The four stages of cellulite (plus pre-cellulite)

Four grades of cellulite + pre-cellulite

🏷️ cellulite stages 🏷️ is cellulite reversible 🏷️ visible cellulite 🏷️ what does cellulite look like

• Methods of cellulite severity classification

• 4 cellulite stages

• Cellulite Grade/Stage 0: the pre-cellulite stage

• Cellulite Stage/Grade 1: visible only when pinching the skin

• Cellulite Grade/Stage 1: not very progressed and easily treated

• Cellulite Stage/Grade 2: visible only when standing

• Cellulite Grade/Stage 2: quite progressed but still treated well

• Cellulite Stage/Grade 3: visible even when lying down

• Cellulite Grade/Stage 3: very progressed and treated with a lot of work

• Cellulite Stage/Grade 4: fibrous cellulite with deep indentations

• Cellulite Grade/Stage 4: very difficult to treat

• Not set in stone

Methods of cellulite severity classification

There are different methods to classify the severity of cellulite, some more accurate, some more technical and complicated and some more practical.

As there are different types of cellulite (more on that below) and as the appearance of cellulite changes even from day to day, it is impossible to use an exact, measurable number to describe the severity of cellulite, as in 83% or similar.

Furthermore, there is no objective, accurate, widely accepted way, to put an exact number and describe the severity of cellulite.

4 cellulite grades/stages

So in the end the simplest way is the best. People care about how their cellulite looks, not about numbers, so the 4-stage cellulite classification is the most widely used.

This method is in fact quite intuitive, accurate and descriptive of the different stages of cellulite, as we will see below.

Cellulite Stage / grade 0: pre-cellulite

Grade 0 / Stage 0 cellulite is the absence of any visible cellulite, even when pinching the skin. There may be a little water retention or skin looseness at some places at this stage, but that’s all.

A slight honeycomb-like cellulite appearance is seen only when pinching, but that is part of the normal structure of the female skin - what is called pre-cellulite.

(Read more on the pre-cellulite female skin structure.)

If you are worried that your Stage 0 cellulite is progressing, you can prevent that happening with:

• Exercise/diet/lifestyle

• By topically applying multiple, high-purity, high-concentration actives (i.e. a real cellulite cream)

• A strong cellulite-specific massage

• And occasional treatments (perhaps once a month or every two months) of deep-acting, high-power radiofrequency and/or high-power ultrasound cavitation, the two most effective cellulite technologies

We see a very small number such cases at the clinic, usually from very healthy/fitness conscious people.

Cellulite grade / Stage 1: visible only when pinching the skin

Stage/Grade 1 cellulite is cellulite visible only when pinching the skin.

Gravity cannot reveal such a small extent of cellulite, so Grade 1 cellulite remains invisible while standing or lying down.

Stage 1 cellulite may also be visible when contracting the buttock muscles or when sitting on a chair and the skin gets compressed against the chair (these last two occasions mimic pinching).

Grade 1 cellulite is barely visible under changing room light - the worst kind of lighting for the appearance of the legs and the best light to assess cellulite.

Thankfully, such lighting does not exist anywhere else in everyday life (although the harsh midday sun on the beach comes quite close).

We see a few of these cases at the clinic. This is because people usually wait until it’s too late to do something about cellulite (or anything else in life, for that matter).

Cellulite Stage / Grade 1: not very progressed and easily treated

It takes from months to years to progress from Stage 0 to Stage 1 cellulite.

With Stage 1 cellulite, fat globules are still small, skin is not very loose yet and fibrosis of the cellulite septa has not progressed much. There is usually some water retention at this stage.

In most cases, Grade 1 cellulite can be reversed completely to the pre-cellulite stage with:

• Exercise/diet/lifestyle (always important, regardless of the stage of cellulite)

• By topically applying multiple, high-purity, high-concentration actives (i.e. a real cellulite cream)

• A strong cellulite-specific massage (still works well at this stage)

• And a small course of regular treatments of deep-acting, high-power radiofrequency / high-power ultrasound cavitation, the two most effective cellulite technologies (perhaps 6 weekly/fortnightly sessions)

Cellulite Grade / Stage 2: visible only when standing

Grade 2 cellulite is cellulite visible only when standing.

Gravity always makes cellulite (and skin laxity) look worse. So as soon as cellulite progresses from Stage 1 to Stage 2, it becomes visible while standing. Stage 2 cellulite is still invisible while lying down.

Grade 2 cellulite may also be visible when lying down in different angles that place pressure on the skin.

Grade 2 cellulite is clearly visible under changing room light. In fact, that lighting quite often makes cellulite look much worse than what it really is.

We see lots of these cases at the clinic from either health / fitness / appearance-conscious women or from those who are worried that cellulite may become even worse.

Cellulite Stage /Grade 2: quite progressed but still treated well

It takes from months to years to progress from Grade 1 to Grade 2 cellulite, but sometimes it can progress from Grade 0 to Grade 2 in just a few months (usually due to sudden weight gain, hormonal imbalances, hormonal treatment or hormonal contraception).

At this stage cellulite has progressed from the Stage 0 or 1 and the skin has weakened, allowing gravity to reveal the enlarged fat globules and the septal fibrosis that create the familiar cellulite bump appearance. There is usually more water retention at this stage.

