microcirculation.
The treatment's mechanical massage brings deep
massaging and stimulating action on the subcutaneous
tissue, which results in a tighter appearance in the treated
areas.
This particular treatment, when done in a series of
sessions, offers an effective way to significantly reduce the
appearance of cellulite and enhance the overall appearance
body contouring.

Anna S. Ranti

58

CELLULITE TREATMENT
Normally, the series can be done annually with
follow-up monthly maintenance treatments.
Tri-Active systems were originally developed three
years ago by laser scientists in Italy and are in use all over
the world.

Anna S. Ranti

59

Solving the cellulite puzzle

"Patients are asking questions," says Dr. Goldman,
"because the press is talking. If they can't go to a
dermatologists for answers, where will they go?"
Last year, Dr. Goldman gave one of the first American
Academy of Dermatology (AAD) lectures on the topic, but
getting a slot on the program wasn't easy.
The AAD public relations staff was on his side, but
the conference committee balked, he says.

Anna S. Ranti

60

Solving the cellulite puzzle

He prevailed by making the case that:

All women have cellulite.
They don't like running around the pool with cottage
cheese thighs.
Some treatments work; others are scams. Dermatologists
need to know the difference.
Cellulite is a huge international business.
On the last point, Dr. Goldman adds, "Even in the
middle of Estonia, Latvia and El Salvador, you find
pharmacies selling treatments and creams.
Suddenly, the U.S. cosmetic industry is realizing the
profit potential."

Anna S. Ranti

61

Solving the cellulite puzzle

Defining, treating One of only two dermatologists in
the United States researching cellulite, Dr. Goldman
describes the condition as a normal physiological
condition in post-adolescent women.
From an evolutionary perspective, fatter women have
a better store of calories for pregnancy and lactation.
Adipose tissue also helps with thermal insulation,
support and protection of organs.

Anna S. Ranti

62

Solving the cellulite puzzle

When adipose deposits increase in the thighs and
buttocks, the longitudinal fibers of connective fascia
segregate it into channels.
But perpendicular tissues remain fixed.
This causes the skin to pucker or dimple.
In primitive societies, cellulite was a sign of beauty.
Today, it's a sign of being overweight and out of shape.
Four modalities Treatment falls into four modalities:
lifestyle measures, topical agents,systemic agents and
physical therapies.
One of the most popular is mesotherapy.
Anna S. Ranti

63

Solving the cellulite puzzle

Featured often in magazines and television news
programs, it involves direct injection of pharmacologic
agents into the venous circulation, or local infiltration into
the dermal-subcutaneous junction.
In theory, the agents reduce cellulite through lipolysis
of fat or reduction in the size of adipocytes.
"This has been going on for 10 years in South
America," says Dr. Goldman. "There's no scientific
evidence it works."
According to Dr. Goldman, cellulite can't be cured.

Anna S. Ranti

64

Solving the cellulite puzzle

However, the appearance can be improved.
Patients want easy, inexpensive treatments that are
slow to reverse.
For patients who don't need immediate results, Dr.
Goldman recommends using a topical cream, possibly with
occlusion, at a cost of approximately $20 for several
months of treatment.
He has tested several creams, markets one himself,
and says some work quite well.

Anna S. Ranti

65

Solving the cellulite puzzle

Study results In a recent double-blind, randomized study,
Dr. Goldman evaluated the efficacy of a nightly cream on
17 women with moderate to severe cellulite.
At the four-week endpoint, 76 percent of subjects reported
an overall improvement in their condition.
Dermatologist evaluators found improvement in 65 percent
of treated legs with occlusion and 59 percent in treated legs
without occlusion.
Creams take about a month to work. For patients seeking
faster results, Dr. Goldman suggests a three-step program.

Anna S. Ranti

66

Solving the cellulite puzzle

It begins with ionithermie, which uses lotions to break
down fatty deposits and release toxins, followed by
galvanic and faradic stimulation.
The result is a quick loss in inches around the thighs
and hips, improving the appearance of cellulite.
Next comes treatment with a TriActive laser
(Cynosure Inc.).
The low-energy diode laser was designed to increase
lymphatic drainage, tighten the skin, and increase
superficial blood flow.

