Prominent Swedish doctors, masseurs, and gymnasts understood the connection between body appearance and body health towards the end of the 19th century. They discovered the presence of lumpy, node-like formations just under the skin which they treated with a special method of massage, diet, and exercise. Among the various names they gave these lumpy masses were cellulite, panniculite, and myocellulite. Always zealous to maintain their leadership in the field of beauty, the French quickly adopted the name cellulite. The word is a combination of the French word for “cell” and the suffix “-ite,” meaning disease.

WHAT IS CELLULITE?
Medically speaking, cellulite is localized lipodystrophy – defined as misshapen fat in one or several specific areas of the body. Recent research has shown that cellulite has less to do with fat cells and more to do with connective tissue that shape the fat and keep it in place.
Cellulite is the “fat” you just cannot seem to lose. It is a gel-like substance made up of fat, water, and wastes, trapped in lumpy, immovable pockets just beneath the skin. It is found on approximately 85 percent of mature women.
Because cellulite is not normal fat, even the strictest diets fail. When the normal intake of food is diminished, the body automatically burns its own reservoir of stored fat. On a low-calorie diet, fat will burn off in many areas, but the cellulite bulges will remain. They do not burn off like normal fat.
Cellulite is formed when connective tissues beneath the skin that shape the fat become weak and deformed. This connective tissue acts as an anchor between the muscles and the skin; it also forms the chambers that hold the superficial fascia (body fat that lies beneath the skin).
When the connective tissues become weak, the superficial fascia bulges upward and causes an uneven appearance in the skin. This has long been thought to be the cause of cellulite, however, there are theories that the primary cause is poor blood and lymph circulation. Poor circulation causes a higher fluid density in the surface layer of fat. This prevents the fat from being properly absorbed into the blood and causes it to swell with excess fluids; thereby, stretching the connective tissues and leaving the lumpy irregular appearance.

CELLULITE FORMATION
The human body is comprised of skin, bones, nerves, muscles, brain, and blood supply, all working in harmony. Each part has a unique function. When addressing cellulite, the connective tissues are the
most important.
All muscles are wrapped in a padding of fatty connective tissue. The various thickness of the padding gives the female shilloutte its roundness and contour. The round fatty cells of the padding are surrounded in a liquid medium and are held in place by an intricate fiber network. Circulating constantly through the network are nourishing liquids such as water, blood, and lymphatic fluid. These liquids transport oxygen and nutrients through the tissues and also cleanse and detoxify wastes.
The change occurs when the waste removal process is slowed down in the cellulite-prone areas. As a result, the connective tissues are saturated with water and wastes which thickens, hardens, and forms immovable pockets. The end result is bulging and puffing-up to produce the “orange peel” characteristic texture of cellulite.

CAUSES OF CELLULITE
Our lifestyle is the major contributing factor in the formation of cellulite. Some of the contributing factors are tension, fatigue, poor eating habits, insufficient water intake, poor breathing, sedentary living, and lack of exercise. This all results in sluggish digestion, constipation, and poor circulation. The normal process of elimination cannot flush out toxic materials when it occurs. Another major contributing factor is estrogen. This female hormone is heavily secreted through the body a few days before each menstrual period and sometimes during ovulation. At both times, the body retains water, intensifying the already bloated areas where cellulite is present.
Another contributing factor is crash dieting. This type of eating, with its quick, severe deprivation, is abusive to the body. The up-again, down-again syndrome to lose weight quickly causes tissues to lose their elasticity and firmness with this fat-again, thin-again type of treatment, causing tissues to become soft and saggy.
Diuretic pills may contribute to weight loss, but it is only water and the weight returns as soon as the pills are discontinued.
Poor circulation and cellulite seem to be related. Cellulite generally “chooses” areas that have poor circulation to begin with and once it forms, cellulite slows circulation even more.

AUTOINTOXICATION
The body has a system for eliminating wastes through the lungs, liver, kidneys, intestines, and skin. Through abuse, the normal process of elimination is unable to completely flush out wastes and toxic materials. Common “poisons” in excess can include: alcohol, tea, coffee, spices, pork, animal fat, chocolate, cream, and fried foods. Diet pills are another culprit.

THE ESTROGEN FACTOR
The female hormone estrogen is responsible for softening the fibrous tissue that closes the womb just before delivering a baby. Without the role of this hormone, childbirth would be impossible. During pregnancy, the body system is flooded with estrogen which favors water retention and results in bloating. This stress on the body interferes with proper blood circulation in the veins and often causes constipation. The action of estrogen is not limited to childbirth. An excess of estrogen in women is believed to cause the weakening of the connective tissue that allows the fat to bulge up into the skin.
Cellulite can appear at any age, starting as early as 14 or 15 years. It generally accompanies the onset of the menstrual cycle, or it can make its first appearance much later in life around menopause. Cellulite is generally insidious, coming on slowly after the body has been abused for some time. Among many women, it is birth control pills or pregnancy that seems to bring it on. Birth control pills simulate pregnancy. A high estrogen content is a responsible factor in retaining water in the tissues and may interfere with proper circulation in the veins.
Generally, cellulite is a feminine problem. Men will sometimes find cellulite on the stomach and at the nape of the neck. Women have more than twice as much fatty tissue as men. In general, normal fat represents 24 percent of a woman’s weight and only 11 percent of a man’s weight.

