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Cellulite: Buttocks, thighs and localised fatty deposits

Cellulite: Buttocks, thighs and localised fatty deposits

Written on 6th June 2018
by Dr. Roberto Dell'Avanzato

Cellulite on legs is formed due to:

  • Hormonal factors
  • Genetic predisposition to cellulite
  • Little or no physical activity
  • Unhealthy diet
  • Vascular problems

Cellulite on legs is often more pronounced when too much fat is present under the skin; however, orange-peel skin and fatty deposits can be seen even when there is little fat, thus also affecting slim women.


Dell'Avanzato Roberto

Aestethic Surgeon

2342 Arezzo



Fat on the legs is often difficult to remove without invasive treatments because certain strategic areas of the body are used as natural fat deposits, especially in women. These fat deposits serve as an emergency energy reserve in the event of facing periods of lack of food, and help during pregnancy and breastfeeding.

What are the aggravating factors and causes of cellulite on legs?

Several factors can increase the appearance of orange-peel skin on legs, including:

  • The amount of fat present under the skin: the greater the fat, the deeper and more visible the cellulite
  • Hormonal factors may include, for example, contraception; some contraceptive pills tend to aggravate the appearance of orange-peel skin
  • Circulatory factors: venous insufficiency, varicose veins, varicosities, lymphoedema (excess fluid in the lymph vessels of the legs), swelling (fluid retention in the buttocks, legs and thighs)
  • Cigarette smoking
  • Shoes with heels that are too high or clothes that are too tight and close-fitting

What can be done against cellulite on legs?

If the cause of cellulite is due to localised fatty deposits, then specific treatments are required; these can include:

  • Creams
  • Aesthetic medicine treatments
  • Cosmetic surgery treatments

Creams for cellulite on legs

Cellulite creams act on improving circulation through lymphatic drainage (which can decongest the tissues and reduce oedema). As a result, this can lead to the better control of functional disorders related to varicose veins thanks to the grape seed extracts and red vines extracts, to name but a few, that these creams contain. The anti-cellulite components also act on fat cells thanks to the inclusion of caffeine in cream formulas.

Is an anti-cellulite cream for legs enough?

It is rare that the application of a cream alone will have a significant impact on cellulite: it is therefore useful to combine the cream with other treatments or activities such as sport and a proper diet.

How to apply an anti-cellulite cream on legs?

The best way is to apply the cream is with a massage, encouraging circulation through lymphatic drainage, that is to say, massaging the cream in from the bottom upwards (from the legs to the buttocks).

Sports and cellulite on legs

Localised fatty deposits are linked to the presence of fat. When needed, our muscles take their energy from the fat deposits stored around the buttocks, hips and thighs. Good sporting habits are developed over time, and in order to combat cellulite, physical exercise must therefore be constant and performed on a daily basis. It is recommended that the leg muscles be exercised every day, for example by climbing stairs instead of taking the lift which also exercises the gluteal muscles. However, exercising muscles is rarely enough on its own to fully combat cellulite. Exercises must be targeted strategically in order to achieve the desired results.

Diet and cellulite on legs and buttocks

Diets to fight cellulite are very similar to the “classic” weight loss regimes, although with correct and suitable nutrition. Indeed, fat loss through dieting also helps to reduce fat in the critical storage areas such as thighs, buttocks and legs. Therefore, anti-cellulite regimes are in fact little more than a classical diet:

  • Reduced intake of animal fats
  • Less sugar
  • No alcohol
  • Drinking plenty of water
  • Eating more fruit and vegetables

It is important to plan your diet under the supervision of a professional, such as a doctor, dietician or nutritionist, to avoid nutrition mistakes and deficiencies. In addition, an incorrect nutrition plan, such as a do-it-yourself diet, is often followed by rapid weight gain (leading to the “yo-yo” effect).

Treatments against cellulite on legs

Lymphatic drainage

Why does lymphatic drainage help combat cellulite on legs?
Lymphatic drainage in the legs is a delicate massage, usually performed by a physiotherapist, that helps the small lymphatic vessels to function properly. Lymphatic drainage acts against lymphatic accumulations and circulatory problems that exacerbate cellulite.
Lymphatic drainage is usually performed at a physiotherapy clinic.
A lymphatic drainage massage involves the whole body and, when correctly performed, lasts about 1 hour.
Lymphatic drainage helps the flow of lymph to return to the heart thanks to the gentle pressure applied by the hands on certain points of the lymphatic network.
Lymphatic drainage is therefore a kind of gentle massage on areas of the body which, through delicate and rhythmic strokes, reactivates lymphatic circulation. Lymphatic drainage is often followed by a feeling of well-being and lightness since lymphatic accumulation in the tissues can cause a feeling of heaviness and swelling.
Lymphatic drainage also brings benefits to venous circulation, even when venous insufficiency is present.

