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Fat accompli
Cellulite, the bane of women. Is there any hope at all?

By Suzanne Ng

THE cellulite-busting industry is bursting at the seams.

Cellulite, the bane of women. Is there any hope at all? -- DESMOND FOO

There are so many methods claiming to smoothen dimply skin that pharmacies, cosmetic houses, beauty salons and plastic surgeons are all in the business.

From popping pills and slathering on creams to having a machine roll over the thighs, an increasing number of women are seeking these solutions to orange-peel skin.

In fact, industry players have seen demand for treatments and products more than double over the past 10 years.

According to German medical researcher Dr Rudolf Weyergans, who was here last month to hold a workshop for Leonard Drake Skincare and Health Spa Centre, 80 per cent of women suffer from the complaint now. This compares to one in three women 30 years ago.

However, just as it is impossible to put a price tag on a baby-smooth bottom, it is hard to gauge how much the lucrative anti-cellulite market is worth, given that it is spread over various sectors.

For instance, slimming packages, which often include anti-cellulite treatments, make up about 15 to 20 per cent of the $200 million beauty, hairdressing and spa industry here, say insiders. This industry has grown about 30 per cent over the past five years.

The retail value of pharmacy brands, such as Elancyl, Activa and Nectarscell, is about $10 million annually, estimates Mr Thomas Ng, managing director of Color Play.

The company, which is a major player in the market, started distributing Elancyl products here 16 years ago.

As creams, gels and scrubs become more popular, big-name cosmetic brands such as Christian Dior and Clarins have joined the fight against stubborn fat cells.

Over-the-counter pills, such as Italian brand Cellasene and Nouvelle Cellulite Tablets from the United States, also claim to expunge cellulite.

While some women swear they work, doctors remain sceptical.

Dr Cheong Wai Kwong, president of the Dermatological Society of Singapore, says: 'One of the difficulties in treatment with creams is in getting the active ingredients past the layers of the skin and into the fat.'

To those looking for a proven solution, he dispenses the age-old advice: 'Plenty of exercise and a good diet are simple steps to minimise cellulite.'

Knead to know

UNFORTUNATELY, exercising has never been the favourite activity of housewife Sarah Chan, who is in her 30s. To get rid of cellulite, the mother of a seven-year-old girl forked out more than $3,000 to seek treatment at MD Specialist Healthcare last year.

In a process known as endermologie, the skin and underlying superficial fat are kneaded and massaged by special mechanised rollers operated by a trained therapist.

She likens the twice-weekly sessions to 'a vacuum cleaner sucking over the body'.

This physical manipulation increases local blood and lymphatic circulation.

Dr Martin Huang, a leading plastic surgeon with MD Specialist Healthcare, says: 'The fat is 'burned' off metabolically, resulting in a reduction in superficial fat content, and thus a reduction in the dimpled appearance.'

Says Ms Chan: 'I am confident enough now to wear swimsuits.'

Similar machines which target lymphatic drainage are available at beauty salons such as Expressions, Leonard Drake and Marie France Bodyline.

According to Dr Huang, the main difference between consulting a plastic surgeon and a beauty salon is the therapist operating the machine.

The more experienced and well-trained the therapist, the more effective the treatment.

Another cellulite-busting treatment available at both cosmetic surgeons and beauty parlours is low-frequency ultrasound waves, which break down fat and semi-liquefies it.

This process is usually followed by vacuum therapy, which further breaks down the semi-liquefied fat.

The final step is electrical stimulation of the lymphatic drainage system that drains the liquefied fat to the liver.

There, it is metabolised and removed from the system.

After six weeks of thrice-weekly sessions at slimming salon Unisense, Ms Pamela Jenkins reports a vast improvement on her thighs, bottom and tummy.

'You see all these ads and wonder how effective it would be. I'm surprised it works,' says the 44-year-old managing director of a small company.

The time and money spent - 27 hours and $3,000 so far - is well worth it, she says.

