Cellulite: An Evidence-Based Review



Cellulite is a multifactorial condition that is present in 80–90 % of post-pubertal women. Despite its high prevalence, it remains a major cosmetic concern for women. A wide range of products and treatments for cellulite reduction is available; however, no systematic review has been performed so far to evaluate the efficacy of the available treatment options for cellulite.


The objective of this review is to provide a systematic evaluation of the scientific evidence of the efficacy of treatments for cellulite reduction.


This systematic review followed the PRISMA guidelines for reporting systematic reviews and meta-analyses. Only original articles in English or German reporting data on the efficacy of cellulite treatments from in vivo human studies were considered. In total, 67 articles were analyzed for the following information: therapy, presence of a control group, randomization, blinding, sample size, description of statistical methods, results, and level of evidence.


Most of the evaluated studies, including laser- and light-based modalities, radiofrequency, and others had important methodological flaws; some did not use cellulite severity as an endpoint or did not provide sufficient statistical analyses. Of the 67 studies analyzed in this review, only 19 were placebo-controlled studies with randomization. Some evidence for potential benefit was only seen for acoustic wave therapy (AWT) and the 1440 nm Nd:YAG minimally invasive laser.


This article provides a systematic evaluation of the scientific evidence of the efficacy of treatment for cellulite reduction. No clear evidence of good efficacy could be identified in any of the evaluated cellulite treatments.

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  1. 1.

    Nürnberger F, Müller G. So-called cellulite: an invented disease. J Dermatol Surg Oncol. 1978;4(3):221–9.

    PubMed  Google Scholar 

  2. 2.

    Piérard GE, Nizet JL, Piérard-Franchimont C. Cellulite: from standing fat herniation to hypodermal stretch marks. Am J Dermatopathol. 2000;22(1):34–7.

    PubMed  Google Scholar 

  3. 3.

    Emanuele E. Cellulite: advances in treatment: facts and controversies. Clin Dermatol. 2013;31(6):725–30.

    PubMed  Google Scholar 

  4. 4.

    Hexsel DM, Abreu M, Rodrigues TC, Soirefmann M, do Prado DZ, Gamboa MML. Side-by-side comparison of areas with and without cellulite depressions using magnetic resonance imaging. Dermatol Surg. 2009;35(10):1471–77.

  5. 5.

    Alster TS, Tanzi EL. Cellulite treatment using a novel combination radiofrequency, infrared light, and mechanical tissue manipulation device. J Cosmet Laser Ther. 2005;7(2):81–5.

    PubMed  Google Scholar 

  6. 6.

    Sadick N, Magro C. A study evaluating the safety and efficacy of the VelaSmooth system in the treatment of cellulite. J Cosmet Laser Ther. 2007;9(1):15–20.

    PubMed  Google Scholar 

  7. 7.

    Bayrakci Tunay V, Akbayrak T, Bakar Y, Kayihan H, Ergun N. Effects of mechanical massage, manual lymphatic drainage and connective tissue manipulation techniques on fat mass in women with cellulite. J Eur Acad Dermatol Venereol. 2010;24(2):138–42.

  8. 8.

    Lach E. Reduction of subcutaneous fat and improvement in cellulite appearance by dual-wavelength, low-level laser energy combined with vacuum and massage. J Cosmet Laser Ther. 2008;10(4):202–9.

    PubMed  Google Scholar 

  9. 9.

    Smalls LK, Hicks M, Passeretti D, Gersin K, Kitzmiller WJ, Bakhsh A, Wickett RR, Whitestone J, Visscher MO. Effect of weight loss on cellulite: gynoid lypodystrophy. Plast Reconstr Surg. 2006;118(2):510–6.

    CAS  PubMed  Google Scholar 

  10. 10.

    Sasaki GH. Single treatment of grades II and III cellulite using a minimally invasive 1,440-nm pulsed Nd:YAG laser and side-firing fiber: an institutional review board-approved study with a 24-month follow-up period. Aesthetic Plast Surg. 2013;37(6):1073–89.

    PubMed  Google Scholar 

  11. 11.

    Bagatin E, Miot HA, Soares JLM, Sanudo A, Afonso JPJM, de Barros Junior N, Talarico S. Long-wave infrared radiation reflected by compression stockings in the treatment of cellulite: a clinical double-blind, randomized and controlled study. Int J Cosmet Sci. 2013;35(5):502–9.