In order to correct a cellulite condition, three steps must be reversed by:

1. Returning the connective tissue to its normal elasticity and suppleness.
2. Freeing the trapped substances.
3. Draining and removing these materials.

These three steps are interdependent. Each must be given individual attention and all three must be carefully followed to alleviate the condition.

HOW TO IDENTIFY CELLULITE
How do you recognize cellulite? Visually, fat and cellulite look different. Regular fat, when squeezed, is smooth in texture and does not show any ripples or lumps. There is one fool-proof test that does not fail in recognizing cellulite. Press (or squeeze) the skin between the thumb and index finger or between the palms of both hands. If the skin ripples and looks like an orange peel, cellulite is present. There is also a sensitivity present when squeezing cellulite and not present when squeezing a non-cellulite or fat area. In an advanced stage, the ripples will be noticeable without applying any pressure. These areas will be flabby and sensitive.
Masses of cellulite make parts of the body on which they form very heavy and out of proportion. There are two types of cellulite: solid and soft. Solid cellulite is “thick” tissue that seems to adhere to the muscles. It is very difficult to lift the cellulite away from its underlying structure. In addition, squeezing or pressing of the tissue is very sensitive to the touch because some nerve endings have probably become compressed.
Solid cellulite is generally found on young women in good physical condition. However, women of all ages are susceptible, including those with firm, well-toned tissues (athletic types). These are women who have most likely not experienced extreme weight fluctuation or undergone crash diets, both extremely harmful measures, and since their tissues have not been mistreated, they remain firm.
Skin in solid cellulite areas is typically dry and sometimes rough due to poor nourishment. Stretch marks may also be evident. Elastic, flexible fibers enable skin to move, stretch, and contract. When these fibers are stretched too much or for too long a period of time, they rupture, leaving scar-like traces. This generally occurs after pregnancy.
Soft cellulite is neither dense nor concentrated like solid cellulite. It tends to engross large areas, is loose, and seems to float between muscles and skin. Soft cellulite is very noticeable. There is a lot of mobility in soft cellulite, which slides easily over muscle. Soft cellulite hangs and sags in folds and flabby bulges because it is loose. It shakes with bodily movement. Soft cellulite can also be found on once active women who have been inactive for some time.

THE AESTHETICIAN’S ROLE
Cellulite can be moderately treated and in some cases, successfully treated. Excellent results have been achieved by skin care professionals with a program of cellulite massage and
mechanical manipulation.

Cellulite Massage
There are five massage movements that help break down cellulite. They are: stroking, kneading, knuckling, “S” formation, and wringing. Light stroking prepares the skin for the massage movements that follow. Wringing, knuckling, and “S” formation, all forms of kneading, break down and dissolve the cellulite nodes. Deep stroking, used at the end of each session, sends the waste loosened by kneading on their way through the system and out of the body.

• Light Stroking: These are long, fluid movements that move the skin in one direction only – toward the heart. This massage prepares the area for heavier movements that follow.
• Kneading: Grasp a large area of flesh, lifting it away from the underlying structure and squeezing it. This can be done with fingers or with the whole hand.
• Knuckling: This is a crushing movement done in a circular direction with fingers curled so that the knuckles press the skin. Apply pressure to crush cellulite. Very effective for hips, upper thighs, and stomach.
• “S” Formation: Use the thumb and fingers of both hands to lift up a portion of flesh. The hands go back and forth in opposite directions to form an “S” shape fold. This is a deep massage, best used on stomach, hips, thighs, and around the knee, inside and out.
• Wringing: Same technique as “S” Formation without picking up the flesh. This is a deep massage. Rest both hands around the area and twist back and forward, similar to wringing clothes. Perform on thigh area.
• Deep Stroking: This ends every massage. It is a heavy stroking movement, at full pressure, going in the direction of the heart. This increases blood and lymph circulation, relieves congestion, and speeds removal of waste matter from the tissues.

Mechanical Manipulation Devices
Mechanical manipulation devices treat cutaneous and subcutaneous connective tissue, thereby promoting blood flow and relieves sore muscles and tension. These are hand-held massagers which vacuum and roll deposits of cellulite painlessly. It is a non-invasive way to re sculpture the body. These types of systems change the appearance of the body in measurable ways and is not only a water loss change, disappearing as soon as water is consumed again. Water intake is encouraged during these treatments which consist of approximately 18 sessions, each lasting around 35 minutes. In the San Francisco Bay area, a series of 18 sessions is $1,500 or $83 per treatment.

To have your clients get the most treatment, they must really want to solve their cellulite condition. It is best to work out a personal schedule that allows maximum time for exercise and massage. In addition, they must shop for and prepare proper meals. With practice and commitment, your clients will learn to do their cellulite routine in no time. As their aesthetician, you should be available for moral support, as well as aforementioned services.

Ottmar Stubler is an aesthetician and president of PFB Vanish Inc. He formulated PFB Vanish, a topical serum for the treatment of ingrown hairs, razor burn and bumps, as well as skin irritations. 415-499-1985, This email address is being protected from spambots. You need JavaScript enabled to view it., www.pfbvanish.com