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A New Look at Cellulite, Part 1


  • Figure 1

    Figure 1

    Ultrasound Image of Leg at Gluteal-femoral Fold

    Pugliese Figure 1
  • Figure 2

    Figure 2

    Architecture of Gluteal Fat

  • Figure 3

    Figure 3

    The Normal Menstrual Cycle

    Pugliese Figure 3: The Normal Menstrual Cycle
  • Figure 4

    Figure 4

    Difference in Male and Female Thighs

    Pugliese Figure 4: Thighs
By: Peter T. Pugliese, MD
Posted: June 26, 2008, from the July 2008 issue of Skin Inc. magazine.

It is a well-known adage in medicine that if you have more than one treatment for a disease, you do not have the right treatment. Most medical treatments are based on a knowledge of the nature of the disease being treated. When the cause and course of the disease are well known, a specific treatment is then either developed, or research workers try to find the correct one. As an example, a bacterial infection requires a specific antibacterial agent, and diabetes mellitus requires insulin and dietary control.

Cellulite, however, is a very misunderstood disease—in fact, to a large measure, it is not understood at all. Since no one dies from cellulite, there is no political impetus to fund research about it. Somehow, the untold misery and unhappiness of millions of women does not seem to be motive enough for serious research into cellulite.

Before the most probable cause is examined, this article will explore the current concepts and look at some of the treatments offered. Conventional wisdom suggests that cellulite is a disease of the fatty tissue, and is due to lack of exercise and a poor diet. Most so-called beauty magazines advocate exercise and diet as the only effective treatment. Unfortunately, any woman who has tried these modalities realizes they are next to worthless in regard to cellulite.

Both the circulatory and lymphatic systems are critical to a person’s health, but they play only an insignificant role in the genesis of cellulite. Toxins are blamed for everything from erectile dysfunction to brain tumors, so it is not surprising to see it pop up when cellulite is considered, which is sheer nonsense; none of these advocates of cellulite toxins can name a single one or verify the physiological effects of these toxins on cellulite.

Lipodystrophy suggests that there is something wrong with the fatty tissue. The displaced water theory has been around for many years, and goes along with intercellular fluid accumulation. Trauma as cause fits into this category, as does fibrosis.