    CAS  PubMed  Google Scholar 

  12. 12.

    Bertin C, Zunino H, Pittet JC, Beau P, Pineau P, Massonneau M, Robert C, Hopkins J. A double-blind evaluation of the activity of an anti-cellulite product containing retinol, caffeine, and ruscogenine by a combination of several non-invasive methods. J Cosmet Sci. 2001;52(4):199–210.

    CAS  PubMed  Google Scholar 

  13. 13.

    Sparavigna A, Guglielmini G, Togni S, Cristoni A, Maramaldi G. Evaluation of anti-cellulite efficacy: a topical cosmetic treatment for cellulite blemishes - a multifunctional formulation. J Cosmet Sci. 2011;62(3):305–16.

    CAS  PubMed  Google Scholar 

  14. 14.

    Hexsel DM, Dal’forno T, Hexsel CL. A validated photonumeric cellulite severity scale. J Eur Acad Dermatol Venereol. 2009;23(5):523–8.

    CAS  PubMed  Google Scholar 

  15. 15.

    Bielfeldt S, Buttgereit P, Brandt M, Springmann G, Wilhelm K-P. Non-invasive evaluation techniques to quantify the efficacy of cosmetic anti-cellulite products. Skin Res Technol. 2008;14(3):336–46.

    PubMed  Google Scholar 

  16. 16.

    Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.

  17. 17.

    Avram MM. Cellulite: a review of its physiology and treatment. J Cosmet Laser Ther. 2004;6(4):181–5.

    PubMed  Google Scholar 

  18. 18.

    Gold MH. Cellulite—an overview of non-invasive therapy with energy-based systems. J Dtsch Dermatol Ges. 2012;10(8):553–8.

    PubMed  Google Scholar 

  19. 19.

    Khan MH, Victor F, Rao B, Sadick NS. Treatment of cellulite: Part II. Advances and controversies. J Am Acad Dermatol. 2010;62(3):373–84.

    CAS  PubMed  Google Scholar 

  20. 20.

    Pavicic T, Borelli C, Korting HC. Cellulite—the greatest skin problem in healthy people? An approach. J Dtsch Dermatol Ges. 2006;4(10):861–70.

    PubMed  Google Scholar 

  21. 21.

    Peterson JD, Goldman MP. Laser, light, and energy devices for cellulite and lipodystrophy. Clin Plast Surg. 2011;38(3):463–74.

    PubMed  Google Scholar 

  22. 22.

    Proebstle TM. Cellulite. Hautarzt. 2010;61(10):864–72.

    CAS  PubMed  Google Scholar 

  23. 23.

    Rawlings AV. Cellulite and its treatment. Int J Cosmet Sci. 2006;28(3):175–90.

    CAS  PubMed  Google Scholar 

  24. 24.

    Rossi AB, Vergnanini AL. Cellulite: a review. J Eur Acad Dermatol Venereol. 2000;14(4):251–62.

    CAS  PubMed  Google Scholar 

  25. 25.

    Rossi AM, Katz BE. A modern approach to the treatment of cellulite. Dermatol Clin. 2014;32(1):51–9.

    CAS  PubMed  Google Scholar 

  26. 26.

    Van Vliet M, Ortiz A, Avram MM, Yamauchi PS. An assessment of traditional and novel therapies for cellulite. J Cosmet Laser Ther. 2005;7(1):7–10.

    PubMed  Google Scholar 

  27. 27.

    Wanner M, Avram M. An evidence-based assessment of treatments for cellulite. J Drugs Dermatol. 2008;7(4):341–5.

    PubMed  Google Scholar 

  28. 28.

    Wassef C, Rao BK. The science of cellulite treatment and its long-term effectiveness. J Cosmet Laser Ther. 2012;14(2):50–8.

    PubMed  Google Scholar 

  29. 29.

    Auxilium Pharmaceuticals, Inc. Mid and high level doses demonstrate statistically significant improvement in cellulite across all endpoints; nearly 70 % of mid and high dose patients satisfied or very satisfied with results. 2014. http://ir.auxilium.com/phoenix.zhtml?c=142125&p=irol-newsArticle&ID=1960062. Accessed 15 Sept 2015.

  30. 30.

    Güleç AT. Treatment of cellulite with LPG endermologie. Int J Dermatol. 2009;48(3):265–70.

