What Causes Cellulite?

I am 25 and I've always been very fit, but now out of nowhere I am suddenly seeing cellulite on my bum!  I do squats every day and eat healthy, I quit smoking, I don't drink coffee, I'm not overweight... so how the heck am I getting cellulite?!  I don't want to put on a bathing suit ever again! I know cellulite is common for women, but I just don't understand why this is happening to me.  Where does cellulite come from?  Is there anything I can do to get rid of it, or at least slow it down and stop it from forming more? 

Doctor Answers 12

Two types of cellulite, many causes

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I tell my patients that there are essentially two types of cellulite that we see most frequently.

"Cottage cheese" cellulite

To simplify them, there seems to be one type that is like cottage cheese. Where you see cells of fat under very thin skin, so it looks like tissue paper over cottage cheese. Still this is a defect in the thickness of the skin or collagen of the dermis. This is not the most common type of cellulite, and is more a function of having very thin skin (where the dermis has thinned too much). Very thin skin can be genetic (such as many Scottish people) or it can be with age. We know that menopause does affect the dermis, and that it thins out quite a bit.

"Lattice-work" cellulite

A second type of cellulite that I see in my practice comes from losing elasticity from the skin elements. There are little bands of collagen that run from the deeper structures (muscle or bone) to the skin that hold the subcutaneous fat in a lattice work. These bands are the steel bands that don't give way over time (collagen more like your fingernails). As the skin loses its elasticity from getting older, smoking, sun exposure, and weight gain and loss, the skin sags around these steel bands and isn't as tight. The lattice-work collagen holds onto the skin at spots, making indentations or cellulite.

Anything that we can do to decrease the loss of elasticity of the skin and dermal elements will be helpful to keep cellulite in check.

  • We know that good hydration is helpful.
  • Since smoking decreases the elastic fibers, don't smoke (even when you are young and think it is cool--you will pay for it someday).
  • Radiation decreases the elastic fibers in the skin, and we get more radiation from sun exposure than any other way. This is cumulative over your life. So when you get sun at 20 years of age, you are going to pay for it when you are 60.
  • Having children makes it hard not to gain and lose weight.
  • And we all, as much as we hate it, get older.

Keep it in perspective: getting older is better than the alternative of dying young!

Orange County Plastic Surgeon
4.8 out of 5 stars 33 reviews

Multifactorial and I am not sure anyone really knows.

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In actuality, we really don't know what causes cellulite. One theory suggests cellulite arises from swelling within localized fatty areas. This can be accentuated by increases in lymphatic pressure or venous blood pressure. For some, excess fat, loose skin, or a combination of the two additionally contribute to the problem. Stress, trauma, diet, medications, and pregnancy have also been listed as possible contributing factors.

In my mind, the two main causes of cellulite are 1) abnormal skin related (bulges) due to both fat and swelling which is accentuated by adjacent tight supportive connective tissue of the skin (think button on a pillow) or 2) loose skin causing a traction on this connective tissue. For some patients, both factors come into play.

What treatment options are there?

After a thorough review of the literature on the topic I can conclusively say that some of the treatment options help a little, some of the time. Not very authoritative, I know, but that is the problem with cellulite. If there were really a method of treatment that was very effective there would not be so many options out there, would there?

Mesotherapy - (Lipodissolve is one version) - Highly advertised and hyped. Basically the injection of a nonstandardized mixture of chemicals intended to dissolve fat painlessly without surgery. Not generally supported by plastic surgeons and in my opinion a complete waste of money. Unbiased, comparative studies reveal no measurable effect (Plastic and Reconstructive Surgery, April 2008). I have actually seen a few patients who claim that this increased fat. I have never used this and at this point have no interest.

Cellulite creams - I have never seen a study or even anecdotal evidence that showed any improvement, I have seen studies that show no improvement (Plastic and Reconstructive Surgery, Sept 1999).

Body wraps - see creams

Endermologie - An external machine is used to roll and suck the skin which claims to reduce the appearance of cellulite.

UltraShape - Not FDA approved. Non-thermal ultrasound energy to break up the fat which is reabsorbed by the body. Promising in theory, needs the benefit of more time and research to know for sure. My only concern is where does it all go. The coronary arteries?

Velasmooth - A combination of RF and light energy applied externally to break up fat cells. Again, promising but needs more time and where does the fat go?

Velashape - basically Endermologie plus Velasmooth

Tumescent Liposuction - This is what I use for body contouring. Actually, I use a version of this, power assisted liposuction because it is a little quicker, easier and gentler on the patient. This does a fairly lousy job of treating cellulite by itself and I warn patients to this effect. With release of the depressions with a V shaped cannula and a little fat grafting this can be improved somewhat more. I would estimate about a 50% improvement.

Laser Liposuction (SmartLipo) - Highly advertised and hyped. Burn the tissue with a laser prior to removing it with liposuction (or leave it to be reabsorbed by the body). To me this is good as a marketing tool because who wouldn't want something "smart". Studies have failed to show any improvement (Plastic and Reconstructive Surgery, Sept 2006). Most surgeons (or non surgeons) using this technology are not plastic surgeons at this point. The danger is that a patient can focus on the technology rather than the experience and artistry of the surgeon which is vastly more important.

Ultrasound liposuction (Vaser liposuction) - In my opinion similar to laser lipo

It is easy to see why there is so much confusion about the treatment of cellulite. First, no one, and I mean no one really knows all of the causes for cellulite. Second, proponents of each method of treatment will try to sell their own technique in favor of others. The truth is, there is little scientific support for any of these methods for the treatment of cellulite. Even in the best cases the benefit is minor.

