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Patient Selection and Combination Treatments for Optimal Results—A Review and Our Experience

Davis, DiAnne S. MD, MS*; Boen, Monica MD, FAAD; Fabi, Sabrina G. MD, FAAD, FAACS

doi: 10.1097/DSS.0000000000001776
Review Article

BACKGROUND More than 90% of women have reported concerns of cellulite on their skin. Both commercially advertised creams and topical pharmacological agents have shown limited improvement. Thus far, there has been a paucity of thorough review articles on how to address and treat this condition.

OBJECTIVE To investigate how the etiology and pathogenesis of cellulite can help guide treatment combinations and provide a more algorithmic approach to comprehensively address a condition that affects so many women.

MATERIALS AND METHODS A review of the literature surrounding treatment options for cellulite and the authors' experience in this area are provided.

CONCLUSION This review summarizes available treatment options for cellulite, including topical agents, controlled subcision, energy-based devices, dermal fillers, and new injectable medications. Furthermore, the various ways that these treatments can be combined in an algorithmic and sequential approach based on the degree of volume loss, skin laxity, and excess adiposity associated with cellulite are addressed. These combination therapies for cellulite are supported both in the published literature and the authors' experience to help clinicians tailor a comprehensive treatment plan for the multiple factors that contribute to cellulite. Further clinical trials are needed to compare various devices and techniques for cellulite as well as combination treatments.

*Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma;

Cosmetic Laser Dermatology, San Diego, California

Address correspondence and reprint requests to: DiAnne S. Davis, MD, MS, Gateway Aesthetic Institute and Laser Center, 440 West 200 South, Suite 250, Salt Lake City, UT 84102, or e-mail:

The authors have indicated no significant interest with commercial supporters in regards to this article.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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