    PubMed  Google Scholar 

  31. 31.

    Chang P, Wiseman J, Jacoby T, Salisbury AV, Ersek RA. Noninvasive mechanical body contouring: (endermologie) a one-year clinical outcome study update. Aesthetic Plast Surg. 1998;22(2):145–53.

    CAS  PubMed  Google Scholar 

  32. 32.

    De Godoy JMP, de Godoy M de FG. Treatment of cellulite based on the hypothesis of a novel physiopathology. Clin Cosmet Investig Dermatol 2011;4:55–9.

  33. 33.

    Rosenbaum M, Prieto V, Hellmer J, Boschmann M, Krueger J, Leibel RL, Ship AG. An exploratory investigation of the morphology and biochemistry of cellulite. Plast Reconstr Surg. 1998;101(7):1934–9.

    CAS  PubMed  Google Scholar 

  34. 34.

    Kutlubay Z, Songur A, Engin B, Khatib R, Calay Ö, Serdaroğlu S. An alternative treatment modality for cellulite: LPG endermologie. J Cosmet Laser Ther. 2013;15(5):266–70.

    PubMed  Google Scholar 

  35. 35.

    De Godoy JMP, Groggia MY, Ferro Laks L, Guerreiro de Godoy M de F. Intensive treatment of cellulite based on physiopathological principles. Dermatol Res Pract. 2012. doi:10.1155/2012/834280.

  36. 36.

    Schonvvetter B, Soares JLM, Bagatin E. Longitudinal evaluation of manual lymphatic drainage for the treatment of gynoid lipodystrophy. An Bras Dermatol. 2014;89(5):712–8.

    PubMed Central  PubMed  Google Scholar 

  37. 37.

    Hexsel D, Orlandi C, Zechmeister do Prado D. Botanical extracts used in the treatment of cellulite. Dermatol Surg. 2005;31(7 Pt 2):866–72.

  38. 38.

    Herman A, Herman AP. Caffeine’s mechanisms of action and its cosmetic use. Skin Pharmacol Physiol. 2013;26(1):8–14.

    CAS  PubMed  Google Scholar 

  39. 39.

    Garcia E, Lacasa D, Agli B, Giudicelli Y, Castelli D. Antiadipogenic properties of retinol in primary cultured differentiating human adipocyte precursor cells. Int J Cosmet Sci. 2000;22(2):95–103.

    CAS  PubMed  Google Scholar 

  40. 40.

    Machinal-Quélin F, Dieudonné MN, Leneveu MC, Pecquery R, Castelli D, Oddos T, Giudicelli Y. Expression studies of key adipogenic transcriptional factors reveal that the anti-adipogenic properties of retinol in primary cultured human preadipocytes are due to retinol per se. Int J Cosmet Sci. 2001;23(5):299–308.

    PubMed  Google Scholar 

  41. 41.

    Dupont E, Journet M, Oula M-L, Gomez J, Léveillé C, Loing E, Bilodeau D. An integral topical gel for cellulite reduction: results from a double-blind, randomized, placebo-controlled evaluation of efficacy. Clin Cosmet Investig Dermatol. 2014;7:73–88.

  42. 42.

    Piérard-Franchimont C, Piérard GE, Henry F, Vroome V, Cauwenbergh G. A randomized, placebo-controlled trial of topical retinol in the treatment of cellulite. Am J Clin Dermatol. 2000;1(6):369–74.

    PubMed  Google Scholar 

  43. 43.

    Al-Bader T, Byrne A, Gillbro J, Mitarotonda A, Metois A, Vial F, Rawlings AV, Laloeuf A. Effect of cosmetic ingredients as anticellulite agents: synergistic action of actives with in vitro and in vivo efficacy. J Cosmet Dermatol. 2012;11(1):17–26.

    PubMed  Google Scholar 

  44. 44.

    Epstein E, Young VL, Schorr M, Young AE, Weisenborn S. Prospective and randomized determination of the efficacy of topical lipolytic agents. Aesthetic Surg J. 1997;17(5):304–7.

    CAS  Google Scholar 

  45. 45.

    Kligman A, Pagnoni A, Stoudemayer T. Topical retinol improves cellulite. J Dermatol Treat. 1999;10(2):119–25.

    CAS  Google Scholar 

  46. 46.

