At the Doctor's Office
Wanner says a "dizzying" number of machines are available through doctors' offices that promise to treat cellulite without surgery.
Some cellulite machines, such as VelaSmooth, Venus Freeze, Thermage, and Accent XL, use radio wave energy. Others, including Smooth Shapes and Zerona, use lasers. A newer group of machines, such as the Acoustic Wave Therapy system, uses high intensity sound waves.
Lasers and radio waves work by applying heat. The heat is meant to firm and thicken skin, and it may help melt some of the bulging fat underneath. Acoustic waves aim to break up the septae bands that pull down on the skin, creating dimples.
Most of these technologies require multiple treatments. The cost can range from $1,500 to $5,000, depending on how many times you go and which technology you choose.
How much improvement can you expect?
Wanner says even using the best technologies, "about 25% to 50% of people may see an improvement of 25% to 50%, which may diminish over time."
From a Cosmetic Surgeon
In January 2012, the FDA cleared the surgical treatment for cellulite called Cellulaze.
Cellulaze is a side-firing laser that's inserted under the skin using a few tiny cuts. Working in a grid pattern, a surgeon uses the laser to sizzle away the septae bands that are pulling down on the skin. The laser also cooks pockets of fat, reducing bulges. The company that makes the laser says it also helps thin, sagging skin.
The surgery may take several hours, depending on the size of the area that's treated. The doctor injects a painkiller to numb the area before starting.
Recovery may take 3 to 4 weeks to get over bruising and soreness. Other side effects include temporary swelling, itching, and discoloration, similar to those seen with liposuction. Peak results are achieved 6 months after the surgery, which costs around $7,500.
Despite the initial discomfort, "patients have had a high degree of satisfaction, above the 90% mark," says Barry DiBernardo, MD. He's a board-certified plastic surgeon in Montclair, N.J., and the lead clinical investigator for Cellulaze.
So far, the procedure has only been studied in about 50 patients, DiBernardo says. He says people see about a 65% improvement in their cellulite, on average, and the improvement appears to last as long as 2 years.
DiBernardo says Cellulaze works well for dimpling and for women who have mild to moderate "hills and valleys." But he says it doesn't appear to be the right tool for women with deep depressions and large folds of fat.
“It is a technology that really does attempt to change the three-dimensional structure of the skin, which I think is very interesting," says Wanner, who has no financial interest in Cellulaze.