Anna S. Ranti

67

Solving the cellulite puzzle

(As with ionithermie, there are no published studies
validating claims that TriActive improves cellulite.)
The regimen is generally one to three treatments a
week for a total of 10 to 15 treatments.
Step three is long-term use of a topical cream in
combination with diet and exercise.

Anna S. Ranti

68

Research reveals some side effects,

good results with
phosphatidylcholine
"The term originated from the words 'subcutaneous'
and 'incisionless' and describes surgery in the
subcutaneous structures that does not require any
incisions," she explains.
Dr. Hexsel says that in 1997 she and Rosemary
Mazzuco, M.D., developed this cellulite treatment based
on the original Subcision technique introduced in 1995 by
David Orentreich, M.D., and Normal Orentreich, M.D., to
correct wrinkles, scars and other skin surface depressions.

Anna S. Ranti

69

Research reveals some side effects,

good results with
phosphatidylcholine

For cellulite, the Subcision mechanism of action is a

"redistribution of the tension and traction forces exerted by
the fat and subcutaneous septa on the depressed areas of
the thighs, buttocks and other parts of the body."
Among the 10 Subcision studies Dr. Hexsel has
conducted, one demonstrated the technique's effectiveness
in 232 women aged 18 to 52 years who had cellulite on the
thighs and buttocks.

Anna S. Ranti

70

Research reveals some side effects,

good results with
phosphatidylcholine

Although all patients experienced post-operative pain,

bruises and hemosiderosis, patients were highly satisfied
and had improved surface depressions.
"The treatment of cellulite is complex, as its success
depends on measures such as physical exercises, weight
control, diet and others," she points out.

Anna S. Ranti

71

Research reveals some side effects,

good results with
phosphatidylcholine

Miami Beach, Fla. New information regarding the

treatment of fat and cellulite gives dermatologists
something to consider as an option to traditional
treatments.
According to Doris M. Hexsel, M.D., the new
research and clinical experience she presented at the H&H
Dermatology Seminar are crucial to decisions about
incorporating any new treatment method.

Anna S. Ranti

72

Research reveals some side effects,

good results with
phosphatidylcholine

Fat deposits "Localized fat deposits are a cause of

discomfort and anguish, leading patients to undergo
surgical procedures such as liposuction and
dermolipectomy," says Dr. Hexsel, a dermatologist and
former professor of dermatology at the University of Passo
Fundo in Brazil.
She is also coordinator of the Brazilian Society of
Dermatology and a member of the American Academy of
Dermatology.

Anna S. Ranti

73

Research reveals some side effects,

good results with
phosphatidylcholine

A new injectable for localized fat

phosphatidylcholine (Lipostabil or Essentiale, Natterman
International GMBH) is emerging in some countries and
has been used off-label cosmetically in Brazil since the late
1990s.
This phospholipid is extracted from soybean lecithin
and is abundant in cell membranes.
It actively functions to structure cells and transport
between cells and can alter cholesterol and other
triglyceride metabolisms.

Anna S. Ranti

74

Research reveals some side effects,

good results with
phosphatidylcholine

Phosphatidylcholine was initially used in emergencies

to treat atheroma plaques in cardiac diseases and is
approved in some European countries for cardiac use.
Because it can change the composition of fat deposits,
this agent has been used to treat hypercholesterolemia, fat
embolism, arterial-wall fatty deposits or plaques and lipid
atheromas.

Anna S. Ranti

75

Research reveals some side effects,

good results with
phosphatidylcholine
Although Dr. Hexsel says no histological or
pharmacodynamic studies have demonstrated
phosphatidylcholine's mechanism of action, it is
hypothesized that the agent penetrates the adipocyte
through the double lipid layer, thus emulsifying and
altering the stored lipids to make them water soluble.
Being incompatible with the liposoluble material
stored in the adipocyte, the fat is eliminated from the site.
Dr. Hexsel says that phosphatidylcholine has been
widely used in Brazil to treat fat deposits in subcutaneous
tissue, but in 2003 the country's regulatory agency took
action.