    Lesser T, Ritvo E, Moy LS. Modification of subcutaneous adipose tissue by a methylxanthine formulation: a double-blind controlled study. Dermatol Surg. 1999;25(6):455–62.

    CAS  PubMed  Google Scholar 

  47. 47.

    Roure R, Oddos T, Rossi A, Vial F, Bertin C. Evaluation of the efficacy of a topical cosmetic slimming product combining tetrahydroxypropyl ethylenediamine, caffeine, carnitine, forskolin and retinol, In vitro, ex vivo and in vivo studies. Int J Cosmet Sci. 2011;33(6):519–26.

    CAS  PubMed  Google Scholar 

  48. 48.

    Lupi O, Semenovitch IJ, Treu C, Bottino D, Bouskela E. Evaluation of the effects of caffeine in the microcirculation and edema on thighs and buttocks using the orthogonal polarization spectral imaging and clinical parameters. J Cosmet Dermatol. 2007;6(2):102–7.

    PubMed  Google Scholar 

  49. 49.

    Vogelgesang B, Bonnet I, Godard N, Sohm B, Perrier E. In vitro and in vivo efficacy of sulfo-carrabiose, a sugar-based cosmetic ingredient with anti-cellulite properties. Int J Cosmet Sci. 2011;33(2):120–5.

    CAS  PubMed  Google Scholar 

  50. 50.

    Collis N, Elliot LA, Sharpe C, Sharpe DT. Cellulite treatment: a myth or reality: a prospective randomized, controlled trial of two therapies, endermologie and aminophylline cream. Plast Reconstr Surg. 1999;104(4):1110–7.

    CAS  PubMed  Google Scholar 

  51. 51.

    Mlosek RK, Dębowska RM, Lewandowski M, Malinowska S, Nowicki A, Eris I. Imaging of the skin and subcutaneous tissue using classical and high-frequency ultrasonographies in anti-cellulite therapy. Skin Res Technol. 2011;17(4):461–8.

    PubMed  Google Scholar 

  52. 52.

    Sasaki GH, Oberg K, Tucker B, Gaston M. The effectiveness and safety of topical PhotoActif phosphatidylcholine-based anti-cellulite gel and LED (red and near-infrared) light on Grade II-III thigh cellulite: a randomized, double-blinded study. J Cosmet Laser Ther. 2007;9(2):87–96.

    PubMed  Google Scholar 

  53. 53.

    Turati F, Pelucchi C, Marzatico F, Ferraroni M, Decarli A, Gallus S, La Vecchia C, Galeone C. Efficacy of cosmetic products in cellulite reduction: systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2014;28(1):1–15.

    CAS  PubMed  Google Scholar 

  54. 54.

    Rao J, Gold MH, Goldman MP. A two-center, double-blinded, randomized trial testing the tolerability and efficacy of a novel therapeutic agent for cellulite reduction. J Cosmet Dermatol. 2005;4(2):93–102.

    PubMed  Google Scholar 

  55. 55.

    Fink JS, Mermelstein H, Thomas A, Trow R. Use of intense pulsed light and a retinyl-based cream as a potential treatment for cellulite: a pilot study. J Cosmet Dermatol. 2006;5(3):254–62.

    PubMed  Google Scholar 

  56. 56.

    Kuhn C, Angehrn F, Sonnabend O, Voss A. Impact of extracorporeal shock waves on the human skin with cellulite: a case study of an unique instance. Clin Interv Aging. 2008;3(1):201–10.

    PubMed Central  PubMed  Google Scholar 

  57. 57.

    Gerdesmeyer L, Maier M, Haake M, Schmitz C. Physical-technical principles of extracorporeal shockwave therapy (ESWT). Orthop. 2002;31(7):610–7.

    CAS  Google Scholar 

  58. 58.

    Angehrn F, Kuhn C, Voss A. Can cellulite be treated with low-energy extracorporeal shock wave therapy? Clin Interv Aging. 2007;2(4):623–30.

    PubMed Central  PubMed  Google Scholar 

  59. 59.

    Ogden JA, Tóth-Kischkat A, Schultheiss R. Principles of shock wave therapy. Clin Orthop. 2001;387:8–17.

    PubMed  Google Scholar 

  60. 60.

