The bane of bathing suit season, no longer. The T&C Know It All’s Guide to cellulite treatments has the answers.

By April Long

It is, sorry to say, a fact of life: Cellulite exists. And no, it is not a plague visited only upon those who have spent their lives eating Cheetos and drinking Coke. Pinch some thigh flesh on even the most sylph-like silhouette, and there will be likely be a dimple or two. Cellulite is a perfectly normal skin condition that affects 90% of women, even if decades of airbrushing, blurring, and filtering have tried to convince us otherwise. Like so many other insults of aging, it gains traction with advancing years, and it is notoriously tough to shift: You can GLP-1 yourself to oblivion, and lo, those bumps will remain.

Some of us live acceptingly with cellulite more easily than others, but it’s fair to assume that there’s no one who fully embraces it. With midsummer upon us, we can choose to let it all hang out or take measures to mitigate—or at least disguise—the bumpy terrain of our behinds. Here’s a look at what works best to smooth and sculpt even the most troublesome spots.

The Basics.

What is cellulite?

Essentially, fat that is pushing through the matrix of connective tissue beneath the skin. Fibrous cords, called septae, connect the skin to the muscle like the fasteners in a mattress. As the septae pull downwards, the fat bulges up between them, creating a bumpy appearance. Cellulite is most common in women because men’s connective tissue is crisscrossed differently, creating a framework that holds fat in place more securely.

What causes it, and why is it so hard to get rid of?

Subcutaneous fat can become more visible for a variety of reasons. The main culprit is collagen and elastin breakdown, which can be due to age, hormonal shifts, pregnancy, weight fluctuations, or sun damage. Genetics can play a big role, too. All of these things thin the skin and degrade the support system that keeps tissue firm. Add fat deposits and stubborn septae to the mix and you have a structural issue that no amount of dry brushing or miracle creams can erase.

That's also why those dimples are so frustratingly difficult to eradicate. "The most effective treatments are those that address multiple causes of cellulite simultaneously," says board-certified plastic surgeon Dr. Leif Rogers. A procedure may tighten skin, reduce fat, stimulate collagen, or release the fibrous bands causing dimples—but rarely all of the above. Most treatments improve cellulite rather than eliminate it entirely.

The Treatments

What non-invasive procedures can treat it?

Sofwave

Sofwave, an ultrasound-based device that was originally developed for skin tightening and lifting, has recently been FDA cleared for cellulite. It works by delivering focused ultrasound energy into the dermis, stimulating new collagen production and increasing skin thickness.

"Sofwave is not designed to cut or release the fibrous bands that cause cellulite," explains New York plastic surgeon Dr. David Rapaport, who offers Sofwave at Aethos, his comprehensive Upper East Side aesthetic practice.. "Instead, it improves the quality, thickness, and structural support of the skin above these bands." Thicker, firmer skin can make dimpling appear less pronounced.

The treatment is particularly effective for women with mild-to-moderate cellulite accompanied by skin laxity. According to Rapaport, most patients undergo two sessions spaced roughly six weeks apart, with improvements becoming visible over the following three months as new collagen forms. Results can last many months, though maintenance treatments are often recommended.

Lindsay Malachowski, founder of New York’s Treat Medspa, calls it one of the most promising cellulite treatments currently available. "Ultrasound has been used to treat cellulite for over two decades, typically requiring eight to 10 weekly sessions or more,” she says. “With Sofwave, however, we can achieve significant improvement in one to two sessions spaced one to three months apart, with no downtime.”

Morpheus8

If Sofwave works from above, Kardashian favorite Morpheus8 attacks cellulite from several angles at once. The radiofrequency microneedling device uses ultra-fine needles to deliver heat deep into the skin and subcutaneous tissue, stimulating collagen production while remodeling connective tissue and reducing small pockets of fat.

"Morpheus8 can stimulate collagen production, tighten the skin, improve the fibrous septal network, and produce a smooth, even reduction of subcutaneous fat," says Rogers. Most patients require a series of treatments for optimal results. Downtime is generally limited to a few days of redness and swelling. As with Sofwave, Morpheus8 can be painful. Topical numbing cream as well as oral pain blockers are frequently recommended.

