Affecting a vast majority of women (up to 80-90%) as well as a small number of men, cellulite is a highly common condition that often occurs in the hips, buttocks, and thighs but can also appear on the breasts, upper arms, and lower abdomen. Even individuals who are physically fit, highly athletic, or toned can still be impacted by cellulite.

Typically accompanied by skin laxity and water retention, cellulite is inflammation and scarring of the superficial fat tissue. Collagen fibers anchor the skin down to the deeper tissues while fat tissue simultaneously pushes the loose skin upwards. This causes the all-too-familiar cellulite appearance, characterized by lumpy, dimpled, rippled, and wavy skin. There are varying grades of cellulite, ranging from a mild, orange-peel appearance to a moderate, “cottage cheese” appearance to a “quilted mattress” look with severe dimpling and indentation.

 

While there is no 100% cure for cellulite, board-certified dermatologist and non-surgical skin tightening specialist Dr. Jason Emer employs a range of techniques and devices to obtain visible reduction in cellulite, including Cellfina, the only FDA-cleared, minimally invasive procedure clinically proven to improve the appearance of cellulite for at least 3 years — the longest FDA-cleared duration for any cellulite treatment. According to Dr. Emer, Cellfina is the gold standard for cellulite improvement and is most effective when combined with:

• Sculptra, an injectable collagen stimulator
• fat grafting with platelet-rich plasma (PRP) and injectable fillers such as Renuva and/or Bellafill to plump indentations, dimples, and waves in the skin’s surface
• external, non-invasive radiofrequency energy devices (including Thermage, BTL Vanquish Me, Venus Legacy, BTL Exilis Ultra, InMode Forma/Contoura, and InMode BodyFX) to further stimulate collagen production and promote skin tightening while also softening the thick connective tissue pulling down the skin
• microneedling with radiofrequency devices, including InMode Fractora, InMode Morpheus8, and EndyMed Intensif
• vibration / shockwave therapy devices (such as eVIVE, Cellutone, and ZWave) to improve skin texture
• non-surgical thread lifting with Silhouette InstaLift or smooth NovaThreads to address individual dimples or “waves”
• truSculpt iD, CoolSculpting, and BTL Vanquish Me for fat reduction and buttock contouring

For those who are prime surgical candidates, Dr. Emer recommends:

• VASER Hi-Definition Liposuction with InMode BodyTite and/or Renuvion (formerly J-Plasma) for optimal fat reduction, body contouring, sculpting, and definition
• butt lift and/or spiral thigh lift with surgical skin tightening and excess skin removal

How does Cellfina work?

The process begins by creating a roadmap of the procedure with Dr. Emer, who views your body under a special overhead light and identifies the ripples, dimples, bumps, and waves on the skin. Marking the area with small circles and crosses is an essential step as it allows Dr. Emer to identify which dimples and waves are good candidates for the Cellfina treatment — and it also ensures accuracy once the patient is in treatment. While Cellfina is most effective on dimples, it can also help improve waves and ripples when paired with Sculptra, fillers, fat grafting, and energy-based skin tightening treatments.

The second phase involves numbing the identified treatment area prior to the Cellfina procedure. A numbing and anti-inflammatory solution is injected across the buttocks and thighs (all the pre-marked treatment areas) to ensure that there is no pain or discomfort during treatment.

Once the area has been numbed, Dr. Emer positions the Cellfina applicator over the areas with cellulite and injects a motorized needle beneath the skin (the depth where cellulite bands live). Cellfina tackles the primary cause of cellulite: the connective bands woven throughout fat in the thighs and buttocks, which pull down the skin and create the rippling and dimpling effect on the surface that we recognize as cellulite. Cellfina’s motorized needle penetrates the skin to cut and release the fibrous bands and to disrupt any scars and tissue tugging on the skin. Once the bands are ruptured or released, the treated skin bounces back, the ripples gradually fade, and the skin retains a smoother texture.

Following the Cellfina treatment, Dr. Emer injects Sculptra underneath and around the treated areas to stimulate natural, long-term collagen production. Made from an absorbable, synthetic material called poly-L-lactic acid (PLLA), Sculptra acts a fertilizer deep beneath the skin, boosting collagen production and helping to restore your skin’s inner structure and volume. With a series of treatments, the remodeled collagen strands restore lost volume, provide fullness to dimples and indentations, and tighten the skin over the course of several months. Large volumes of Sculptra can be used alone or with fillers like Bellafill and/or Renuva synthetic donor fat to help give volume and contour to the buttock if desired.

Overall, Cellfina + Sculptra can improve cellulite, smooth the surface of the skin, and promote long-lasting skin tightening. The procedure can be performed either asleep or awake depending on each patient’s personal preference.

 

How does Dr. Emer do it differently?