    Christ C, Brenke R, Sattler G, Siems W, Novak P, Daser A. Improvement in skin elasticity in the treatment of cellulite and connective tissue weakness by means of extracorporeal pulse activation therapy. Aesthetic Surg J. 2008;28(5):538–44.

    Google Scholar 

  61. 61.

    Siems W, Grune T, Voss P, Brenke R. Anti-fibrosclerotic effects of shock wave therapy in lipedema and cellulite. Biofactors Oxf Engl. 2005;24(1–4):275–82.

    CAS  Google Scholar 

  62. 62.

    Adatto M, Adatto-Neilson R, Servant J-J, Vester J, Novak P, Krotz A. Controlled, randomized study evaluating the effects of treating cellulite with AWT/EPAT. J Cosmet Laser Ther. 2010;12(4):176–82.

    PubMed  Google Scholar 

  63. 63.

    Russe-Wilflingseder K, Russe-Wilfingsleder K, Russe E, Vester JC, Haller G, Novak P, Krotz A. Placebo controlled, prospectively randomized, double-blinded study for the investigation of the effectiveness and safety of the acoustic wave therapy (AWT®) for cellulite treatment. J Cosmet Laser Ther. 2013;15(3):155–62.

    PubMed  Google Scholar 

  64. 64.

    Knobloch K, Joest B, Krämer R, Vogt PM. Cellulite and focused extracorporeal shockwave therapy for non-invasive body contouring: a randomized trial. Dermatol Ther. 2013;3(2):143–55.

    Google Scholar 

  65. 65.

    Schlaudraff K-U, Kiessling MC, Császár NB, Schmitz C. Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite. Clin Cosmet Investig Dermatol. 2014;7:171–83.

  66. 66.

    Mani-Babu S, Morrissey D, Waugh C, Screen H, Barton C. The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review. Am J Sports Med. 2015;43(3):752–61.

    PubMed  Google Scholar 

  67. 67.

    Zhiyun L, Tao J, Zengwu S. Meta-analysis of high-energy extracorporeal shock wave therapy in recalcitrant plantar fasciitis. Swiss Med Wkly. 2013;143:w13825.

    PubMed  Google Scholar 

  68. 68.

    Aqil A, Siddiqui MRS, Solan M, Redfern DJ, Gulati V, Cobb JP. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs. Clin Orthop. 2013;471(11):3645–52.

    PubMed Central  PubMed  Google Scholar 

  69. 69.

    Ioppolo F, Tattoli M, Di Sante L, Venditto T, Tognolo L, Delicata M, Rizzo RS, Di Tanna G, Santilli V. Clinical improvement and resorption of calcifications in calcific tendinitis of the shoulder after shock wave therapy at 6 months’ follow-up: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2013;94(9):1699–706.

    PubMed  Google Scholar 

  70. 70.

    Dayan SH, Vartanian AJ, Menaker G, Mobley SR, Dayan AN. Nonablative laser resurfacing using the long-pulse (1064-nm) Nd:YAG laser. Arch Facial Plast Surg. 2003;5(4):310–5.

    PubMed  Google Scholar 

  71. 71.

    Trelles MA, Alvarez X, Martín-Vázquez MJ, Trelles O, Velez M, Levy JL, Allones I. Assessment of the efficacy of nonablative long-pulsed 1064-nm Nd:YAG laser treatment of wrinkles compared at 2, 4, and 6 months. Facial Plast Surg. 2005;21(2):145–53.

    CAS  PubMed  Google Scholar 

  72. 72.

    Keller R, Belda Júnior W, Valente NYS, Rodrigues CJ. Nonablative 1,064-nm Nd:YAG laser for treating atrophic facial acne scars: histologic and clinical analysis. Dermatol Surg. 2007;33(12):1470–6.

    CAS  PubMed  Google Scholar 

  73. 73.

    Prieto VG, Diwan AH, Shea CR, Zhang P, Sadick NS. Effects of intense pulsed light and the 1,064 nm Nd:YAG laser on sun-damaged human skin: histologic and immunohistochemical analysis. Dermatol Surg. 2005;31(5):522–5.

    CAS  PubMed  Google Scholar 

  74. 74.

    Truitt A, Elkeeb L, Ortiz A, Saedi N, Echague A, Kelly KM. Evaluation of a long pulsed 1064-nm Nd:YAG laser for improvement in appearance of cellulite. J Cosmet Laser Ther. 2012;14(3):139–44.