Anna S. Ranti

76

Research reveals some side effects,

good results with
phosphatidylcholine

"Due to concern about the uncontrolled and overuse

of phosphatidylcholine injections, the Brazilian National
Agency of Health Inspection (ANVISA), which regulates
the use of medication in Brazil, prohibited its use at a
national level," she reports.
Dr. Hexsel says this treatment is best suited for a
patient with a small and localized fat area that can be
treated with one or two injections.
This treatment is not for patients who "want to lose
weight by injecting any available new treatment and who
do not worry about their health."
77
Anna S. Ranti

Research reveals some side effects,

good results with
phosphatidylcholine

Concerned about the absence of medical research

proving the safety of phosphatidylchloine, in 2003 she and
colleagues reported on their research into the safety and
efficacy of the agent to treat fat deposits.
They treated 18 patients with 250 mg/ml
phosphatidylcholine injections in various subcutaneous fat
deposits and performed 15 lab exams before treatment and
at days two or three and 15.
Maximum dosage was 10 ml per session.
Each patient had five treatments, with at least 10 days
between applications.

Anna S. Ranti

78

Research reveals some side effects,

good results with
phosphatidylcholine

"These measures were taken to avoid adverse

systemic effects that may result from excessive doses or
short intervals between injections," Dr. Hexsel notes.
"Phosphatidylcholine altered slightly the hepatic
enzymes, but they returned to normal levels by the 15th
day, so this is the therapeutic protocol we established with
our patients."
Other adverse effects can include moderate to severe
edema, erythema, localized heat, slight to moderate
discomfort, bruises, and slight to moderate itching.

Anna S. Ranti

79

Research reveals some side effects,

good results with
phosphatidylcholine

They concluded that "the off-label use of

phosphatidylcholine in the treatment of fatty pads and
small areas of localized fat is safe, low-cost and effective."
Dr. Hexsel says, "Liposuction is still best to remove
medium to large amounts of fat. Dermolipectomy is safe
and effective to remove fat and excessive skin."

Anna S. Ranti

80

Research reveals some side effects,

good results with
phosphatidylcholine

Cellulite Dr. Hexsel also reported on the minimally

invasive treatment for cellulite called Subcision in which
needle injections release tensions of the subcutaneous
fibrous septa that cause cellulite dimpling. In 10 years, she
has treated more than 1,500 patients with this technique.
Someone with a high degree of cellulite without loose
skin or large fat deposit areas is a good candidate for
Subcision.
The term originated from the words 'subcutaneous'
and 'incisionless' and describes surgery in the
subcutaneous structures that does not require any
incisions," she explains.

Anna S. Ranti

81

Research reveals some side effects,

good results with
phosphatidylcholine

Dr. Hexsel says that in 1997 she and Rosemary

Mazzuco, M.D., developed this cellulite treatment based
on the original Subcision technique introduced in 1995 by
David Orentreich, M.D., and Normal Orentreich, M.D., to
correct wrinkles, scars and other skin surface depressions.
For cellulite, the Subcision mechanism of action is a
"redistribution of the tension and traction forces exerted by
the fat and subcutaneous septa on the depressed areas of
the thighs, buttocks and other parts of the body."

Anna S. Ranti

82

Research reveals some side effects,

good results with
phosphatidylcholine

Among the 10 Subcision studies Dr. Hexsel has

conducted, one demonstrated the technique's effectiveness
in 232 women aged 18 to 52 years who had cellulite on the
thighs and buttocks.
Although all patients experienced post-operative pain,
bruises and hemosiderosis, patients were highly satisfied
and had improved surface depressions.
"The treatment of cellulite is complex, as its success
depends on measures such as physical exercises, weight
control, diet and others," she points out.

