Ashley Graham, Demi Lovato, Olivia Munn and Lizzo are among the stars who have posted cellulite-revealing selfies on social media as they talk to celebrate being perfectly imperfect. “I have cellulite,” Amy Schumer has said, “and I still deserve love.”
Others in the spotlight continue to search for minimally invasive solutions to get rid of that stubborn dimpled skin, found primarily on the thighs, buttocks, and stomach. Cellulite is more common in women (due to the distribution of fat, muscle, and connective tissue) and occurs when lattice-like fibrous cords pull down and accumulate fat in the middle. So all the topical creams, massages and dry brushing in the world won’t make a difference.
But recent advances in non-surgical devices for toning and firming the skin, along with Qwo, the first FDA-approved injectable enzyme treatment for cellulite on the buttocks, offer a variety of promising tools for fighting cellulite.
Beverly Hills dermatologist Harold Lancer, whose general practice clientele includes Margot Robbie and Beyoncé, focuses on three key treatments. To address the more superficial ripples in large areas, the doctor turns to the Emsculpt Neo machine, a combination of radiofrequency and electromagnetic energies that “help to tighten some of the ‘rings’ or fibrous junctions between the skin and the subfat lining, called fascia, as well as reducing some of the superficial fat,” he says. Lancer also uses Morpheus8’s latest M8 radiofrequency microneedle technology that penetrates “deep enough to heat the crevices and uneven contours of cellulite-prone skin.” For smaller regions, such as above the navel or on the inside of the arms, he uses Venus Legacy radiofrequency to tighten skin fibers. Larger “cup-shaped depressions” require subcision, a surgical procedure with low risk of side effects that uses local anesthesia and specially designed needles to cut individual cords one by one. Treatments are followed by injections of hyperdiluted Sculptra filler.
“The way people talk, you’d think cellulite is the scourge of Western civilization,” says Los Angeles-based dermatologist Ava Shamban, whose general client list includes Angela Bassett and Molly Sims. She stresses that the “button mattress appearance” of cellulite is seen more pronounced in “loose, sagging skin,” which is a separate topic.
Like Lancer, Shamban uses various modalities. “We really hit the cellulite, either with an injectable enzyme [Qwo] dissolve bands in two to three treatments or subcision to loosen bands; Radiesse or Sculptra injections to fill in dimples; then Emtone or Morpheus8 thermal radiofrequency to tighten the skin,” he says.
As for the pros and cons of Qwo, Shamban says, “The great thing about Qwo is that it’s quick and painless, even for people with lower pain thresholds, and it works. The current drawback is bruising. [which lasts about two weeks]so this isn’t something you can do right before filming or putting on a bikini, but the company is actively researching how to minimize it. We find that compression helps, and we can treat some with a laser, like we do with Botox or filler bruises.”
Shamban mentions two other new FDA-approved cellulite therapies for the buttocks and thighs: Resonic, a device that uses fast, advanced acoustic waves to break down fibrous tissue, and Avéli, a hook-shaped device that requires short, local anesthesia. connective tissue bands. He has yet to use either and considers Avéli “too invasive” for his practice.
Beverly Hills dermatologist Simon Ourian, whose general practice has clients like Lady Gaga, Eva Mendes and Megan Fox, turns to acoustic wave treatment for cases with large amounts of cellulite dimpling. “We use transacoustic therapy to bombard the area and release a lot of the weaker tissue, so we’re left with maybe 10 or 15 dimples that we can treat better,” he says (starts at about $3,000 for legs). Then he also uses a combination of subcision, filler, Emsculpt Neo, and radio frequency devices like Morpheus8. The newer laser, ultrasound, and radiofrequency treatments, he says, “work aggressively to shrink the skin. If we create enough heat, the cords of the skin become stronger, the collagen sheets become tighter, pulling the entire skin down to create a firmer elasticity.” Multi-modality packages at these doctors can cost anywhere from $5,000 to $18,000 for two or more visits. On its own, a three-session treatment with Qwo costs around $3,000 to $4,000, depending on the size of the area.
But while these tools help fight cellulite, there is still no single, simple solution. Ourian exclaims, “We’re all looking for that holy grail!”
This story first appeared in the August 17 issue of The Hollywood Reporter magazine. Click here for subscribe.