Aesthetic medicine and cellulite on legs

The following are some of the most common treatments:

  • Tissue stabilized guided subcision
  • Mesotherapy
  • Ultrasound
  • Radiofrequency
  • Carboxytherapy
  • Cryolipolysis

Tissue stabilized guided subcision is the real innovation in the fight against cellulite

In October 2016, Dr. Roberto Dell’Avanzato was one of the first in Europe to begin experimenting with a new clinically-tested minimally-invasive treatment to improve cellulite hollows for at least four years from a single session. This procedure is currently the only one to have been approved by the American FDA. In order to demonstrate the results of the tissue stabilized guided subcision, photographs of the patient were assessed according to the Global Aesthetic Improvement Scale (GAIS). Patient satisfaction was also recorded according to a 5-point Likert scale, and a Visual Analog Scale (VAS) was used to record the level of pain. The treatment takes around 45-65 minutes. After outlining the cellulite hollows, the device that relaxes and stabilises the tissue in a vacuum chamber is then applied while local anaesthetic is administered. A precise and minimally invasive release of the subcutaneous connective tissues is performed with the use of a micro-needle (tissue stabilized guided subcision) without any cutting or incisions. Slight compression is applied after treatment and patients can immediately return to their daily life. This procedure has allowed us to successfully treat the primary structural causes of cellulite, with a very high percentage of satisfaction. This revolutionary procedure against the blemishes of cellulite combines a proven but now obsolete method of treatment, tissue stabilized guided subcision, with innovative technology in order to treat the primary structural causes of cellulite in the back of the thighs and buttocks. This study confirms the safety and effectiveness of this treatment due to the precision of the controlled tissue release with the vacuum chamber guide, and thanks to the proven overall satisfaction of patients.

Surgical treatment against cellulite on legs

Liposuction. Cellulite surgery primarily involves the removal of excess fat. Cellulite surgery may also include operations that attempt to remodel the tissue after removing excess fat.

What are liposuction and laser liposculpture?

Liposuction is a cosmetic surgery technique performed by a surgeon, which sucks out fat by means of a cannula inserted under the skin. Liposuction can be performed on many areas where excess fat is present: abdomen, hips, inner and outer thighs and knees, under the chin; its applications are therefore not limited to the treatment of only cellulite on legs. Since 2002, Dr. Roberto Dell’Avanzato has been among the first to incorporate a new method of liposuction called Laser-Assisted Liposculpture. Thanks to a micro-cannula, this method allows for the selective destruction of fat, and thanks to its 1470nm wavelength, can also remodel the skin without destroying the lymphatic vessels or muscle and nerve tissue, thereby avoiding the creation of “gaps” as occurred with the older methods of liposuction. In 2006, the American FDA subsequently established that the effectiveness of laser liposculpture is at least 50% greater than the old liposuction method in its ability to reduce the amount of sagging skin, as well as being more precise and selective in the destruction of fat alone.

In the preliminary phase, the doctor must be aware of:

  • The medical history of the individual wishing to undergo surgery (including coagulation disorders, risk of phlebitis and thrombosis), tobacco consumption, morbid obesity, current medication, any allergies to drugs
  • The type of excess fat and where the excess fat is located
  • The appearance of the skin and the amount of cutaneous and muscular sagging
  • Pre-operative anaesthesia assessment to evaluate the risk of possible contraindications for liposuction surgery. Laser liposculpture is usually performed under local anaesthesia with mild sedation. The patient is generally discharged the same day as the operation.

What are the risks of the old method of liposuction?

Liposuction is a surgical procedure with all the usual risks that surgery entails.

Among the most common, are:

  • Haematoma
  • Bruising
  • Infections
  • Bleeding
  • Post-operative phlebitis
  • Embolism or pulmonary oedema

For this reason, laser-assisted liposculpture is only performed in the most advanced cosmetic surgery centres, thereby reducing the risks of the old method of liposuction to the maximum.

There are also some aesthetic risks, including:

  • Scarring
  • “Loose” skin, especially if it was flabby before surgery, due to lack of elasticity. This risk is basically removed when using the innovative diode fibre laser-assisted liposculpture.

How to control cellulite on legs?

  • Follow a balanced diet
  • Carry out regular physical exercise
  • Avoid wearing high heels
  • Avoid wearing tight-fitting clothing
  • Manage stress levels

Following these steps helps improve the appearance of cellulite on legs and reduce the appearance of “orange peel” skin. Is lifestyle enough? If lifestyle choices fail to present the desired results, you can also resort to more specific treatments to reduce cellulite on legs and localised fatty deposits.

About Dr. Dell’Avanzato Roberto

State Medical Board: 2342 Arezzo
Dr. Roberto Dell’Avanzato is specialized in Surgery and earned a Master’s Degree in Cosmetic Surgery. He is an external faculty member of Laser and Laser Liposuction in the Master’s Programme of Cosmetics. Dr. Dell’Avanzato also obtained the University Diploma in Mini-Invasive Surgery.
In 2018 he won the prestigious Enrico Follador Award with his protocol “Endolift & microfocalized ultrasounds” for the best non-surgical facelift of the face, neck and body.

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