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Zellulitis

Cellulite

Zusammenfassung

Zellulitis ist eine sich bevorzugt an den Oberschenkeln und der Glutealregion bei nahezu allen Frauen entwickelnde Veränderung von Haut und Subkutangewebe. Makroskopisches Kennzeichen der Zellulitis ist eine Dellenbildung, die entweder spontan sichtbar oder durch Provokationsmanöver hervorzurufen ist. Während die bislang publizierten Konzepte zur Pathophysiologie der Zellulitis teilweise widersprüchlich oder unschlüssig sind, gibt es aktuell doch einige Studien, die strukturelle und anatomische Veränderungen an Dermis und Subkutangewebe gefunden oder bestätigt haben: (1) ein geschlechtsspezifischer Dimorphismus mit orthogonaler Ausrichtung der subkutanen Bindegewebssepten zur Hautoberfläche sowie Fettgewebsprotrusionen nach intradermal; (2) diese Fettgewebsprotrusionen sind nicht allein ein Dimorphismus, sondern korrelieren tatsächlich auch mit dem Vorkommen der Zellulitis; (3) eine Korrelation von Zellulitis mit der subkutanen Fettschichtdicke; (4) eine Korrelation von Zellulitis zu fokalen hypertrophen subkutanen Bindegewebssträngen und verringerter Dichte der Bindegewebssepten im Subkutangewebe insgesamt. Die Therapie der Zellulitis zielt (1) auf eine Verringerung der subkutanen Fettschicht, (2) auf eine Steigerung von Dicke und Elastizität der Dermis sowie (3) auf eine Durchtrennung hypertropher subkutaner Septen, die für die ausgeprägtesten Dellenbildungen verantwortlich sind. Von topischem Retinol bis hin zu interstitieller Anwendung von Lasern steht hier mittlerweile eine Vielzahl von Verfahren zur Verfügung.

Abstract

Cellulite is a condition affecting the dermal and subdermal compartment and developing on thighs and buttocks of almost every woman. Macroscopically, cellulite is characterized by dimpling, visible either spontaneously or after provoking maneuvers. While published concepts on the pathophysiology of cellulite are in parts inconclusive or contradictory, there are at least some recent studies describing or confirming structural and anatomic changes on dermal and subdermal tissues: (1) A gender specific dimorphism with subdermal septae oriented orthogonally towards the skin surface as well as protrusion of fat tissue into the dermis. (2) These intradermal fat protrusions additionally correlate with the presence of cellulite. (3) There is also a correlation between the thickness of the subdermal fat layer and the presence of cellulite. (4) Cellulite also correlates with focal hypertrophic subcutaneous septae and a reduced density of septae in general. Treatment of cellulite aims at (1) the reduction of the subcutaneous fat layer, (2) increase in dermal thickness and elasticity and (3) dissection of hypertrophic connective tissue septae, responsible for the most pronounced dermal indentions. A variety of treatment options have evoleved ranging from topical retinol to interstitial laser

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Der Autor hat mit dem Inhalt des Artikels in Zusammenhang stehende Vorträge und Workshops gegen Honorar für die Firmen Sciton, CA, USA, und Cooltouch CA, USA, gehalten.

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Correspondence to T.M. Proebstle.

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Proebstle, T. Zellulitis. Hautarzt 61, 864–872 (2010). https://doi.org/10.1007/s00105-010-1986-8

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Schlüsselwörter

  • Laser
  • Liposuktion
  • Radiofrequenz
  • Gewichtsreduktion
  • Ultraschall

Keywords

  • Laser
  • Liposuction
  • Radiofrequency
  • Weight reduction
  • Ultrasound