Firm skin, beautiful legs

ore and more patients want to have their legs beautified.
Eliminating unwanted leg veins, reducing light aging changes, tightening skin, and reducing fatty tissue are among the most common requests.

What is cellulite, anyway?

Dr. Salama: Cellulite is the term used to describe a padded surface of the skin with orange peel-like dimples, also known as orange peel skin. Although sound epidemiological data are currently lacking, an estimated 80 to 98% of postpubertal women are affected by cellulite. This means that cellulite is indeed a widespread problem.

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Can cellulite vary in severity?
Dr. Salama: There are different degrees of severity in cellulite, depending on the condition of the skin. In grade 1 cellulite, the skin is smooth and supple when standing, while it looks like an orange peel when sitting. In grade 2, the skin looks equally like an orange peel skin when standing and sitting. Grade 3 results in an orange peel-like appearance with noticeable bumps and dimples when standing.

What are the causes of cellulite?

Dr. Salama: Due to the different structure of the skin and subcutaneous tissue (with fatty and connective tissue), cellulite is more common in women. The strength and flexibility of the dermis (thickness of the dermis) decreases with age in both men and women. This means that the main cause of cellulite is not age-related changes in the dermis, but the Beschaffenheit of the skin layers. Cellulite is caused by a change in fat tissue that protrudes into weakened skin tissue. Studies show that the fat cell chambers of women are larger than those of men, which can cause the enlarged cells to penetrate the overlying skin layer. The dividing or septa of the fat cell chambers, also called septa, are at a 45° angle to the skin in men, while in women they are perpendicular to the skin. As a result, continuous and increasing tension on the septa creates dimples and depressions in the skin that cause cellulite.

What therapies and treatments are available for cellulite?
Dr. Salama: Cellulite can be reduced through various therapies and treatment options. Although locally applied creams whose ingredients stimulate blood circulation can lead to a significant improvement, this is usually only of very short duration. This applies equally to mechanical massage. Extracorporeal shockwave therapy uses electrical energy to cause mechanical disruption of the tissue, leading to extracellular healing re- actions. But it is unclear whether the improvements affect the severity of cellulite because the results have not been statistically measured in relevant efficacy studies. Clinical studies show that low-level laser therapy (LLLT) triggers a biological response that stimulates collagen production.

The various options for treating cellulite have advantages and disadvantages. What are the methods for rejuvenating the legs?
Dr. Salama: Over the course of a lifetime, there is a systemic breakdown of collagen fibers and subcutaneous fatty tissue as we age. For beautiful, smooth and taut skin, the use of a laser is extremely useful. We at the Leibnitz LBCL Surgery and Vein Practice have decided to take a combined approach to the treatment of cellulite and signs of aging. We combine a triple use of an endolaser with a subsequent skin tightening treatment with the neodymium YAG laser to achieve superior collagen synthesis and improved skin elasticity. We also use an alternative approach to cellulite treatment to treat the adipose tissue, dermis and septa. The number of treatment sessions depends on the severity of cellulite. Each treatment is associated with a twelve-week follow-up, as well as an (optional) aftercare plan of up to 18 months. In this way we achieve the best results for our patients. After that, we keep an eye on progress, as follow-up treatment may be necessary.