It would be great for patients and surgeons alike if one of these treatments or something on the horizon could treat cellulite consistently and effectively. In the meantime, I won't buy the hype of current methods or experiment on my patients with new technology until it is proven. For fatty bulges liposuction does very well but for cellulite don't expect too much.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 185 reviews

The cause of cellulite

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Unfortunately, even fit women can develop cellulite.  The anatomical structure of a woman's superficial layer of fat is different than a man's, which is why it is rare to see a man with cellulite.  The dermal layer of the skin is weak, and has "pockets" of fat herniating into it, which causes the orange peel look.  The dimples are caused by vertical fibrous bands, and the the bulges are caused by fat from a deeper layer pushing into the outermost area. 

I would recommend Cellulaze for your cellulite. 

Cellulaze is the first FDA approved minimally invasive, one-time treatment for cellulite.  It utilizes a 1440 nm side-firing laser fiber optic to treat the three main causes of cellulite:  It breaks down the fatty bulges, then cuts the fibrous septae that cause dimpling, then finally stimulates the dermis to shrink and thicken in order to improve the look of you cellulite areas.

Good luck in your endeavors!

Robert Kratschmer, MD

Genetics most likely cellulite cause

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Most women have some amount of cellulite. It simply has to do with the way women's bodies are genetically engineered to have more fat then men. Much of a woman's predisposition for cellulite can be traced to her mother, and other female family members. The best thing you can do if you know your family has a certain predisposition to cellulite is to eat healthy and exercise. There are some things that can aggravate your tendency for cellulite including stress and smoking. If you choose to have treatments for cellulite, the most promising results occur if a patient starts them at in their 20's and 30's while the body is still able to "bounce back" and respond to treatments. There are new fat reduction techniques available today that are producing very positive results. Best of luck.

Common Causes & Connections to Cellulite

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Cellulite is simply normal fat beneath the skin. It is caused by rubber-band-like connective tissues under the skin that compress the fat into dimples.  The fat appears bumpy because it pushes against connective tissue, causing the skin above it to pucker. 

Although, cellulite is not harmful to one's health, many people strive to eliminate it due to it's appearance. Cellulite is more common among women than men. If other women in your family have or had cellulite, there's a good chance you will as well.
Other factors that influence cellulite and it's visibility include:
• Poor #diet
• Fad dieting
• Slow #metabolism
• Lack of physical #activity
• #Hormone changes
• #Dehydration
• Total body #fat
• Thickness and color of your #skin
Cellulite tends to be less noticeable on darker skin. Further, having cellulite does not imply one is overweight. Thin people can also have it. If one is overweight,  however, losing weight may reduce cellulite.
There are many #products and #treatments that promise to get rid of cellulite on #thighs and #buttocks. But there is little evidence that shows that many of them work well or for long. Clinical treatments offer the most #effective and longest lasting results.  We can now offer improvements that should last at least 2-3 years. I recommend three different #procedures: #ThermiSmooth, #VelaShape 3, and #Cellfina.

Cellulite is a normal condition and can be improved with Thermi250, cellfina, ThermiTight, Velashape and Endermologie

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Cellulite is extremely common in women and why it develops suddenly is not easily understood. Many children exhibit cellulite so it's not old age. The fat puckers up through the bands that hold the skin down to muscle.

The condition has been treated with maintenance Endermologie and Velashape treatments which use a deep lymphatic type of massage (Velashape delivers radiofrequency energy in addition to the massage) but there is no long term reduction once the treatments stop.  Cellfina and ThermiTight have been shown to induce  improvement longer than the former two technologies. Recently Thermi250, a more powerful type of ThermiSmooth radiofrequency treatment, can improve the skin's contour affected by cellulite, but we will have to see how long the improvement lasts after the Thermi250 treatments stop.

Cellulite typically does not improve with diet or exercise.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Cellulite cases

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Cellulite can affect people of almost any age. In general it represents loosening of the connections between the undersurface of the skin and the muscle. As such, liposuction generally is not the answer. Celfina is the latest breakthrough in technology that treats the underlying problems responsible for cellulite formation.

Brazilian Cellulite Treatment

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Cellulite is caused by fascio-dermal fibers that are too abundant or tight. I use the Brazilian Cellulite Treatment as the primary modality for improvement of cellulite. 


Dr. Karamanoukian 

Causes and Treatments for Cellulite

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While we don’t know exactly what causes cellulite, we do know that a number of factors impact its development. These include hormonal imbalances and genetic makeup, with slow metabolism and poor circulation playing a contributing role. Additionally, it is believed that toxins and a diet that’s high in fat, salt, and sugar increase the likelihood of cellulite development, which makes a fiber-rich diet even more important. Lifestyle factors also have an impact, especially smoking and lack of exercise. So you’re doing the right thing by pursuing a healthy lifestyle, but diet and exercise alone won’t eliminate cellulite once it appears. There are effective non-surgical treatments, however, such as Shockwave (Radial Pulse) Therapy and Lipolaser, to name a few.

Hal Michael Bass, MD
Miami Plastic Surgeon

Cellulaze for Cellulite

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Cellulaze is a FDA approved one time treatment that utilizes a 1440 nm wavelength laser to accomplish 3 things:  1) melt away fat bulging out 2) break up fibrous septae (attachments) that create the indentations and 3) help thicken the dermis (skin) to prevent future recurrence.   The procedure can take between 60-90 minutes and can be completed under local or just IV sedation (depending on the length of your procedure and number of areas being treated). To see your final results takes between 3-6 months. You can visit the cellulaze . com website to learn more about the procedure and find a plastic surgeon who performs the procedure near you. Best of luck!
Dr. Basu
Houston, TX

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.