    PubMed  Google Scholar 

  75. 75.

    Bousquet-Rouaud R, Bazan M, Chaintreuil J, Echague AV. High-frequency ultrasound evaluation of cellulite treated with the 1064 nm Nd:YAG laser. J Cosmet Laser Ther. 2009;11(1):34–44.

    PubMed  Google Scholar 

  76. 76.

    DiBernardo BE. Treatment of cellulite using a 1440-nm pulsed laser with one-year follow-up. Aesthetic Surg J. 2011;31(3):328–41.

    Google Scholar 

  77. 77.

    DiBernardo B, Sasaki G, Katz BE, Hunstad JP, Petti C, Burns AJ. A multicenter study for a single, three-step laser treatment for cellulite using a 1440-nm Nd:YAG laser, a novel side-firing fiber, and a temperature-sensing cannula. Aesthetic Surg J. 2013;33(4):576–84.

    Google Scholar 

  78. 78.

    Katz B. Quantitative and qualitative evaluation of the efficacy of a 1440 nm Nd:YAG laser with novel bi-directional optical fiber in the treatment of cellulite as measured by 3-dimensional surface imaging. J Drugs Dermatol. 2013;12(11):1224–30.

    PubMed  Google Scholar 

  79. 79.

    Goldman A, Gotkin RH, Sarnoff DS, Prati C, Rossato F. Cellulite: a new treatment approach combining subdermal Nd: YAG laser lipolysis and autologous fat transplantation. Aesthetic Surg J. 2008;28(6):656–62.

    Google Scholar 

  80. 80.

    Nestor MS, Zarraga MB, Park H. Effect of 635 nm low-level laser therapy on upper arm circumference reduction. J Clin Aesthetic Dermatol. 2012;5(2):42–8.

    Google Scholar 

  81. 81.

    Houreld NN, Ayuk SM, Abrahamse H. Expression of genes in normal fibroblast cells (WS1) in response to irradiation at 660 nm. J Photochem Photobiol 2014;130:146–152.

  82. 82.

    De Castro ICV, Rocha CAG, Gomes Henriques AC, Cavalcanti de Sousa AP, Lisboa MV, Sotero D da R, Pinheiro ALB, Cury PR, Santos JND. Do laser and led phototherapies influence mast cells and myofibroblasts to produce collagen? Lasers Med Sci. 2014;29(4):1405–10.

    PubMed  Google Scholar 

  83. 83.

    Nootheti PK, Magpantay A, Yosowitz G, Calderon S, Goldman MP. A single center, randomized, comparative, prospective clinical study to determine the efficacy of the VelaSmooth system versus the Triactive system for the treatment of cellulite. Lasers Surg Med. 2006;38(10):908–12.

    PubMed  Google Scholar 

  84. 84.

    Jackson RF, Roche GC, Shanks SC. A double-blind, placebo-controlled randomized trial evaluating the ability of low-level laser therapy to improve the appearance of cellulite. Lasers Surg Med. 2013;45(3):141–7.

    PubMed  Google Scholar 

  85. 85.

    Savoia A, Landi S, Vannini F, Baldi A. Low-level laser therapy and vibration therapy for the treatment of localized adiposity and fibrous cellulite. Dermatol Ther. 2013;3(1):41–52.

    Google Scholar 

  86. 86.

    Whelan HT, Smits RL, Buchman EV, Whelan NT, Turner SG, Margolis DA, Cevenini V, Stinson H, Ignatius R, Martin T, Cwiklinski J, Philippi AF, Graf WR, Hodgson B, Gould L, Kane M, Chen G, Caviness J. Effect of NASA light-emitting diode irradiation on wound healing. J Clin Laser Med Surg. 2001;19(6):305–14.

    CAS  PubMed  Google Scholar 

  87. 87.

    Paolillo FR, Borghi-Silva A, Parizotto NA, Kurachi C, Bagnato VS. New treatment of cellulite with infrared-LED illumination applied during high-intensity treadmill training. J Cosmet Laser Ther. 2011;13(4):166–71.

    PubMed  Google Scholar 

  88. 88.

    Anderson RR, Farinelli W, Laubach H, Manstein D, Yaroslavsky AN, Gubeli J 3rd, Jordan K, Neil GR, Shinn M, Chandler W, Williams GP, Benson SV, Douglas DR, Dylla HF. Selective photothermolysis of lipid-rich tissues: a free electron laser study. Lasers Surg Med. 2006;38(10):913–9.

