What is Cellulite?
It is a rough, rough skin appearance resembling orange peel, especially on the upper outer and back parts of the thighs, buttocks, abdomen, breasts and upper arms. Although obesity is not necessary for cellulite, it is usually seen in areas where fat tissue storage is high.
It affects 85-98 per cent of women after puberty in all races and also affects men in cases of androgen deficiency. It is not important in terms of health but cosmetically important.
Why Cellulite Occurs?
Although the cause of cellulite is not known exactly, there are some theories:
Vascular theory; The lower layer of the skin called dermis is rich in capillaries that provide skin nutrition. The pressure on the vessels caused by the increase in fat tissue under the dermis prevents the fluid between the tissues from entering the vessels. In addition, after the damage to the vessels, the formation of protein used in the repair of connective tissue is impaired. Subcutaneous adipose tissue is pushed upwards, resulting in thinning of the dermis and a rough skin appearance.
Structural theory is based on the fact that cellulite is mostly seen in obese women. It argues that reducing the structure of fat lobules by losing weight will correct cellulite. It also recommends an increase in muscle tone with exercise and support of adipose tissue. This theory is the least accepted.
Inflammatory theory; It is a theory that accepts that cellulite occurs as a result of herniation of subcutaneous fat tissue formed by the destruction of collagen, a connective tissue element in the dermis. The fact that cellulite begins to be seen in women after puberty and after menstrual bleeding suggests the effect of hormonal changes on cellulite. Enzymes are secreted from the glands in the uterus and uterine tissue to break down collagen in order to bleed during each menstrual period. However, these enzymes also break down collagen in the dermis. As the support dose decreases, the fat tissue herniates towards the dermis and epidermis. With repeated menstrual cycles, collagen destruction increases even more and cellulite worsens with age. This theory is currently the most scientifically supported theory.
Grading of Cellulite
I degree; cellulitis is in the deep layer and there is no change on the skin surface, only microscopic cellulitis changes are seen when biopsy is taken.
In II degree cellulitis, there is no change on the skin surface at rest. When the skin is compressed, muscle contraction or pressure, rough, indented and protruding appearance appears on the skin surface, there is a decrease in skin elasticity.
At III degree, there is an orange peel appearance on the skin surface even at rest, there may be pain sensitivity with touch, there is a decrease in elasticity and skin temperature.
IV degree is similar to III, in addition, there are nodules in raised areas. The skin surface has a distinct wavy appearance. There is a feeling of pain discomfort due to compression of the nerves with these nodules.
The skin has a tight appearance. The appearance does not change with position such as standing or lying down. When the skin is squeezed between two fingers, an orange peel appearance occurs. This form is most commonly seen in young women with striae who do regular sports.
It is seen in women after 40 years of age who suddenly lose weight or who are sedentary and do not do sports. It is associated with muscle laxity. Roughness is evident on the skin surface, shakes with movement and changes with position. It is usually associated with capillary dilatation and circulatory disorders such as varicose veins.
It is the most severe but the least common. There is swelling all over the legs, the skin is shiny and thin. There is a feeling of heaviness and pain sensitivity in the legs
It is the most common type of cellulite. It is the coexistence of different types of cellulitis in different areas in the same patient.
What are the Methods Applied in Cellulite Treatment?
In the treatment of cellulite, it is important to adopt a healthy lifestyle. It is important to reduce the factors that may cause cellulite, proper nutrition, plenty of water intake, stress control.
In addition, there are many treatment methods such as iontophoresis, ultrasound, endermology (LPG), radiofrequency, infrared, thermotherapy, ultrasound, pressotherapy, lymphatic drainage, liposuction, massage, externally applied creams and gels, carboxytherapy and mesotherapy.
Endermology (LPG) is a mechanical device consisting of two motorised wheels and a controlled vacuum device. It is a method that affects the entire skin and subcutaneous tissue without disrupting the skin integrity. Pressure and vacuum cause displacement of fat tissue, stimulation of collagen-producing cells called fibroblasts and thus increase of collagen and elastin fibres. It also contributes to muscle stimulation and lymphatic drainage. Studies have shown that it also causes thinning in the body with cellulite.
Carboxytherapy; It is applied by injecting CO2 gas into the subcutaneous tissue. This gas accelerates the metabolism in the skin and subcutaneous tissue by causing the release of oxygen from the blood, lipolysis increases.
Pressotherapy; It is a method that includes an air massage device. Massage is performed in the direction of circulatory flow. It is a lymphatic drainage system that is also used in many vascular diseases that cause lodgement in the veins.
