Cellulite is a common condition that usually affects thigh and buttocks areas. Various treatments are currently available to treat cellulite. Although we offer different options to improve the skin appearance, including LPG and mesotherapy, one of my preferred and most used methods to treat cellulite is using hyaluronic acid (HA) dermal fillers. HA body fillers offer results that last over a year, avoiding constant touch-ups and increasing patient satisfaction. Regarding the choice of filler, it must have a high normal force to project and elevate the skin in the area to be treated. 

Cellulite presents an irregularskin topography evident by skin dimpling due to fibers pulling the skin downwards, so a filler with a higher capacity to push the skin tissues to project them is needed. Another important consideration is the quantity of material to be used. Usually, around 10 ml of filler are required; thus, from a  cost-benefit perspective, it is more convenient to use body fillers in which prices/ml are lower. I use Genefill Contour.

There are several factors to consider when performing this treatment. First, I determine if the patient is the right candidate for the procedure by assessing the laxity of the skin on the area to be treated. Evaluating before treatment if the patient has cellulite or pseudo-cellulite (skin laxity) is crucial to ascertain that the patient is fit for this type of treatment and if satisfactory results are possible to achieve. 

Moreover, it helps to manage the patient’s expectations as results in pseudo-cellulitis would not be as effective. Although different methods have been used to measure skin laxity, I prefer to rely on practical experience. Second, before procedure, it is necessary to review the patient’s medical history, e.g., use of blood thinners. It is always essential to disinfect the area well to avoid infections.

Also, the transfer of the product from a 10 mL syringe to a 1 mL syringe allows smaller needles and easier and more precise placement of the filler. Third, regarding injection technique, I place the body filler under the skin, between the dermis and the fat, applying multiple injections. During procedure, there might be skin dimplings with fibers pulling the skin down perpendicularly.

Some of these fibers are lax, allowing placement of the filler and elevation of the skin. However, some of these fibers hold down the skin impeding volume restoration by the filler. In these cases, it is necessary to cut the fiber using a Nokor needle and place the filler, which will act as a spacer between the skin and future new fibers helping to maintain results longer. 

Finally, filler effects will be noted immediately after procedure, offering a high rate of satisfaction to the patient with a very low rate of adverse reactions.

Dr.Athanasios Christopoulos. Plastic Surgeon / Greece

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