CELLULITE EVOLUTION STAGES

Composition of healthy tissue

First stage of cellulite: Affectation of microcirculation

While no superficial changes are observed, in a microscopic evaluation thickening of the alveolar fat layer is revealed along with increased capillary permeability.

While no superficial changes are observed, in a microscopic evaluation thickening of the alveolar fat layer is revealed along with increased capillary permeability.

Second stage of cellulite: Cellulite secretion stage

Vasodilation from the previous stage increases and is converted into the release of liquids to the extracellular space. The oedema produces an increase in pressure in the connective tissue tracts and the nerve fibres which could cause pain. The collagen and elastic fibres in the periphery of the vessels and between the fat lobes harden, thicken and increase in amount due to the stimulation to the metabolism of the fibroblasts which synthesise more material. The fat cells become hyperplasic and hypertrophic, increasing the amount of fatty matter.

There is a tendency in this stage to visualise orange peel skin texture and fat deposits may appear such as localised lipodystrophy that can cause visible deformity.

After the skin compression or muscular contraction, the skin is pale with low permeability and temperature.

Composition of tissue with cellulitis

Third stage of cellulite: Cellulite Fibrosing Stage

Adipose cells increase in number and size, clustering in the form of micro modules, highly loaded with lipids, while trapped between the fibrous septa that are hardened and deformed. The septal fibrils further thicken and become turgid and translucent. The extracellular space is loaded with fibrin and muco-polysaccharides which also trap the nerves and vascular structures. This leads to an alteration in vascular exchange.

Optically, the third stage of evolution of cellulite is displayed in that the protrusions and irregularities are clearly visible and accompanied by areas of depressions.

The spongy appearance or orange peel skin is obvious in a lying position.

Fourth Stage of Cellulite: Cellulite Sclerosis Stage

The micro-nodes of fat cluster into larger and more rigid macro-nodes.

They generate a greater projection on the dermis and are even more visible.

All the alterations worsen, microvascularisation is more static, in an extracellular medium charged with glycosaminoglycans and poor exchange. The septal fibres thicken and harden further with greater hyperplasic and hypertrophic stimulus of the adipocytes. All of this increase the existing pressure in the area and cell hypoxia also worsens.

The cellulite is markedly visible to the naked eye, with irregularities, depressions and highly distinct protrusions adhering to the deep dermal planes that are usually accompanied by flaccidity and stretch marks. Telangiectasic dilations may appear on occasion.

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Last update: 19 / 02 / 2012
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