A point to note

FOR those unafraid of needles, there is a newer form of treatment known as mesotherapy.

Drugs and enzymes which break down fat are injected using a motorised syringe, with the needle moving rapidly like in the sewing machine.

This minimally-invasive treatment, done by cosmetic surgeons, not only sounds painful but also hurts the pocket.

Compared to a 14-session course of endermologie which costs about $1,400, mesotherapy will cost at least twice as much.

While Dr Huang, who offers mesotherapy at his clinic, vouches for its effectiveness, other doctors insist there is no cure for cellulite.

Dr Tey Beng Hea, director of the Weight Management Programme at Alexandra Hospital, says current available evidence points to how machines, creams and lotions 'are of no use in the removal of excess fat from the body in the absence of exercise or activity'.

He adds: 'The only proven method of fat removal is through liposuction.'

Liposuction is a surgical procedure which uses a suction device to permanently remove unwanted deposits of fat tissue.

However, he stresses the need for a healthy lifestyle and diet, and normal Body Mass Index before undergoing liposuction.

If not, the fat in the food that is subsequently eaten will be deposited in the face, upper arms and neck, 'resulting in a very grotesque appearance', he cautions.

While Dr Weyergens has claimed that cellulite can lead to diseases such as thrombosis, the majority of doctors agree with Dr Huang when he says: 'Cellulite is purely a cosmetic issue. No one has ever died from cellulite.'

Hate your cellulite but have found a way to get rid of it? Tell us how you did it by e-mailing stlife@sph.com.sg

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What is cellulite? Is it an invention by the beauty industry?

Cellulite is a pseudo medical term. It is just fat. The term was coined in European salons and spas to describe deposits of dimpled fat found on the thighs and buttocks of many women. While it may look dead ugly, no one has ever died from cellulite.

Who are more prone to cellulite?

Those prone to putting on fat are more prone to cellulite. Women, being more sedentary and because of their hormonal status, will tend to put on more fat. Up to 85 per cent of mature women will develop cellulite.

Smokers and alcoholic drinkers tend to put on more fat as well. On top of that, smokers also tend to have poorer circulation, adding to the problem. Those who do not exercise are also likely to develop orange-peel skin.

Why do thin people get cellulite? And do men get it?

Fat distribution in the body is largely dependent on genetic composition and hormonal status. If a thin person does not exercise, has poor skin tone or has a poor diet, she may also get cellulite, though a fat person will be more prone.

Men do not seem to have well-defined superficial fat compartments, and are hence far less likely to have this problem. Also, their fats are well-hidden within the torso, making them appear big, not fat.

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Six degrees of degeneration

CELLULITE does not appear overnight and, likewise, cannot be reduced overnight. Depending on the severity of the problem and the type of treatment, it can take weeks or months. While plastic surgeons generally classify cellulite as mild, moderate and severe, some beauty salons break it down into stages.

STAGE ONE

No visible signs, except that cuts or bruises may take longer to heal.

What's happening: Blood circulation slows down, resulting in fluid retention and poor lymphatic drainage.

STAGE TWO

Broken veins and tiny areas of discolouration appear. If you were to squeeze the skin, it would feel thicker than normal, tender and painful, with a tendency to bruise easily.

What's happening: The veins and capillaries are now weakened, and blood and fluid now seep into the tissue.

STAGE THREE

Signs of swelling become obvious. Even without pinching the skin, a dimpled orange-peel appearance can be seen.

What's happening: The lymph vessels are already slightly damaged and possibly squashed by the increasing tissue pressure. Fluid retention is now permanent. The tissues become swollen and thick and push against the hair follicles and sweat glands.

STAGE FOUR

The skin is cold to the touch, larger veins are broken and there is spontaneous bruising. A coarse skin tone, often known as 'mattress skin', develops.

What's happening: Because lymph fluid is now at a virtual standstill, protein separates from it and congeals into fibres.

These fibres form a meshwork around fat cells, creating the mattress skin effect.

