“I have studied cellulite for more than two decades; during that time have performed thousands of treatments; and in the last four years I have also performed hundreds of ultrasound scans of cellulite. After all that study experience I can tell you that cellulite is NOT found in the subcutaneous adipose tissue, as many people (even doctors and scientists) confusingly and mistakenly state. Even very deep cellulite is rooted in the hypodermis, which is a distinct tissue and quite different in its structure and function to the subcutaneous adipose tissue. On surface, this may seem to just be technical detail but it has important implications in the treatment of cellulite.”
Superficial, deep and very deep cellulite: what are the differences?
Cellulite = fat + fibrosis
Superficial cellulite (upper hypodermal cellulite)
Treatment for superficial cellulite
Deep cellulite (lower hypodermal cellulite)
Treatment for deep cellulite
Very deep cellulite
Treatment for very deep cellulite
Liposuction and very deep cellulite
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Cellulite = fat + fibrosis
Cellulite is defined as hypodermal adipose tissue, i.e. fat within the lower skin layer.
Cellulite comprises fat pockets within the skin that are attached to and/or surrounded by fibrotic (hardened) collagen strands.
The fat pockets push up and bulge out of the surface of the skin, while the collagen strands pull down skin that is adjacent to the bulges. The combination creates the cellulite peaks (fat pocket makes skin push out) and troughs (collagen strands keep skin down).
Cellulite can appear at two depths inside the skin:
At the dermal-hypodermal level (superficial cellulite)
At the hypodermal level (deep cellulite)
We will look at each of them in detail.
Superficial cellulite (dermal-hypodermal cellulite)
Superficial cellulite occurs within the upper part of the third layer of the skin, i.e. the dermal-hypodermal junction.
As this layer is not very thick, the fat pockets are quite small (about 0.5cm in diameter or smaller), but they are still visible and there are literally 100s to 1000s of them on the thighs, buttocks, calves, stomach and arms.
(Obviously, cellulite surgery like subcision/cellfina, which only removes 15-25 deep bumps, cannot do anything for the 100s and 1000s of superficial cellulite bumps.)
Superficial cellulite is not as visible as the two other deeper types, but can still be unsightly.
Treatment for superficial cellulite
Superficial cellulite is removed best with deep-acting, high-power radio frequency and/or ultrasound cavitation - in addition to diet and exercise, of course. Strong cellulite-specific massage can help.
Ultrasound cavitation seems to be more targeted on this layer.
Deep cellulite (lower hypodermal cellulite)
Deep cellulite refers to fat pockets in the hypodermis.
As this layer can be quite thick, fat pockets are larger (about 0.5-3cm) and there can be literally 10s to 100s of them throughout the body.
(Again, cellulite surgery such as subcision/cellfina, which only removes 15-25 such deep bumps, does very little for the 10s or 100s of deep cellulite bumps.)
This is the most common type of cellulite.
Treatment for deep cellulite
Deep-acting, high-power radio frequency and/or ultrasound cavitation remains the best method to remove hypodermal cellulite - always in addition to diet and exercise. Strong cellulite massage can help.
Deep tissue radiofrequency seems to better target this layer but it all depends on individual anatomy.
Deep cellulite may also be removed with cellulite surgery with an upward-facing laser or ultrasound cannula, but results are usually worse after the procedure than before it, due to the scar tissue bumps produced and other surgery complications.
very deep cellulite
Very deep “cellulite” refers to fat pockets still in the hypodermis. The only difference is that in very deep cellulite the hypodermis is very deep.
As this layer is very thick and cellulite here can be any size from 3cm upwards. In such cases, there is only a smaller number of bumps in the whole body, perhaps up to 10 or 20.
This deep cellulite-like appearance is due to deeply rooted connective tissue strands (retinaculae) that originate from the deeply seated intermediate fascia at the bottom all the way to the superficial fascia at the top.
Since the number of such bumps is very small, cellulite surgery such as subcision/cellfina, does remove enough number of them (15-25) but it leaves you with 15-25 incision scars, which may become hyper-pigmented in darker people.
