The best anti cellulite treatments

If your dimpled thighs ever stopped you from wearing a short skirt or caused you to keep your cover-up on at the pool, you're not alone: 90% of women have cellulite. And the quest to get rid of cellulite has become a billion-dollar business. In the past 6 years, the market for products claiming to reduce cellulite fast has grown by more than 113% worldwide, and it shows no signs of slowing down.

Most cellulite "cures," doctors and scientists agree, have been ineffective, to put it charitably. Recent research into the structure of skin confirms that cellulite is not the result of toxic buildup or inflammation, as is often touted by marketers. Instead, cellulite is the product of anatomy, genes, and hormones.

What to try to cure cellulite?

The solution, therefore, is to alter what Mother Nature gave you - at least for a certain time. There is no permanent cure, no magic cellulite-squelching cream or surgery, but there are advances: A drug delivery system is being put to a cosmetic purpose; wrinkle-reducing, skin-tightening lights and lasers are being turned from the face to the lower body; deep dimples are being filled; and in Europe, an injectable fat melter is being studied. If you want to reduce cellulite fast, here's what's new—and what works.

1. Anti cellulite tools

Treatments for cellulite with lasers and other devices are sometimes painful, need to be repeated periodically, and must be done by a physician. But women who want to reduce cellulite fast may want to try these pricey techniques before lower-tech options.

A caveat: Some of the technologies are FDA-approved as Class I devices—meaning, they present minimal potential for harm. But others are being used off-label—that is, not for the purpose for which they are approved. And some are still being tested and have not yet been submitted for FDA approval.

• anti cellulite laser treatment

Laser Toning For cellulite that has more ripples than isolated, divotlike depressions, Beverly Hills dermatologist Harold Lancer, MD, relies on the Galaxy, a device commonly used for facial wrinkles. It directs radio frequency and laser light energy beneath the skin's surface, causing a wound response that lays down new collagen and tightens the skin. "I've treated 100 patients with the Galaxy, and the results are good," he says. He is one of a few doctors using the laser for cellulite reduction.

Cold-Laser Massage The Tri-Active laser was approved by the FDA in January 2004 and is permitted to claim that it "temporarily reduces the appearance of cellulite." This device combines suction massage to increase lymphatic drainage, which filters fluid from cells; low-intensity diode heat to stimulate collagen production and tighten skin; and a cooling head to counter any burning sensation. "It's so painless you can fall asleep while it's being done," says Mitchel Goldman, MD, an associate professor of dermatology at the University of California, San Diego.

But that may depend on how deeply you sleep. One patient reported: "The feeling ranges from that of a pleasant, light massage to an uncomfortable, deep-tissue rubdown."

• VelaSmooth

VelaSmooth This handheld device combines radio frequency with infrared light (both of which, the company claims, soften and rearrange fat) and suction (to stretch out the fibrous strands that cause dimpling). Testing required for FDA approval is under way at approximately 100 doctors' offices across the US. One of the investigators, Lisa Benest, MD, a dermatologist in private practice in Burbank, CA, says, "After eight sessions, patients' measurements are an inch or two smaller, and their skin looks tighter with less rippling. We believe that fat is being melted."

• anti cellulite massage

Mechanical Massage Endermologie' is a handheld device that sucks up about an inch of skin between rollers and squeezes it to increase blood and lymphatic flow and stretch out the dimple-causing cords. "It hurts a little, depending on how high the dial is cranked up," says one patient. The temporary swelling that results helps disguise cellulite, reports V. Leroy Young, MD, chairman of the nonsurgical procedures committee of the American Society of Aesthetic Plastic Surgery (ASAPS). "There's a good animal study showing Endermologie produces a little collagen in deep dermis," he says.

• anti cellulite injections that melt fat

Fat-Melting Injections From the south of France to South America, where smooth thighs are a national obsession, fat-melting injections have been used on everything from thigh flab to undereye fat pads. The drug—phosphatidylcholine, an extract of lecithin from soybeans—was first intended to dissolve artery-blocking plaque, but when injected repeatedly just under the skin (a technique called mesotherapy) is said to melt subcutaneous fat.

Though the drug sounds like the answer to a cellulite-ridden woman's prayers, animal studies indicate it may cause serious side effects such as bleeding and ulcers. Phosphatidylcholine has now been banned in Brazil but is being studied in Europe. In the US, Lancer says, it is a "backroom" treatment and "not proven to be safe or effective."

2. Anti cellulite fillers or cutting treatments

• liposuction

Liposuction can remodel your contours, but it can't do much for skin texture. So some doctors are attempting to treat cellulite dimple by dimple.

Filling the Holes

For large cellulite dents, Young says a filler can give good results, and he prefers to use the person's own fat. "It makes the most sense to try to fill with fat. The only problem is that you get spotty survival. However, the fat that is established will last for years," he says.

• Sculptra

Sculptra, a material that is more predictable than fat and is FDA-approved to fill out the faces of those with AIDS, hasn't been studied for lifting cellulite dents, but Lancer has injected it. "By manipulating the skin I can see exactly where the [fibrous] tether is, which I inject with a pea-size amount of Sculptra," he says. "The needle detaches the tether, and the depression puffs up nicely with the filler. It smooths out the puckering." Other physicians, including Prevention advisor Mary Lupo, MD, a clinical professor of dermatology at Tulane University School of Medicine, don't approve of this off-label use of Sculptra. It can cause lumpiness if overinjected, she warns, adding, "If a woman goes on to lose weight, she'll lose some of the cellulite and then for 3 years be left with lumps where the Sculptra was injected."

• Surgery

A surgeon slips an instrument similar to a pickle fork beneath the skin to cut the individual fibrous cords that cause cellulite's depressions. Then a little fat is injected to discourage those fibers from growing back.

"This technique is not great, but it's the best thing we have surgically," says Los Angeles plastic surgeon Peter B. Fodor, MD, president of ASAPS. He reserves the technique for the deepest dents and spot treatments remaining after liposuction.

In the past, a few surgeons experimented with cutting the fibrous cords, the tethers holding down the skin. In some cases, the results were disastrous, causing skin sloughing, or loss.