    PubMed  Google Scholar 

  89. 89.

    Neira R, Arroyave J, Ramirez H, Ortiz CL, Solarte E, Sequeda F, Gutierrez MI. Fat liquefaction: effect of low-level laser energy on adipose tissue. Plast Reconstr Surg. 2002;110(3):912–25.

    PubMed  Google Scholar 

  90. 90.

    Gold MH, Khatri KA, Hails K, Weiss RA, Fournier N. Reduction in thigh circumference and improvement in the appearance of cellulite with dual-wavelength, low-level laser energy and massage. J Cosmet Laser Ther. 2011;13(1):13–20.

    PubMed  Google Scholar 

  91. 91.

    Kulick MI. Evaluation of a noninvasive, dual-wavelength laser-suction and massage device for the regional treatment of cellulite. Plast Reconstr Surg. 2010;125(6):1788–96.

    CAS  PubMed  Google Scholar 

  92. 92.

    Hexsel D, Siega C, Schilling-Souza J, De Oliveira DH. Noninvasive treatment of cellulite utilizing an expedited treatment protocol with a dual wavelength laser-suction and massage device. J Cosmet Laser Ther. 2013;15(2):65–9.

    PubMed  Google Scholar 

  93. 93.

    Emilia del Pino M, Rosado RH, Azuela A, Graciela Guzmán M, Argüelles D, Rodríguez C, Rosado GM. Effect of controlled volumetric tissue heating with radiofrequency on cellulite and the subcutaneous tissue of the buttocks and thighs. J Drugs Dermatol. 2006;5(8):714–22.

    PubMed  Google Scholar 

  94. 94.

    Van der Lugt C, Romero C, Ancona D, Al-Zarouni M, Perera J, Trelles MA. A multicenter study of cellulite treatment with a variable emission radio frequency system. Dermatol Ther. 2009;22(1):74–84.

    PubMed  Google Scholar 

  95. 95.

    Boisnic S, Branchet M-C, Birnstiel O, Beilin G. Clinical and histopathological study of the TriPollar home-use device for body treatments. Eur J Dermatol. 2010;20(3):367–72.

    PubMed  Google Scholar 

  96. 96.

    Fisher GH, Jacobson LG, Bernstein LJ, Kim KH, Geronemus RG. Nonablative radiofrequency treatment of facial laxity. Dermatol Surg. 2005;31(9 Pt 2):1237–41.

    CAS  PubMed  Google Scholar 

  97. 97.

    Manuskiatti W, Wachirakaphan C, Lektrakul N, Varothai S. Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study. J Eur Acad Dermatol Venereol. 2009;23(7):820–7.

    CAS  PubMed  Google Scholar 

  98. 98.

    Mlosek RK, Woźniak W, Malinowska S, Lewandowski M, Nowicki A. The effectiveness of anticellulite treatment using tripolar radiofrequency monitored by classic and high-frequency ultrasound. J Eur Acad Dermatol Venereol. 2012;26(6):696–703.

    CAS  PubMed  Google Scholar 

  99. 99.

    Alexiades-Armenakas M, Dover JS, Arndt KA. Unipolar radiofrequency treatment to improve the appearance of cellulite. J Cosmet Laser Ther. 2008;10(3):148–53.

    PubMed  Google Scholar 

  100. 100.

    Goldberg DJ, Fazeli A, Berlin AL. Clinical, laboratory, and MRI analysis of cellulite treatment with a unipolar radiofrequency device. Dermatol Surg. 2008;34(2):204–9.

    CAS  PubMed  Google Scholar 

  101. 101.

    Romero C, Caballero N, Herrero M, Ruíz R, Sadick NS, Trelles MA. Effects of cellulite treatment with RF, IR light, mechanical massage and suction treating one buttock with the contralateral as a control. J Cosmet Laser Ther. 2008;10(4):193–201.

    PubMed  Google Scholar 

  102. 102.

    Hexsel DM, Siega C, Schilling-Souza J, Porto MD, Rodrigues TC. A bipolar radiofrequency, infrared, vacuum and mechanical massage device for treatment of cellulite: a pilot study. J Cosmet Laser Ther. 2011;13(6):297–302.