In most cases, Stage 2 cellulite cannot be reversed completely, as fibrosis has become permanent in many of the septae and fat globules cannot empty completely of the fat they contain, unless the person becomes very, very skinny (usually not a good idea).

However, Grade 2 cellulite can be reduced to Grade 1 (and occasionally even to the pre-cellulite stage / Stage 0) with:

• Exercise/diet/lifestyle (always important, regardless of the stage of cellulite)

• By topically applying multiple, high-purity, high-concentration actives (i.e. a real cellulite cream)

• A strong cellulite-specific massage (it can still offer some help well at this stage)

• And a course of 6-12 regular treatments (taken twice-weekly / weekly / fortnightly) of deep-acting, high-power radiofrequency / high-power ultrasound cavitation, the two most effective cellulite technologies available today

Cellulite surgery (subcision) does not make sense in Stage 2 cellulite, as the scars, skin laxity, complications and adverse reactions that come with such surgery are not worth such a minor stage of cellulite.

Furthermore, a typical person with Stage 2 cellulite has already 100 or more Stage 2 cellulite bumps, while subcision surgery can only undercut 15-25 of them. And even if all of them were possible to be undercut, no one would want 100 surgery scars on their legs. That would look like self-harm and much worse than cellulite.

Cellulite Grade / Stage 3: visible even when lying down

Stage 3 cellulite is cellulite visible even when lying down.

In this case cellulite is so progressed that it is visible regardless of the effect of gravity.

Grade 3 cellulite is very visible under changing room light, which, as always, amplifies its progressed appearance.

We see a lot of these cases at the clinic, as many as Stage 2 cases, especially in people in their 40s, 50s and 60s - but sometimes even in women in their late 20s and 30s.

Cellulite Stage / Grade 3: very progressed, needs more work to treat

It takes from months to years to progress from Stage 2 to Stage 3 cellulite, but sometimes it can progress from Stage 1 to Stage 3 in just a few months (usually due to sudden weight gain, hormonal imbalances, hormonal treatment or hormonal contraception).

At this stage cellulite has progressed from the Stage 1 or 2, the skin has weakened a lot, fat accumulation on the hypodermal fat globules has increased and fibrosis has become quite significant. There is usually a lot of water retention at this stage.

Grade 3 cellulite can never be reversed completely, as fibrosis has become very pronounced and fat globules cannot empty completely of the fat they contain, regardless of how much weight the person loses.

However, Grade 3 cellulite can be reduced to Stage 2 (and occasionally even to the Stage 1) with:

• Exercise/diet/lifestyle (always important, regardless of the stage of cellulite)

• By topically applying multiple, high-purity, high-concentration actives (i.e. a real cellulite cream; it can still offer some help well at this stage)

• And a course of 12-20 regular treatments (recieved twice-weekly/weekly/fortnightly) of deep-acting, high-power radiofrequency / high-power ultrasound cavitation, the two most effective cellulite technologies available today

Cellulite surgery (subcision) sometimes makes some sense in Stage 3 cellulite for 15-25 deep cellulite troughs (if such deep troughs exist), but the scars, skin laxity and complications/adverse reactions that come with such surgery must be taken into consideration.

However, hundreds of the other Stage 3, Stage 2 and Stage 1 cellulite bumps must still be treated, so subcision should always be accompanied by exercise/diet/lifestyle, topical actives and RF/ultrasound treatments.

RF is particularly needed after subcision to tighten up the skin that becomes very loose after subcision surgery.

Cellulite Grade / Stage 4: very progressed and treated with a lot of work

Grade 4 / Stage 4 cellulite is in essence Stage / Grade 3 cellulite (i.e. visible when lying down) but with very deep troughs and with a lot of fibrosis, quite often visible through leggings, dresses etc.

We see a few of these cases at the clinic, especially in people in their 50s and 60s - and very rarely in their 40s.

Cellulite Stage / Grade 4: very progressed and very difficult to treat

A this stage not much can be done to reduce cellulite to lower stages, but deep-acting, high-power radiofrequency and high-power ultrasound cavitation treatments can improve the overall look of the skin, i.e. improve the fibrosis and reduce the troughs / bumps in depth.

Cellulite-specific massage can improve the usually very poor circulation.

Cellulite takes months or years to progress from Stage 3 to Stage 4. There is no sudden conversion from Grade 2 to 4 or from Grade 3 to 4. The fibrosis and deep troughs need time to reach cellulite Grade 4 level.

And subcision type of surgery can theoretically relieve pressure off the 15-25 deepest troughs / bumps, but as always with surgery, things can go awry due to adverse reactions / complications.

Still, the hundreds of other Stage 3 and Stage 2 cellulite bumps must still be treated (there is always a mix of different stages of cellulite on the same person), so subcision should always be accompanied by exercise/diet/lifestyle, topical actives and RF/ultrasound treatments.

RF is particularly needed after subcision to tighten up the skin that becomes very loose after subcision surgery.

Not set in stone

This and any other classification is not set in stone,

Cellulite severity and appearance often changes with the menstrual cycle, the lighting used and the position of sitting/standing etc.

But most importantly, as mentioned above, different areas can be have different grades of cellulite even on the same person, e.g. Grade 3 on the buttocks, Grade 1 and 2 on different parts of the thighs, Grade 1 on the arms and pre-cellulite / Grade 0 the stomach.