Published by: Kenneth Pettine, MD (Retired) 

INTRODUCTION:  Cellulite is a skin alteration often described as an “orange peel”, mattress or dimpling appearance of the skin on the thighs, buttocks, lower abdomen and upper arms of otherwise healthy women. Approximately 85% of post-pubertal women have a form cellulite.

WHAT IS CELLULITE?  The outermost layer of skin is referred to as the epidermis. Immediately beneath the epidermis is the dermis. The dermis is filled with sweat glands, blood vessels, nerve receptors and connective tissue. The connective tissue consists of collagen. The only cell that can produce collagen is the fibroblast. Cellulite is caused when this connective tissue barrier that separates the dermis from the underlying subcutaneous fat becomes lax or develops rents within the connective tissue collagen mesh. These rents or laxity allow the underlying subcutaneous fat to protrude, or herniate, through the collagen fibers and produce a bumpy appearance in the skin referred to as cellulite.

WHAT IS THE CAUSE OF CELLULITE?  The connective tissue in the dermis provides the framework, insulation, and stability to prevent the subcutaneous fat from protruding or herniating through to the skin. It is composed primarily of collagen (firmness), elastin (elasticity), and glycosaminoglycan (GAG) (hydration). The only cell that can produce these proteins is the fibroblast. The etiology of cellulite is a dysfunction of the fibroblast. Either there are not enough fibroblasts, or the fibroblasts that are present in the dermis are not producing enough collagen, elastin, or GAG. Without these proteins, in the dermis, the subcutaneous fat herniates and causes the “orange peel” of cellulite. The pathology of cellulite is almost completely due to genetics.  Thin young highly athletic women can have cellulite. The only stem cell that produces fibroblasts is the mesenchymal stem cell. Without this stem cell, the body cannot produce new fibroblast cells. Without new fibroblast cells, the body cannot produce collagen, elastin or GAG. Without these proteins, the body will develop cellulite.

WHAT ARE THE PROPOSED TREATMENTS FOR CELLULITE?  The following is a review of surgical options, injectable interventions, noninvasive devices, thermo treatments, topical appointments, herbals, lasers and shockwave treatments that have all been used in the treatment of cellulite.

LIPOSUCTION:  Most dermatologists do not recommend liposuction to treat cellulite. A few subjective reports indicate a small temporary improvement while others report liposuction worsens the dimpled skin appearance of cellulite.

SUBCISION is a technique of producing trauma in the dermis with a needle. Adverse side effects include pain, bruising for up to 3 to 6 months, and skin pigmentation alterations. There is no objective scientific data to recommend this technique.

INJECTABLES, such as phosphatidylcholine, are injected into the subcutaneous tissue to dissolve the fat. No current scientific evidence is available to show the effectiveness of any injectables.

MESOTHERAPHY is basically the same treatment as injectables with no data to show its efficacy.

ENDERMOLOGIE is a suction massage developed in France. This type of electrically powered device has two components. Treatments range from 10 to 45 minutes of sometimes rolling the skin of the hips, thighs, legs, buttocks and stomach. There is no data to show it has any efficacy in the treatment of cellulite.

MASSAGE of any type has not shown to have any efficacy in treating cellulite.

THERMOTHERAPHY is a heat application technique that promotes blood flow and vasodilatation. Studies show it may actually worsen cellulite.

TOPICAL OINTMENTS of any kind have shown a modest, at best, improvement in the appearance of cellulite even after six months of treatment.

HERBALS also show at best a modest improvement in the appearance of cellulite, for up to six months following treatment.

LASERS: Within the past few years, researchers have been testing lasers to treat cellulite. There have been reports of improvement in the appearance after multiple treatments for up to six months.

SHOCK WAVE THERAPY is used to treat kidney stones. The application of shock therapy on soft tissue is very recent. One study using shockwave therapy twice a week for six weeks showed improvement in most of the 21 women in the study. Both of these treatments cause trauma to the dermis which results in inflammation. The theory, similar to micro-needling in the face, is that the inflammation stimulates the fibroblasts in the dermis to produce more collagen, elastin, and GAG. This effect, if it occurs, is temporary.

CONCLUSIONS ABOUT CURRENT TREATMENTS FOR CELLULITE:  Do not invest your hopes or money in liposuction, subcision, injectables, skin kneading and manipulation techniques, thermotherapy, topical appointments or herbals for cellulite treatment. Laser therapy and shockwave therapy may have efficacy in temporarily reducing the appearance of cellulite. More research is required to see if these last two treatments actually provide any long-term efficacy.

WHAT IS THE BENNULIFE NEOFIBROBLAST STEM CELL TREATMENT FOR CELLULITE?  This is a proprietary procedure protected by several patents. The procedure involves three steps. The first step is the collection of blood from a vein along with bone marrow from the iliac wing. This is performed with IV sedation and does not cause discomfort. The second step involves concentrating the platelets from the blood and the stem cells from the bone marrow aspirate. Platelets are rich in growth factors. Bennulife’s patented technology results in three times the concentration of platelets and twice as many stem cells as competitive techniques. The third step is the application of the concentrated bone marrow and platelets into the dermis. The skin is prepared with a miniature facial, followed by a microdermabrasion treatment to exfoliate the outer layer of skin. The highly concentrated platelet serum combined with the concentrated stem cells are then infused into the dermis with our unique Micro-needling device. This achieves a diffuse infusion of concentrated platelet growth factors and mesenchymal stem cells throughout the dermis of the face, neck, chest and backs of the hands. After this, additional concentrated platelets and mesenchymal stem cells are placed into the lines of the face. The platelets contain numerous growth factors that stimulate the mesenchymal stem cells and fibroblasts.

TREATMENT CONCLUSIONS:  None of the current treatments for cellulite address the real pathology of the condition, which is fibroblast cell dysfunction. Placing mesenchymal stem cells into areas of cellulite may provide long-term or even a lifetime improvement in cellulite. Mesenchymal stem cells are the only cells that can produce the fibroblast. Only the fibroblasts can produce collagen, elastin, and GAG. These are the three proteins that make skin firmer, elastic and hydrated.  The mesenchymal stem cells placed into the dermis reproduce themselves endlessly and will differentiate into an endless number of brand new fibroblast cells. This may result in a continuous production of collagen, elastin and GAG and a possible permanent improvement of skin’s firmness, elasticity, and hydration. Healthy fibroblasts have the potential to provide long-term improvement and perhaps a correction of cellulite.



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