Cellulite refers to the lumpy fat bulges on the thighs and buttocks of over 95% of the normal female population. There are many reasons why most women are predisposed to cellulite whereas the condition is much rarer in men. To begin with, the underlying structure of the skin is different in males verses females. Male skin tends to be thicker and the fibrous septae has strong cross-linking of the connective tissue. Females have thinner skin and no cross-linking of the underlying septae. Women have more fat layers than men, and the subcutaneous fat layer in women is regulated by hormones and does not respond to diet and exercise. The female hormone estrogen causes these fat cells to store fat, whereas the male hormone testosterone stimulates the fat cells to break down fat. So, women are genetically superior at storing energy in the form of fat to provide energy during pregnancy. Women also have a higher percentage of body fat in the areas of the thighs, hips, and abdomen, and these fat cells are resistant to diet and exercise. Directly beneath the fat layer there is a layer of connective tissue comprised of collagen called the “fibrous septae.” When the fibrous septae becomes damaged, the subcutaneous fat cells are pushed through the damaged regions and are squeezed into small bulges that give the overlying skin the “puckered” or “dimpled” appearance that we call cellulite.
Women have tried numerous therapies to eliminate their cellulite including various creams, endermologie, lymphatic drainage massage, etc to no avail because none of these therapies correct the underlying physiological problems of poor circulation and damaged collagen septae. Carboxytherapy was originally used for aesthetic purposes by the Brazilians to sculpt residual post-liposuction fatty deposits above the knees and histological studies showed that the fat cells were ruptured by the CO2 gas while leaving the remaining skin structures and nerves unharmed. Collagen remodeling was also shown to occur, as well as thickening and smoothing of the overlying skin.