What affects more than 90% of women and is nearly impossible to treat? Yes, we’re talking about cellulite. The causes of cellulite are nuanced and multifactorial, but the main culprit are vertical, fibrous bands (technical term: septae) that tether the skin to the underlying fascia. As they pull down, the surrounding fat cells bunch up around them, creating the appearance of dimples and depressions. It’s a tough condition to tackle, though there has been a noteworthy evolution in cellulite treatments recently. “We’ve gone from having topical products that really didn’t work at all to various massaging devices that offered temporary improvement to now having some more invasive options that offer a much longer-lasting solution,” explains Dr. Kevin Tehrani, a board-certified plastic surgeon in Great Neck, New York.
Still, the very fact that there are so many different cellulite treatments out there is indicative of just how big of a pain in the butt (pun intended) it is. “The reason we have multiple modalities is that there is no singular, end-all-be-all solution for cellulite,” he says. To that point, each of the current options available comes with its own set of pros and cons. Ahead, everything you need to know about six of the most popular in-office cellulite treatments.
Cellfina
How it works: Cellfina works by targeting—and snipping—the septae. “When dermatologic surgeons first realized, years ago, that these fibrous bands were the issue, they tried surgical subcision, essentially cutting the bands, but this came with lots of downtime,” explains Dr. Elizabeth Tanzi, a board-certified dermatologist in Chevy Chase, Maryland. “Cellfina is a method of controlled subcision, using a unique cutting device that allows for a more targeted and precise cutting of the bands.” However, this is still the most invasive option of them all.
The results: Cellfina works exceptionally well on the dimples on the butt and does offer long-lasting improvement, but the effect it has on rippling or uneven texture on the thighs is limited, says Dr. Tanzi. Cellfina guarantees results for one year, though it bears mentioning that RealSelf members give it just a 43% Worth It Rating.
Number of treatments required: Only one; results begin to show up about three months afterward, says Dr. Tehrani
The downtime: Bruising and swelling can last for several weeks. Soreness is also common but usually subsides within a few days. Strenuous activity is off-limits for about two weeks.
Average cost: $2,500–$5,000
Avéli
How it works: The Avéli device uses a hook with a blade to sever the individual septae responsible for each dimple within the skin. “Avéli offers visualization of the individual bands, so you are able to make sure each band is identified,” says Dr. Jennifer Levine, a board-certified plastic surgeon in New York City. (In other words, it’s more precise than Cellfina.) On top of that, the hook of the Avéli can sever any lingering septae, meaning your provider confirms that a given fiber has been completely severed before moving on—which makes for better results. It’s also less invasive than Cellfina. “It is able to target the cellulite through one insertion point,” says Dr. Levine.
The results: Dr. Levine says that many patients are happy with the results, which take around three months to show. RealSelf members seem to agree: It has an 86% Worth It rating.
Number of treatments required: Just one—and a study in the Aesthetic Surgery Journal that followed participants for 12 months post-procedure found that Avéli’s benefits were long-lasting.
The downtime: The downtime is relatively minimal, according to Dr. Levine—you can usually resume your normal activities within 48 hours. “Patients can expect some soreness and mild bruising,” she says. She also notes that using a light compression garment on the area can be helpful, too, although it’s not necessary.
Average cost: $3,750–$6,500
Cellulaze
How it works: This is yet another modality that breaks down the septae, but it does so via a laser. The added benefit? “The laser not only cleaves the septae, it also helps tighten the skin,” says Dr. Tehrani, who notes that he often combines skin tightening procedures with other cellulite treatments. Why? Unlike singular dimples, more widespread, rippled cellulite is often a combination of not only cellulite but also loose skin. “Picture a comforter that’s strewn across a bed and looks lumpy and bumpy. These skin tightening devices are essentially the equivalent of taking the sides of that comforter and pulling it taut, smoothing everything out,” he explains. For this reason, he finds Cellulaze to be more effective than Cellfina.
The results: Cellulaze also boasts a slightly higher Worth It Rating among RealSelf members than Cellfina—67% as compared to 55%. Results have been shown to last at least a year, if not longer.
Number of treatments required: This is also a one-time deal, with results showing up about three months later.
The downtime: Cellulaze is less invasive than Cellfina, though it still comes with the likelihood of swelling, bruising, and tenderness. You’ll be able to resume normal activities the next day, but strenuous activities are off-limits for two weeks.
Average cost: $5,800
Resonic
How it works: This brand-new treatment is launching this summer, and provides yet another method for targeting those pesky septae. The least invasive of all the options, it delivers high-frequency sound waves that pass through the skin to cleave the fibrous bands, without any cutting of the skin required, explains Dr. Tanzi.
The results: In the initial studies, 93% of patients were satisfied. These studies were based on results three months post-treatment; Dr. Tanzi notes that she’s following patients who were part of the study and are now six months out, still with great results. She also adds that it has proved to work well for cellulite on both the butt and thighs, though those with very loose skin may not see as much improvement.
Number of treatments required: According to the initial FDA studies, a single treatment yielded significant results. However, Dr. Tanzi points out that doctors are now looking to see if additional follow-up treatments will further enhance those results.
The downtime: Pretty much none. Discomfort during the treatment is minimal, about a two on a scale of one to 10, says Dr. Tanzi; there’s no downtime, and there are no restrictions after the fact.
Average cost: $2,500–$3,500
VelaShape & SmoothShapes
How it works: The doctors we spoke with put these two in the same category. They’re procedures that combine massage and suction with energy—radiofrequency, in the case of VelaShape, and laser and LED light, in the case of SmoothShapes. According to them, neither energy modality has a significant effect on the cellulite, but the massage and/or suction offers temporary results. (The key word here is temporary.) “These are much more superficial treatments, offering some improvement by massaging out excess fluid, that can make cellulite look worse,” says Dr. Tehrani.
The results: According to Dr. Tanzi, these treatments are best suited to someone looking for a quick, temporary fix before a singular event (think: a wedding or beach vacation) and who can commit to following through with a series of treatments. However, compared to the other technologies and techniques out there, she says they’re “suboptimal alternatives.” Dr. Tehrani agrees: “If you undergo these types of procedures regularly, sure, your cellulite will look a little better—but it’s by no means a permanent solution. And as soon as you stop, [the cellulite is] going to be the same as it was before.”
Number of treatments required: Anywhere from three to eight, performed weekly.
The downtime: None. In fact, many people find both of these treatments to be somewhat relaxing, akin to a deep tissue massage.
Average cost: $1,100–$1,500 for a series