Body wraps; It is the covering of the body with wraps impregnated with herbal extracts, mud, moss, etc. It causes a decrease in body measurements with the effects of sweating and pressure, but this decrease is due to fluid loss and is temporary. Although it has no effect on cellulite, it may be useful for moisturising the skin.
RADIOFRECENCE, INFRARED COMBINATION (AWT); With this method, a new and effective approach to cellulite treatment has been introduced. It has been scientifically recognised at the level of congresses on effective and successful results in cellulite treatment.
Tiny, powerful sound waves that create a shock effect are used. In fact, this system has been used in medicine for a long time to break kidney stones. It is of German origin. The most obvious advantage of vibration pulses compared to ultrasound waves is that they can directly break down the target tissue, ie fat tissue, without tissue destruction. In addition, while ultrasound waves are effective at a limited depth, shock pulses reach deeper tissue layers. It is effective on all steps that cause cellulite:
Under the skin there are tufts of strands called fibrous septa. Fibrous septa consist of connective tissue and are located between fat tissues. These structures are located perpendicular to the skin in women and when their structure deteriorates and they lose their elasticity, they pull the skin inwards. Thus, they lead to the formation of dimples and bumps. While the shock waves act on the protrusions formed by the fats in the lower dermis, the shock waves produced both pass through the skin and fats and cause the fibrous septa to break down by destroying the fibrous septa with the power of high vibration waves and release the skin. In this way, they provide a smoother surface and eliminate the orange peel appearance. AWT also helps to thicken the dermis and reduce fat bumps. Thanks to ultrasound images, it can be seen that the skin thickens with new collagen formation and improves its quality after treatment.
In addition to cellulite, regional fat excesses and skin laxity problems are also solved with AWT. In studies, it has been reported that the increase in skin elasticity exceeds 70% from the 3rd month. Genetically, there are 18 million fat cells in the male body and 21 million fat cells in the female body, and the female body is slower in terms of lymphatic circulation. Because muscle structure and movement, which is the most important dynamic in lymph flow, is less in women. The difficulty in lymph flow will lead to fluid accumulation in the adipose tissue and as a result of decreased adequate cellular activity, it will lead to dysfunction. In addition, lipogenesis, i.e. fat production, is also higher and easier in women. With AWT, this vicious cycle is reversed, lipolysis increases and oedema is resolved. The two major problems in cellulite are oedema and fat accumulation. The shock waves directly dissolve the fat tissue. In lymphatic vessels, pulses accelerate peristalsis, ie lymphatic flow. In addition, the problem of oedema is solved by releasing special metabolites and increasing permeability.
In studies conducted in controlled groups, it has been biochemically proven that free fatty acids and glycerol, that is, the products released when fat tissue is broken down, increase instantaneously in blood samples taken before and after treatment.
AWT; It is a painless, effective and most importantly, it is a method that does not detach the person from his social life and results are obtained in a short time in regional adiposity and cellulite.
In order to get better results from the treatment, it is necessary to walk at least half an hour a day, drink at least 2.5-3 litres of water a day, eat a protein-rich diet rich in fruits and vegetables and low in carbohydrates, and avoid alcohol, smoking, acidic and caffeinated drinks. It is necessary to ensure that the resulting fatty acids and glycerol are somehow burned and destroyed with the need for energy. There is a noticeable thinning per area due to skin tightening and fat tissue loss. If weight loss is also in question with an appropriate nutrition plan, the result is much more satisfactory. Due to skin tightening and fat tissue loss, there is a thinning between 5-12 cm per area without the need for a special diet.
PEOPLE WHO SHOULD NOT BE ADMINISTERED AWT:
- Those with severe hepatic and renal insufficiency,
- Pregnancy and breastfeeding,
- If there is phlebitis and deep vein thrombosis in the leg,
- If you have inflammation in the area to be treated,
- If a surgical operation has been performed for varicose veins in the legs,
- Those with serious cardiovascular diseases, pacemakers
- Those with untreated bleeding disorders or those who have to take blood thinners,
- Those with uncontrolled diabetes.
- If anti-inflammatory drugs such as aspirin, cortisone should be discontinued 1 week before treatment.
Instant pressure and vibration is felt during application. The application takes 30-60 minutes depending on the area to be treated. The result is usually achieved at the end of 8-12 sessions, 2 sessions per week. The desired results are observed after 1-6 months depending on the self-renewal process of the tissues. Applications should be repeated at 3-month intervals for the permanence of the effect after treatment.
Mild flushing, cramps and tingling observed due to increased blood circulation in the area where AWT is applied improves without the need for additional treatment. Mild diarrhoea may be observed in abdominal applications.