    PubMed  Google Scholar 

  103. 103.

    Kulick M. Evaluation of the combination of radio frequency, infrared energy and mechanical rollers with suction to improve skin surface irregularities (cellulite) in a limited treatment area. J Cosmet Laser Ther. 2006;8(4):185–90.

    PubMed  Google Scholar 

  104. 104.

    Sadick NS, Mulholland RS. A prospective clinical study to evaluate the efficacy and safety of cellulite treatment using the combination of optical and RF energies for subcutaneous tissue heating. J Cosmet Laser Ther. 2004;6(4):187–90.

    PubMed  Google Scholar 

  105. 105.

    Wanitphakdeedecha R, Manuskiatti W. Treatment of cellulite with a bipolar radiofrequency, infrared heat, and pulsatile suction device: a pilot study. J Cosmet Dermatol. 2006;5(4):284–8.

    PubMed  Google Scholar 

  106. 106.

    Alster TS, Tehrani M. Treatment of cellulite with optical devices: an overview with practical considerations. Lasers Surg Med. 2006;38(8):727–30.

    PubMed  Google Scholar 

  107. 107.

    Omi T, Sato S, Kawana S. Ultrastructural assessment of cellulite morphology: clues to a therapeutic strategy? Laser Ther. 2013;22(2):131–6.

    PubMed Central  PubMed  Google Scholar 

  108. 108.

    Distante F, Bacci PA, Carrera M. Efficacy of a multifunctional plant complex in the treatment of the so-called “cellulite”: clinical and instrumental evaluation. Int J Cosmet Sci. 2006;28(3):191–206.

    CAS  PubMed  Google Scholar 

  109. 109.

    Lis-Balchin M. Parallel placebo-controlled clinical study of a mixture of herbs sold as a remedy for cellulite. Phytother Res. 1999;13(7):627–9.

    CAS  PubMed  Google Scholar 

  110. 110.

    Savikin K, Menković N, Zdunić G, Pljevljakušić D, Spasić S, Kardum N, Konić-Ristić A. Dietary supplementation with polyphenol-rich chokeberry juice improves skin morphology in cellulite. J Med Food. 2014;17(5):582–7.

    CAS  PubMed  Google Scholar 

  111. 111.

    Lee GSK. Carbon dioxide therapy in the treatment of cellulite: an audit of clinical practice. Aesthetic Plast Surg. 2010;34(2):239–43.

    PubMed Central  PubMed  Google Scholar 

  112. 112.

    Brandi C, D’Aniello C, Grimaldi L, Bosi B, Dei I, Lattarulo P, Alessandrini C. Carbon dioxide therapy in the treatment of localized adiposities: clinical study and histopathological correlations. Aesthetic Plast Surg. 2001;25(3):170–4.

    CAS  PubMed  Google Scholar 

  113. 113.

    Rao J, Paabo KE, Goldman MP. A double-blinded randomized trial testing the tolerability and efficacy of a novel topical agent with and without occlusion for the treatment of cellulite: a study and review of the literature. J Drugs Dermatol. 2004;3(4):417–25.

    PubMed  Google Scholar 

  114. 114.

    Da Da Silva CM, Mello Pinto MV, Barbosa LG, Filho SDDS, Rocha LLV, Gonçalves RV. Effect of ultrasound and hyaluronidase on gynoid lipodystrophy type II—an ultrasonography study. J Cosmet Laser Ther. 2013;15(4):231–6.

    PubMed  Google Scholar 

  115. 115.

    Orentreich DS, Orentreich N. Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles. Dermatol Surg. 1995;21(6):543–9.

    CAS  PubMed  Google Scholar 

  116. 116.

    Hexsel DM, Mazzuco R. Subcision: a treatment for cellulite. Int J Dermatol. 2000;39(7):539–44.

    CAS  PubMed  Google Scholar 

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No funding was received for the conduct of the study or the preparation of the manuscript. Stefanie Luebberding and Nils Krueger have no conflicts of interest to disclose. Neil S. Sadick received support for travel from Storz Medical AG and owns stock options from Venus Concept.

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Luebberding, S., Krueger, N. & Sadick, N.S. Cellulite: An Evidence-Based Review. Am J Clin Dermatol 16, 243–256 (2015). https://doi.org/10.1007/s40257-015-0129-5

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