I recommend first getting a clear understanding of what cellulite is and what causes it. cellulite is caused by connective tissue that limits the distance from the skin to the underlying muscle fascia to a certain distance and is more prevalent in areas where the body can tolerate a lot of pressure.Areas that have more connective tissue includes soles of the feet, palms of the hands, back of the thigh and the lower inner part of the buttocks.What does subcutaneous fat amount is greater than the length of the connective tissue bands the skin starts acting like tufted furniture.It is not a condition caused by skin laxity the skin laxity makes the condition worse. Typically so does obesity. The best treatments have been aimed at severing the connective tissue bands that pull down on the skin since that is the main cause of cellulite. there are no great treatments for this condition and the plastic surgeons have in vain tried and tried to come up with the holy grail of something that will successfully treat cellulite on a consistent basis. The demand is infinite but in reality there are no treatments that do a good job of treating cellulite.Emsculpt makes absolutely no sense at all since it only causes temporary muscle strengthening. personally I have very little faith in radio frequency treatments causing anything other than placebo effect.There’s no question that there have been patients who have had impressive results from radio frequency treatments just like there are patients who have had negative outcomes.It’s simply doesn’t make sense that radiofrequency would treat the primary underlying ideology of what causes cellulite.Carefully done Subsicion with or without the device Celfina has traditionally been the treatment of choice. One of the newer treatment options is an injection called QWO. I have little faith this treatment will become the standard of care.In the plastic surgery world if something works well it quickly becomes the standard of care and everybody and some using it.No one single treatment has become the industry leader or standard of care for cellulite which typically means that none of the treatments really work.A few things to consider when seeking treatments.Everybody doing these treatments are doing it to make money so recognize that there is great financial gain to be had on the side of the provider. providers who invested a lot of money and equipment trying to not only make a profit but recapture the cost of their equipment. if the equipment is new they may be in the early phase of excitement from having bought a new piece of equipment and have not had enough experience to see what it can or cannot deliver.For cosmetic surgery we rely on before and after pictures and the same is true with non-surgical treatments.Ask to see as many before and after pictures and make sure that those pictures, from the practice who will be treating you and not from some other source. look for manipulation variables like patients who have had weight loss or are holding different body positions in the after pictures.If a treatment works it should work consistently and there should be no shortage of quality before and after pictures.Ask providers honestly what percentage of patients see good improvements, we’re happy with their outcomes and how many patients felt that the treatment didn’t work and wish they didn’t do it.In the end your ability to decipher an ethical an experienced provider becomes important.Looking for the holy Grail of what device works best is impossible because the public does not have access to unbiased information despite all of that information available on the Internet.There is simply no unbiased information to the consumer.Good luck,Mats Hagstrom MD