Moreover, subcision/cellfina sometimes do not really work or make things worse.
And finally, as the collagen strands are there for a reason - to keep skin firm - cellfina and subcision, by definition, leave skin looser and then you need a course of deep-acting, high-power radiofrequency to tighten it.
In this layer we also have long linear pockets of fat (as opposed to the round ones of the superficial and deep cellulite) separated by long troughs, up to 20cm in length.
Treatment for very deep cellulite
Deep-acting, high-power radio frequency and deep-acting, high-power ultrasound also remain the best methods to remove very deep cellulite, in addition to diet and exercise, with ultrasound cavitation being less useful.
A strong and deep-acting RF machine can easily tackle the subcutaneous “cellulite”. Ultrasound can also help but to a lesser extent. Again, it all depends on each individual case.
Strong cellulite massage can also help, but to a much lesser extent than superficial or deep cellulite.
liposuction and very deep cellulite
As liposuction works on the subcutaneous adipose tissue, which is seated below the hypodermis, it does not work on either superficial, deep or even very deep cellulite (all found in the hypodermis, which is an actual part of the skin itself), as no-one wants their actual skin removed and sucked out of the body.
Have a treatment in London with the cellulite experts
At LipoTherapeia we have specialised 100% in skin tightening and cellulite reduction for more than two decades and 20,000+ sessions.
This is all we study and practise every day and have researched and tried hands-on all the important skin tightening equipment and their manufacturers.
As strong, deep acting radiofrequency and deep-acting, high-power ultrasound cavitation are the technologies of choice for skin tightening and cellulite reduction, we have invested in the best RF/ultrasound technologies in the world.
(Of course, we keep looking for new technologies every day and if/when a better technology materialises we will be the first to provide it. However, we will never follow the latest ineffective gimmick, just because it’s good marketing to offer the latest hyped up - yet ineffective and/or unsafe treatment.)
Furthermore, over the last two decades we have developed advanced RF and cavitation treatment protocols in order to make the most of our technologies, for maximum results, naturally and safely.
And for even better, faster results, we now combine our RF/ultrasound treatments with high-power red/infrared light LED treatment.
Our radiofrequency/ultrasound/LED treatments are comfortable, pain-free, downtime-free, injection-free, 99.5%+ safe and always non-invasive.
(No unsafe and ineffective RF microneedling or HIFU and no safe but ineffective acoustic wave therapy, superficial RF (bipolar/tripolar/multipolar etc), low power RF/cavitation, electrical muscle stimulation, lymphatic massage, cupping, dry brushing and no ridiculous bum bum creams.)
Our focus is on honest, realistic, science-based treatment, combined with caring, professional service, with a smile.
We will be pleased to see you, assess your cellulite, skin laxity or fibrosis, listen to your story, discuss your case and offer you the best possible treatment.
The Cellulite School™: Get advanced training in cellulite reduction and skin tightening
Why train with The Cellulite School™?
We all know that training in cellulite reduction and skin tightening is as basic as it gets. It is typically a 4-6 hour training, involving only basic instruction from the manufacturer on how operators can use the machine; lots of myths, erroneous information and misconceptions; and some basic health and safety on how to use the machine.
There is no proper, real training in the science or cellulite, skin tightening, radiofrequency, ultrasound and all related technologies is non-existent - worldwide.
Do you want to deeply understand radiofrequency, ultrasound cavitation, LED phototherapy, cellulite and skin tightening?
Get proper training based on 25-year theory and practical application of cellulite reduction and valuable insights from 24,000+ sessions and 4,200+ clients.
Now you can get instant access to our expertise and save yourself literally thousands of pounds, dollars or euros of expensive mistakes and thousands of hours of study, research and practical application by attending one of our half-day, 1-day, 2-day or 3-day professional consultancy / training courses.
Deeply understand and get properly trained in the science of radiofrequency, ultrasound cavitation, LED phototherapy, cellulite and skin tightening and confidently offer your clients the safest, strongest and most effective treatment possible.
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