Objectives: New insights on the pathophysiology of cellulite have led to the development of different therapeutic strategies to treat it.

Introduction: Cellulite is a multi-factorial condition that is present in 80-90 % of post-pubertal women, and for them it is one of the most intolerable aesthetic imperfections.

Materials / method: The scientific landscape has been thoroughly evaluated to determine solid clinical evidence regarding the safety, efficacy of cellulite treatment options as well as their protocols and techniques.

Results: New technologies using blades, injectable agents and the internal-external approach are discussed. Studies using laser and light modalities, along with radiofrequency showed improvement of cellulite and a good safety profile, although reduction of cellulite was not the primary endpoint of their analyses. Acoustic wave therapy (AWT), vacuum assisted subcision, and the 1440 nm Nd:YAG minimally invasive laser demonstrated beneficial results in cellulite reduction.

Conclusion: Although there is no single treatment to eliminate cellulite, new insights in the pathophysiology, structure and function of this condition, as well as new combination treatments, have resulted in greatly improving its appearance.

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请注明名称（个人，公司，学会等等）: venus, Cutera

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Objectives: Radiofrequency is commonly used for increasing deeper skin temperature without any epidermal or dermal ablation. It is not only used as an efficient method for contracting or inducing skin tightening but also as an effective method for reducing fat in repetition
However, there is no standard protocol for treatment time with RF, and the range of therapeutic sessions were widespread between 1 and 24 weeks
But which one, is the best to treat cellulite and which type cellulite we are discussing ? Is it for remodeling the surface of the skin, to reduce dimples

Introduction: There are a number of controversies about ideal temperatures for treating cellulite. Some authors propose high temperatures: Alster and Lupton treated cellulite, obtaining immediate collagen contraction due to heat and protein denaturation using high temperatures and del Pino et al. observed a thickening and realignment of interlobular septae using temperatures between 39 and 41°C with radiofrequency. These temperatures are considered high, but there is another authors that uses low temperature, about 37 degrees or 5 to 6 degrees above the temperature of the skin.

Materials / method: The problem lies in the fact that most cellulite treatments have proven to be ineffective, since the assessment methods used are mostly subjective or do not provide enough information for the study of subcutaneous tissue. The application of different temperatures to treat cellulite are suggested by several authors, as well as differences between their classification.

Results: According to Goldman et al., the hard cellulite is typical of young subjects with toned tissues, typically in Latin American people. Normally, the area is rigid and presents adherences between superficial and deep layers and the skin thickness is increased.
In these cases, according to some authors , the use of low temperatures would be more interesting to refine fibrous septae.
On the other hand, soft cellulite is common in older people and sedentary, with characteristics of weak and white skin. In this case, radiofrequency with high temperature increases the collagen thickness.

Conclusion: Araujo et al. confirmed that up to 96% of former studies obtained positive outcomes with RF. These data were collected by before and after exposure pictures, patient’s questionnaires, biopsy, etc.. Satisfaction for subcutaneous fat reduction with RF was approximately 71 - 97%, according to patients’ self-reported data.
We have to make a difference between Rf : external device, contact handpiece, microneedle.

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Objectives: to understand the mechanism of cellulite and treatment options

Introduction: Cellulite shows a high prevalence (80%–90%). The cause of Cellulite is multifactorial. Cellulite depressions are associated with a significant increase in the presence and thickness of underlying subcutaneous fibrous septa. Bulging of partitioned subcutaneous fat lobules occurs as a secondary event ( confirmed by MRI and transmission electron micrograph studies)
Several therapies have been described including topical therapy, injectables, lymphatic or vacuum-assisted massage, acoustic wave therapy, light therapy, external noninvasive lasers, and radiofrequency (RF) devices, all leaving unpredi

Materials / method: Subcision (manual, vacuum-assisted, and laser-assisted methods)
releases the reticular dermis from tethering by underlying fibrous septal bands within subcutaneous adipose tissue, resulting in smoother skin topography. Subcision is recommended only for cellulite depressions present at rest, not for depressions visible only with muscle contraction.

Results: Although several different treatment options exist, many of these either lack standardized supporting. Subcision can lead to significant improvement in the clinical appearance of cellulite with a low adverse event profile.

Conclusion: Increasing understanding of the complicated pathophysiology of cellulite will likely enhance current treatment options and lead to the development of more targeted therapies in the near future.

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