Anna S. Ranti

83

Research reveals some side effects,

good results with
phosphatidylcholine

Endermologie is the name of a machine, that was originally

invented in the 70's to standardise scar massage treatments
for burn victims.
It came about that these burn victims had improven
collagen and cellulite distribution so they came up with a
version for cosmetic use.
The crux of the machine, is the handpiece, with two rollers
and a suction action whereby a section of flesh is 'sucked'
up and massaged.
The handpiece is used like a massage machine on problem
areas.
Improvements are seen on the areas massaged after fourteen
to twenty treatments.
84
Anna S. Ranti

Research reveals some side effects,

good results with
phosphatidylcholine

While it does indeed show signs of actually

controlling cellulite, the mechanism of how it does so
remains unknown despite intense research.
The point being that it 'does' work!
To obtain any measurable effect, one has to undergo at
least ten to fourteen treatments.
Once most of the cellulite has been redistributed, a top
up treatment every month is required for life.
If not, the cellulite returns.
Speculation is that the fat clumps up again.

Anna S. Ranti

85

Treatment Methods For Cellulite

Liponic Sculpturing
One of the most popular, and consistently proven
treatments to deal with cellulite.
The procedure involves the use of a computer
controlled machine that uses a special handpiece that is
massaged over the skin.
With a set of rollers, it produces a rolling and sucking
motion.
This improves skin texture, and through some, as yet,
unknown reason, redistributes cellulite and actually firms
up the skin.
86
Anna S. Ranti

Treatment Methods For Cellulite

Results are shown after about ten to fourteen
treatments.
Regular topup treatments are required for life to keep
cellulite at bay.
Endermologie is one of the more popular machines
being used on the market.
Approximate costs are RM2500 and up for a set of
fourteen treatments.
Liponic sculpturing uses a computer controlled
handpiece with rollers.
Via sucking motion, it massages affected parts of the
body.
87
Anna S. Ranti

Treatment Methods For Cellulite

Liposuction
Another means of dealing with cellulite, though in an
indirect manner.
Liposuction does not remove cellulite, but deals with
the underlying fat layer, making it less noticeable.
A surgeon removes fat via a cannula ( a special pipe)
and suction.
Prime areas to remove fat are the abdomen, the hips,
thighs and buttocks.

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88

Treatment Methods For Cellulite

There are various forms of liposuction, and the latest
technique is known as tumescent liposuction, where they
inject solution in the body to reduce damage before
conducting liposuction.
Ultrasound assisted liposuction is another technique
that uses ultrasound to liquefy fat as it is being removed.
Results are permanent, and would assist in the
reduction, but not the elimination of cellulite.
People often use liponic sculpturing along with
liposuction together to achieve a greater effect.
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Treatment Methods For Cellulite

Plastic surgeons are the ones to ask to conduct
liposuction.
Approximate costs vary but go upwards of RM4000
and up depending on surgeons fees and anesthetic
methods.
Liposuction is an invasive procedure done by a
qualified plastic surgeon to remove body fat via suction.

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Treatment Methods For Cellulite

Anti-Cellulite Pills & Creams
Creams and compounds that contain Retinol, a form
of Vitamin A, show the most promise.
Retinol has a proven track record for improving skin
thickness and elasticity by working on the collagen and
elastin tissues in the skin.
Some creams are over the counter, while others
require a dermatologists prescription before use.

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What can I do about it?

In a nutshell, not much.
The conclusion is that cellulite is still not very well
understood, and is still a major eyesore.
So far, after countless years of miracle creams, pills
and whatnot, there is little evidence of a guaranteed way to
eliminate cellulite.
The only one that has been seen to work so far is
liponic sculpturing but it is not a permanent one time
solution.
It requires a lifetime investment.
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What can I do about it?

Some compounds, notably Retinol A have been shown
to work on cellulite. And others remain to be proven.
In the end, it is still a combination of a healthy diet,
lots of exercise, and weight control that contributes to the
minimisation of cellulite.

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