Comparison of Cellulite Severity Scales and Imaging Methods

Abstract

Cellulite is characterized by dimpled contour alterations of the skin and is present in approximately 85% to 90% of postpubertal females. Although the pathophysiology of cellulite remains to be fully elucidated, experimental evidence indicates a multifactorial process involving the number and types of fibrous septae, microvascular dysfunction, subcutaneous inflammation, decreased dermal thickness with age, and fat deposition. Cellulite is a major cosmetic concern for many women, and a number of both noninvasive (eg, massage, cosmeceuticals, laser therapy) and minimally invasive techniques (eg, subcision, collagenase injection) have been evaluated to improve the appearance of the affected skin. However, evidence for many of these treatments is limited, largely due to the lack of a validated, convenient tool for the standardized evaluation of cellulite severity. Various imaging modalities have been used to characterize cellulite severity and the impact of treatment, but only 2-dimensional and 3-dimensional digital photography have been adequately validated. However, in many cases, imaging findings do not correlate with subjective measures of cellulite severity. A number of cellulite rating scales have been developed; some provide only a qualitative measure, while others do not fully capture all clinically relevant aspects of cellulite, including the perspective of the patient. There remains an unmet need for global adoption of a validated scale that can be used easily by clinicians and patients in clinical and research settings. We propose features that should be included in an ideal rating scale for assessment of cellulite severity.

Collagen Stimulators in Body Applications: A Review Focused on Poly-L-Lactic Acid (PLLA)

“…Interestingly, the development of body applications has stimulated clinical research, the set-up of methods for assessing quantitative effects and particularly assessment scales for the main signs as skin laxity, 32 , 33 , 40 , 44 , 48 cellulite severity, 37–39 , 41 , 42 cellulite dimple, 34 wrinkles, 35 , 36 , 49 volume, 45 , 46 and striae distensae. 43 The increasing interest in the body treatment approach is remarkably apparent due to the number of scales published in the recent past years from 2019 to 2021 32–34 , 37 , 38 , 40 , 43–45 for buttocks/thighs, abdomen and knees in addition to the well-established ones logically concerning the neck and chest, hands and cellulite from 2008 to 2016 ( Figure 1 ).…”

Celulite: uma breve revisão / Cellulite: a brief review

“…Embora o termo tenha sido usado pela primeira vez em 1873, a primeira descrição clínica de celulite ocorreu somente em 1920 (YOUNG et al, 2021). Palavra de origem latina, cellulite, foi utilizada para descrever uma alteração estética da superfície da pele e, desde então, vem sendo utilizado para descrever a aparência ondulada e irregular da pele, com aspecto de casca de laranja (FERREIRA et al, 2014).…”

“…Palavra de origem latina, cellulite, foi utilizada para descrever uma alteração estética da superfície da pele e, desde então, vem sendo utilizado para descrever a aparência ondulada e irregular da pele, com aspecto de casca de laranja (FERREIRA et al, 2014). No entanto, o termo celulite não seria o termo mais apropriado, pois a derivação da palavra significa inflamação celular e, estudos sugerem que não são encontrados sinais de inflamação no tecido subcutâneo (YOUNG et al, 2021). As alterações que ocorrem no curso da formação da celulite são fibrose e esclerose, que se manifestam clinicamente como um curso ondulado da superfície da pele e múltiplos nódulos, que são palpáveis (ATAMOROS et al, 2018).…”

Prevalence and factors associated with gynoid lipodystrophy in Brazilian adolescent girls: a cross‐sectional study

“…Recently, a 5-point clinician and patient-reported photonumeric scale to assess buttocks GLD severity in adult women was developed and validated, resulting in an effective tool for clinical practice. 9,10 The comparison of the performance of these two scales is warranted.…”

“…It is reliable for clinical trials because it is based on objective parameters; however, the scale is complex and does not include patient self‐assessment. Recently, a 5‐point clinician and patient‐reported photonumeric scale to assess buttocks GLD severity in adult women was developed and validated, resulting in an effective tool for clinical practice 9,10 . The comparison of the performance of these two scales is warranted.…”