Objectives: Presentation Objectives: To describe clinical aspects of cellulite and skin laxity, and to discuss treatment modalities.
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Cellulite is defined as relief alterations of the skin surface with depressed and, sometimes, raised lesions. It is a gender-related condition, almost ubiquitous amongst women and rarely seen in men. Genetics, age, and BMI may account for its severity.
It is well demonstrated that the subcutaneous septa play a determinant role in the occurrence of the depressed lesions of cellulite. Raised lesions are most likely linked to the presence of localized fat in these areas.
Introduction: Skin laxity can be defined as the loss of skin firmness or elasticity. It occurs mainly due to aging, but can be also caused by significant and quick weight loss. Skin laxity clinically presents as the ptosis of cutaneous and subcutaneous structures, giving the skin a loose and draped appearance, often misdiagnosed as cellulite. It frequently occurs in body regions where the skin is thinner with potentially less retentive capacity over subcutaneous fat and other structures, such as the inner part of the thighs and arms, the region above the knee and other regions such as buttocks and abdomen.
Materials / method: Gravity increases the effects of subcutaneous structures on the skin, increasing laxity and worsening the alterations on the skin surface of the affected areas.
Although these two conditions differ, they are related to each other. Skin laxity is an important aggravating factor of cellulite. With increased laxity, cellulite depressed lesions tend to be more linear or oval than rounded, following the skin lines and giving the skin a draped appearance. Due to the increased skin laxity, depressed lesions become more evident and can appear in patients who previously did not present cellulite.
Results: Treatment modalities for cellulite vary from noninvasive, such as weight loss, massage and topical creams to invasive procedures, such as laser assisted lipolysis, liposuction and subcision. For skin laxity, radiofrequency and ultrasound-based devices have been used with good efficacy results.
The use of collagen biostimulators to improve skin laxity has recently increased. The poly-L-lactic acid (PLLA) is well-known for its long-term effects in soft-tissue augmentation through neocollagenesis stimulation.
Conclusion: Injectable PLLA has been widely used for facial aesthetic enhancement. Its use for the improvement of skin laxity and body contour has showed good results. Calcium hydroxyapatite suspended in an aqueous carboxymethyl cellulose gel carrier is another resorbable biostimulatory filler. It induces fibroblastic response, stimulating collagen and elastin formation. Recent case reports and studies have shown the efficacy of collagen biostimulators alone or combined to other therapies to improve skin laxity on the buttocks and thus, improving also cellulite appearance.
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