While many physicians rely on a single treatment or device to create improvements, Dr. Emer customizes a unique treatment plan for each patient to reduce cellulite long-term, to improve loose, crepey, or sagging skin, and to reduce the fat that accumulates with age in the buttock, posterior thigh, buttock roll, and thighs/legs.

How long do improvements last?

The longevity of the outcome depends on how well the patient’s skin reacts to the Cellfina treatment and the breaking of the connective tissue bands beneath the skin. Although there is no true cure for cellulite, Cellfina’s results are permanent (although more cellulite and sagging occurs as we age) and can be maintained and improved upon with Dr. Emer’s unique combination approach. Sculptra injections for enhanced collagen production can be scheduled as often as 6 weeks for continual improvement.

Fat Transfer & Filler Injections for Cellulite Reduction

Used in combination with Cellfina and Sculptra, autologous fat (from your own body) and dermal fillers can assist in cellulite reduction by plumping and adding volume to the injected areas and filling out the indentations, dimples, ripples, and waves in the skin’s surface.

For those who are too lean or athletic (or for those who are apprehensive about a Hi-Definition Liposuction or fat harvesting procedure), Renuva Adipose Matrix is a safe and effective alternative. Renuva is synthetic donor fat specifically designed to treat small-volume aesthetic irregularities such as cellulite and dimples in the skin. The product is derived from cadavers’ fat cells, which are meticulously tested, screened, purified, and hydrated in fluid to ensure smooth administration to the desired treatment areas.

Subcision & Bellafill for Cellulite Reduction

For patients with mild cellulite or only a small number of dimples and indentations (which may not warrant a more invasive Cellfina treatment), Dr. Emer uses manual in-office subcision, a minimally invasive technique in which a small blade or the tip of a needle is inserted beneath the skin’s surface, breaking apart the tethered bands that create cellulite. Subcision is also used in Dr. Emer’s practice to treat depressed, tethered acne scars.

Following the subcision procedure, Dr. Emer injects Bellafill directly into the treatment area to build collagen and prevent the recurrence of cellulite or dimpling. Made from a safe, biocompatible material, Bellafill is comprised of tiny polymethyl methacrylate (PMMA) microspheres suspended within a smooth collagen gel. Once injected, the collagen gel immediately plumps the depressed skin while the PMMA microspheres bind to the tissue and create a scaffold beneath the skin, thereby promoting natural collagen production. The new collagen creates additional volume and reduces the appearance of cellulite as well as scars, fine lines, wrinkles, folds, furrows, and indentations, resulting in a smooth, subtle, and long-term outcome.

For those seeking cellulite reduction as well as improvement in size and contour, Dr. Emer uses his innovative “BellaLift” technique (a combination of Bellafill and Sculptra) to achieve an enhanced, “perkier” buttock and shape that builds over time. BellaLift requires several initial treatments in a single year followed by maintenance treatments 1 to 2 times per year.

External Energy-Based Devices for Cellulite Reduction

As early as a week after a Cellfina treatment, non-invasive energy-based devices (including Thermage, Vanquish, Venus Legacy, BTL Exilis Ultra, InMode Forma/Contoura, and Body FX) can be used to enhance cellulite reduction and improve skin texture. When delivered to the deeper layers of the skin, RF and ultrasound energy stimulates new collagen formation and fibroblast cell production, resulting in reduced sagging and crepey skin, improved skin texture and tone, and smoother, tighter skin over time. It also slows the aging process by slowing down the degeneration of collagen. With regular treatments, you can maintain a youthful lift and contour for an extended period of time, postponing the need for surgery.

Microneedling RF for Cellulite Reduction

Ideal for non-surgical, non-invasive skin rejuvenation, microneedling RF devices (such as InMode Fractora, InMode Morpheus8, and EndyMed Intensif) introduce heat into the skin without damaging the skin’s surface to help remodel loose and unhealthy collagen. Through microchannels of energy, microneedling RF stimulates the formation of new collagen, prompts subdermal skin tightening, and improves the skin’s elasticity for remarkable short-term and long-term results. Skin tightening occurs immediately upon treatment application but continues to improve with subsequent treatments at 4 to 12 week intervals. Fractora, Morpheus8, and Intensif are also effective preventive treatments that can delay the inevitable signs of aging and can be used on other areas such as the face, neck, arms, knees, and elbows.

Vibration & Shockwave Therapy for Cellulite Reduction

Shockwave and massage therapy treatments (such as Cellutone, eVIVE, and ZWave) deliver high frequency vibrations to enhance micro-circulation and oxygen supply in the affected area, which helps to break up scar tissue, stimulate blood flow, tighten the skin, smooth the skin’s surface, and improve muscle definition. Dr. Emer recommends that his patients maintain the results with bi-monthly treatments and combine shockwave and massage therapy with external RF treatments.

