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Does liposuction increase the risk of cellulite?

Q:

I have read some reviews where people said they had to have cellulite treatments after liposuction because during recovery they noticed the area became riddled with it.  Is it true that liposuction can cause cellulite?

A:

Liposuction does not cause "Cellulite." If anything, it can reduce it. "Cellulite is bumpiness or waviness of the skin from fat filling the areas between fascial (the heavy tissue that connects the skin to the underlying muscle covering) bands causing the skin to bulge. If you have this problem, removing the fat from the deeper layers will not address the 'cellulite." To do this one has to use a very small canula and liposuction the superficial compartment. This has to be done very carefully to prevent dimpling of the skin. This is why it is important to select a plastic surgeon with significant experience in liposuction if you decide to do this.

A:

Cellulite, also known as “orange peel syndrome” and “cottage cheese skin” is the skin dimpling and nodularity caused by the herniation of subcutaneous fat  just below the skin, which is contained within fibrous connective tissue, called septa, that go from the skin down to the underlying muscle. It occurs in most post-pubertal females and rarely in males. There is a hormonal component to it's presentation as well as genetics and the loss of skin elasticity.

Liposuction does not cause cellulite and it is generally not increased by liposuction. In fact, it often may be subtlely improved, but in some patients cellulite may appear to be worse after liposuction, especially if there is poor skin tone to start. Overly aggressive fat removal can lead to irregularities in the form of skin dimples that mimic the appearance of cellulite. Important factors in the results are: use of a very narrow cannula to remove the excess fat, the level of the fat removal, your individual anatomy, and the extent of skin laxity. It is not just the amount of fat that is removed, but also the amount and level of the fat that is left that gives a natural smooth result. Key to achieving an optimal result is the artistry and experience of the surgeon who should be certified by the American Board of Plastic Surgery and ideally a member of The American Society for Aesthetic Plastic Surgery.

Realistically, there is no long term scientifically proven cure for cellulite. There are newer technologies that are being developed that show promise.

Robert Singer, MD  FACS

La Jolla, California

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