Treating cellulite with Surgery- a combination of release and fat grafting. Journal time!

Posted on March 14, 2019

Cellulite sucks.  And as we get older, (oh joy!), it gets worse.  It has a lot to do with skin tone, fibrous dimpling, and fat.  There are methods out there like Cellfina and releases to help with cellulite.  I looked at Cellfina, but didn’t end up getting it because of the cost- to me and to you-, and the fact it was really only effective for the deep dimples.  What about all of that finer, smaller dimply stuff?

In my latest issue of the Aesthetic Surgery Journal I saw a study out of Brazil.  If you don’t know, the Brazilian plastic surgeons do a lot of plastic surgery.  This paper was about how to treat cellulite using a combination of releasing the dimples and then fat grafting. What really got me were the pictures. WOW. They were good.  I know with these articles I need to take the results with a grain of salt.  But I do a lot of fat grafting, and I see how the skin quality improves.  This whole idea of broad release and then grafting makes a ton of sense to me.

So.  “Cellulite: A Surgical Treatment Approach.”  In the October 2018 issue.  This was a study over 26 years, with procedures on 126 patients.

They went through the treatments currently available:

They then went through their technique:

They graded people on their fat distribution, skin quality, photographed, and then assessed by 4 people after at 18 months, and answered a questionnaire of how they felt.

Procedure:

Complications: 7% required correction due to skin irregularities, retractions, or recurrent cellulite.  Bruising was the most common complication, and it resolved with time and massage.  There were two cases of small seromas, which resolved with aspiration.

Results: Overall good to excellent, especially in young patients with good skin elasticity.

In their discussion, they state the reasons for cellulite.  These include

They think their technique is good because of the broad area, the release of the septae, the preservation of the blood supply, and the effect of the stem cells in the fat grafting.

My thoughts?

Their photos are impressive.  I agree with a lot of their thought process.  They only showed a few patients, so it is unclear how their results are, particularly in older patients.  Where I really see cellulite being an issue is in the 45 year and older crowd.  How does this work in their skin types? Do they process the fat? How much do they inject back and where? And I wonder about the 3 weeks of staying taped (do they shower?) and the almost 2 months of a garment.  For sure an interesting idea though.  On a smaller scale, I have tried this as a “spot” treatment in the buttock with varying success.