Non-Surgical Thread Lifting for Cellulite Reduction

Sagging skin or skin laxity occurs in many parts of the body with aging — the lower face, neck, chest/breasts, upper arms, abdomen, thighs, knees, elbows, and buttocks — but many of Dr. Emer’s patients prefer to avoid surgical lifting through non-surgical techniques like thread lifting. In the buttock area, where cellulite most commonly occurs, Silhouette InstaLift can corset and lift the skin of the buttocks and the buttock roll to create immediate lifting and tightening and prevent sagging over time.

 

Silhouette InstaLift sutures contain sugar-based cones that are activated once inserted beneath the skin and ultimately dissolve into the tissue. In the weeks to months following the treatment, new collagen forms in their place. This treatment involves minimal downtime, and improvements are significant in areas that are particularly difficult to lift, including the buttocks, knees, arms, and breasts.

Complementary Fat Reduction Treatments

Dr. Emer often pairs cellulite improvement with non-invasive or minimally invasive fat reduction treatments, which can be performed multiple times until the optimal improvement is achieved.

• Cutera’s truSculpt iD uses RF energy (as opposed to laser energy) and targeted, subdermal heating to achieve permanent fat reduction and skin tightening in just 15 minutes per treatment area and session. Up to 6 handheld applicators are applied directly to the skin during a single treatment, either in a single location or in multiple areas simultaneously. Once applied, the applicators send targeted pulses of individually calibrated radiofrequency energy below the skin’s surface to deliver deep subdermal heat and permanently burn stubborn fat cells.
• CoolSculpting (or cryolipolysis) is a one-of-a-kind non-invasive treatment that crystallizes fat cells. Once the treated fat cells are crystallized (or frozen), the cells die and are naturally processed and eliminated from the body over the course of about 2 to 6 months. CoolSculpting often takes multiple treatments separated 8 to 12 weeks apart to get significant improvement.
• BTL Vanquish Me is a non-invasive treatment that uses radiofrequency to destroy fat cells, which are then processed out by the body’s own lymphatic system. Ideal for athletic individuals with small pockets of stubborn fat, Vanquish deeply heats the skin, literally melts away that hard-to-lose fat, and tighten loose skin in a safe, highly effective way. BTL Vanquish Me is often paired with CoolSculpting as part of the “Fire & Ice” fat reduction and skin tightening procedure.

Treatments such as truSculpt iD, CoolSculpting, and BTL Vanquish are effective complements to injectable fat-reducing treatments such as Kybella, Lipodissolve, and Mesotherapy.

Surgical Cellulite and Buttock Sculpting and Contouring

For patients who are looking not only for cellulite improvement but also for fat reduction, contouring, skin tightening, and definition, a VASER Hi-Definition Liposuction procedure (in combination with fat grafting and minimally invasive “shrink wrap” skin tightening devices like Renuvion and FaceTite/BodyTite) can give you the most toned, sculpted, tight, and smooth result. Dr. Emer’s procedure tightens the skin, improves cellulite, defines and contours the body, and helps to correct botched surgeries and irregularities.

There are plenty of cosmetic and plastic surgeons who can remove fat for mild improvement, but there are only a handful of meticulous, highly skilled Hi-Definition Liposculpture specialists who can remove fat, tighten skin, remove cellulite, correct botched procedures, improve indentations and irregularities, and purify and repurpose the removed fat to create a defined, sculpted figure, all in one procedure.

In the video above, Dr. Emer uses the Toledo Dissection cannula (a unique tool used in Hi-Definition Liposuction procedures or in fat harvesting) to break apart the soft tissue / connective tissue adhesions that cause cellulite and dimpling on the buttocks. The fork-shaped, rounded dissection tip allows for the clearing of soft tissue or fascia with minimal trauma. This technique is combined with internal heating, liposuction, fat grafting, and Cellfina + Sculptra to give much better improvement to the buttock and thighs.

Is Cellfina painful?

Dr. Emer uses an injectable numbing medication to ensure that there is very little pain and discomfort during the Cellfina cellulite reduction treatment. IV sedation, oral pain medications, or general anesthesia can be performed if desired.

What is the downtime for Cellfina?

Despite its dramatic improvements, Cellfina involves very minimal downtime. 24 to 72 hours after the Cellfina treatment, Dr. Emer’s patients are typically back to work or back at the gym with only minor swelling and/or bruising. Swelling and bruising may last up to 2 to 4 weeks after the procedure but will not restrict you from any of your daily activities.

Am I a good candidate for Cellfina?

A formal evaluation with a board-certified dermatologist like Dr. Jason Emer is the best way to determine if you are an ideal candidate for cellulite reduction — and which combination of treatments would be the most effective for the condition of your skin. Dr. Emer can also identify any severe laxity or skin looseness that may require skin removal, surgical lifting, or implants to see significant improvement.

How do I schedule a consultation with Dr. Emer?

To schedule a consultation with Dr. Emer in Beverly Hills / Los Angeles / West Hollywood, California, please reach out to our concierge to schedule an appointment. Call 424-800-4140 or email us at appointments@jasonemermd.com.

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