Cellulite Treatments: Do They Work?

June 4, 2008 — -- I've recently completed my sixth cellulite treatment at a spa in New York's speedily gentrifying Hell's Kitchen neighborhood — about 10 blocks from Times Square.

It cost $1,200 to get my thighs and butt slathered in cold jelly, wrapped in plastic, heated up, chilled to the bone, and pressed with a hand held device emitting lasers and ultrasound waves. At the end of each hour-and-a-half long session my adipose tissue — loaded with watery toxins, I was informed — was kneaded by a Brazilian woman's tiny but preternaturally forceful hands.

Did I mention I'm getting married next month? That could explain why I've gone temporarily insane.

"In Brazil these treatments are much cheaper," Iriana had confided as she kneaded. "And girls start young. Before they even develop cellulite."

I've seen the famous behinds on the beaches of Rio and Bahia, and Iriana's words might have depressed me. But now I knew the girl from Ipanema's secret. Or rather, the skinny brat's grossly unfair advantage.

Last month, before our first session, Iriana took pictures of me from all angles and measured my waist and thighs. Plus that area just above my knees caps which has grown increasingly hateful over the past couple of years.

At this point I'd like to say that if you're ready to deliver me a lecture about women and body-image the evils of self-loathing, know this: I am aware that my physical obsessions are petty and psychologically destructive. I simply choose to indulge them in my free time.

Onward.

Know that there are no studies in medical literature to prove that any laser, sonar, lymphatic massage, electric shock, injections, or creams will get rid of cellulite. Still, spa-goers and estheticians say that intense manipulation with the help of various scientific advances can make lumpy fat appear smoother.

That's what we really want. The airbrushed look of magazine models. Even the rounded models of Dove's "Real Beauty" campaign. If we can't be thin, we want to be sleek and tight like porpoises.

I wanted the treatments to work. I felt that they should work. They were uncomfortable enough. To be fair, Iriana asked me several times if she was pressing too hard. I shook my head no as she dug her little hands into my screaming flesh. I covered my face with a pillow and bit into it. I wanted results, not coddling.

The type of massage which is said to work by loosening the tight tissue that refuses to bend with the fat cells it connects (and instead stays rigid, forcing the fat cells to squeeze through and around), is not of the Swedish variety.

Expect cellulite treatment involving tissue manipulation — be it Endermologie, Vela Smooth, Syneron or some combination — to make you feel like the victim in a pre-code, post-mod Hollywood cult film. You will lie on a slab under fluorescent light in paper underwear and accept your expensive punishment. A few days later you'll return for more.

Read into it what you will, but that was part of the appeal. And I don't believe I am alone here. My thinking goes like this: cellulite is bad. It is the result of a decade of wasted gym memberships, a failure to take the stairs, a stubborn refusal to give up Godiva chocolate clams or cocktails or much else in my quest for beauty. The cellulite must be punished.

This thinking is wrong-headed of course. Not to mention a psychologist's dream (how many years of therapy might it take to break through this ring of pathology? I'll never know — I've spent all my money on cellulite treatments!)

Anyway.

Google "cellulite" and you'll find conflicting information as to its origin. Many say it's metabolic waste — the result of poor circulation and ineffective lymphatic drainage. Others say it stems from wearing tight clothes and high heels. It can be hard for doctors to argue with these ideas, but they are only ideas. There's absolutely no scientific data behind them.

What dermatologists do know is that cellulite can be genetic (shout-outs to my Grandmas on both sides). In addition, many researchers also believe there is a strong hormonal component to cellulite development.

Dr. Bruce Katz, Director of New York's JUVA Skin and Laser Center and member of the American Academy of Dermatology, says that it's the thickness of your dermis — the inner layer of skin — and the pattern of the connective tissue beneath it which holds your fat cells together that matters.

If you are lucky enough to have a sort of cross-hatch pattern, your fat cells are held in with double reinforcements. Regrettably, this pattern is most often seen in men. Most women have connective tissue patterned like columns, says Katz. It's easier for fat cells to bulge out of columns than small openings.

In addition, men generally have a thicker dermis, which serves as a more effective natural girdle.

Taking Katz's words at face value, I have to assume that any results I might have observed from my treatment package were just temporary. I lost about an inch and a half from my waist, hips, and thighs — but that was only after being wrapped in plastic and sweating for over half an hour before the final measurements were taken.

Katz says something called "Laser-Lipo" is far more effective than the combination laser and fat manipulation technique he no longer likes to schedule. No clinical studies have been completed yet, but Katz says the relatively new liposuction technique not only dissolves fat, but the deeply penetrating lasers tighten and thicken the skin. This a very different from regular lipo, which can make cellulite look worse.

If Katz is right, it seems there might be real, lasting, hope — if you're ready to go under the knife.

Now that it's over, I'm thinking less about the (negligible) results and more about the psychological process I went through. The twice-weekly unveiling of parts of myself I'd never before consider unveiling to a stranger.

Although at first the deep massage did feel like a pummeling, as the treatments went on it stopped hurting bad and started hurting good. I fell asleep more than once.

My most shameful fat (and I use that word with full knowledge of all it's Freudian implications) was scrubbed, sqeezed, covered in goo and lasered by three cheerful estheticians. All that attention was surreal and, in the end, liberating.

What had been hidden all winter long, swathed in thick cotton tights and Spanx, was now exposed.

And no one was injured, no one laughed, the camera lens didn't crack.