Lumenis NeuraTite RF

NeuraTite RF is another radiofrequency skin-tightening technology that is being used to achieve significant smoothing in cellulite-prone areas. At New York’s Shafer Clinic, licensed aesthetician Lucia Miranda treats clients with the device regularly, especially in the run-up to Hamptons season. “It’s important to remember that it takes a while for the effects to be visible, so if you don’t start until July, you’ll miss seeing optimal results in peak summer.” She recommends five to six treatments, spaced about a week apart. Unlike some of the more aggressive treatments, NeuraTite is more akin to a hot stone massage, and full treatment of the front and back of the thighs takes about 90 minutes. The heat causes a controlled injury that sparks the formation of new collagen and elastin, she says, while also strengthening connective tissue and breaking down fat cells, which the body sweeps away naturally. “The result is tighter, firmer skin,” she says, “with a nice reduction in dimpling.”

QuantumRF

For those willing to tolerate a bit more downtime in exchange for more dramatic results, QuantumRF occupies a middle ground between non-invasive devices and surgery. The treatment uses a small cannula inserted beneath the skin to deliver radiofrequency energy directly into the tissue. The controlled heat tightens skin, remodels connective tissue, and improves contour over time.

"The remodeling process continues for at least two months following treatment," says Rogers. Because it can activate collagen synthesis at a deeper dermal level, it can deliver more noticeable improvement than surface-level treatments alone.

The Tech.

Can red light therapy help at all?

The evidence is intriguing but limited. "Red light therapy is a fascinating treatment based on the cellular response to visible red and near-infrared light," says Rogers. Studies suggest that these wavelengths may improve cellular energy production, reduce inflammation, accelerate healing, and enhance overall skin quality. So while there is little direct evidence that red light therapy directly eliminates cellulite, healthier, thicker skin may make dimpling less noticeable over time if you are using a device—like the Sunlighten Red Light LED Panel, which has a cellulite setting—regularly. Consistency is key: daily sessions appear to offer the greatest benefit.

What about cryotherapy?

Despite wellness warriors’ claims that it can burn fat and eliminate bumps, cryotherapy is not considered a frontline cellulite treatment. Whole-body cryotherapy may temporarily reduce inflammation and improve circulation, which can create a short-lived tightening effect. However, there is little evidence that it significantly alters the structural causes of cellulite. Consider it a supporting player rather than a star performer.

The Longterm solutions.

Can anything get rid of cellulite permanently?

The closest thing to a lasting solution targets the fibrous bands themselves.

Subcision procedures such as Avéli and Cellfina are specifically designed to release the septae responsible for creating visible dimples. Using a small blade inserted beneath the skin through a tiny incision, the physician identifies and cuts the individual connective tissue bands pulling the skin downward. Unlike energy-based devices that improve the appearance of cellulite indirectly, subcision addresses one of its root causes. Because each dimple is individually treated, results can be dramatic—particularly for discrete, well-defined depressions on the buttocks and thighs. "When a specific dimple is targeted by releasing an individual fibrous septal band, that particular dimple may be permanently corrected," says Rogers.

Laser-assisted Cellulaze works on a similar principle but uses laser energy beneath the skin to both release fibrous bands and stimulate collagen production. The tradeoff is greater downtime and bruising compared with non-invasive options.

That said, even the most effective procedures cannot stop the aging process, hormonal fluctuations, weight changes, or the formation of new cellulite elsewhere. As New York plastic surgeon Dr. Matthew DelMauro notes, recurrence depends largely on the underlying cause. However, "when the ligaments are cut, they rarely return in the same location."

What are the best body-firming topicals to minimize the appearance of cellulite?

No cream can do much to get rid of cellulite, but some ingredients can temporarily improve the look of that dreaded orange-peel effect, whether immediately or over time. For a quick fix, look for a product containing caffeine, which helps temporarily constrict blood vessels and reduce puffiness; for longer-term skin improvement, look for body products with retinol, which can thicken skin over time. Just as in face creams, your best bet is to invest in products with peptides that support collagen production, and moisturizing ingredients such as hyaluronic acid that plump and smooth the skin's surface.

A few of our favorites? Yon-Ka Crème 55, which contains botanical extracts that boost microcirculation and diminish water retention; Sisley Le Sculpteur Instensive Contouring Cream, which works both day and night with toning caffeine and ginger; Cellcosmet BodyStructure XT Deep Firming and Toning Cream, which is powered by a host of firming and smoothing oils; and Biologique Recherche LipoSculpt, which helps eliminate fatty deposits and excess water in the tissues. For an extra boost, try any of these products with daily massage, a Tronque Body Contour Massager, or Gua Sha.

Read Full Article