STAGE FIVE

Certain areas of the skin feel hot among areas of cold tissue when you touch the skin.

What's happening: Increasing pressure within the tissues has re-routed the flow of blood around the cellulite tissue rather than through it.

The areas where the blood now flows are forced to open up and allow huge amounts of blood to pass through, resulting in 'hot islands' among otherwise cold cellulite tissue.

STAGE SIX

Bulky lumps and bumps, known as steatomes, on the skin distort the silhouette of the body.

What's happening: Fat cannot be removed from the cell because of poor blood supply, but continues to be stored. Huge honeycombs of fat, fluid and fibre are formed. The presence of steatomes suggests that the cellulite process has run its full course.

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Cellulite busters

HELTHandFITNESS
By Pradeep Paul

FIRST, the bad news.

There is no exercise that will get rid of cellulite. The doctors LifeStyle spoke to say there is no magic workout that will target cellulite only and zap it away.

Now, the good news.

All the doctors agree that you can do something to prevent the buildup of cellulite.

The magic word here is cardio. Any exercise that gets your heart rate up and the body's metabolism working harder is going to help you burn fat. And that is a sure way of making sure cellulite doesn't start forming.

Dr Kelvin Chew, deputy director of Alexandra Hospital's sports medicine centre, says the strategy to combat cellulite lies in healthy nutrition and regular exercise to reduce the subcutaneous fat and maintain muscle.

A combination of aerobic and resistance exercises is essential to achieve this, he says, and outlines some exercises on the right.

Dr Ben Tan, consultant sports physician at Changi Sports Medicine Centre, adds that any success in controlling cellulite will have to come via a combination of exercise and diet.

Dr Tan, who is also president of the Sports Medicine Association of Singapore, says he usually recommends a 1,000 kcal deficit per day, with about 600 kcal from diet restriction and the rest from energy used during exercise.

This is adjusted on a case-by-case basis.

If you're wondering what 600 kcal translates into in terms of everyday dishes, here's some help from Mrs Magdalin Cheong, chief dietitian at Changi General Hospital. These dishes hover around 600 kcal: a bowl of laksa; a plate of char siew rice or fried Hokkien noodles; nine slices of bread.

To burn 400 kcal a day, you will need to do 200 to 300 minutes of cardiovascular exercise per week at 55 to 70 per cent of maximum heart rate. (In layman's terms, you should start sweating at this pace).

As for the type of cardio exercise, he notes how there is a lot to choose from, ranging from high intensity full weight-bearing impact activities (like running) to weight-bearing non-impact activities (like the elliptical trainer) to non weight-bearing activities (like swimming, rowing, cycling).

High intensity burns the most calories but has the highest risk of overuse injuries, he says. Weight-bearing non-impact exercise burns the least but is safest.

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RUB OUT YOUR WOES

LifeStyle checks out six anti-cellulite products on the market (not US $)

Biotherm Celluli-Zone Intensive Zone Treatment Gel
Price: $68
Where To Get It: Biotherm outlets. Log on to www.biotherm.com.sg for details
What Does It Do: After the first few days, the gel is supposed to smoothen skin and refine skin texture.
How To Use It: Massage gel very lightly to the areas to be treated in the morning and/or evening.

Clarins Body Lift Contour Control
Price: $72
Where To Get It: Clarins' authorised outlets in department stores and Institut Clarins at Wheelock Place.
What Does It Do: Tightens and tones cellulite-prone areas. Helps to give user a more refined silhouette, reduces 'spongy' appearance on the back of the thighs and buttocks and re-texturise skin.
How To Use It: Apply morning or evening beginning at the ankles and working up to the waist. Concentrate on cellulite prone areas.

Christian Dior Bikini Anti-Cellulite
Price: $71
Where To Get It: Christian Dior outlets in department stores
What Does It Do: Refines curves and reduces the spongy appearance in four weeks without any effort or massage.
How To Use It: Spray on areas with cellulite.

Sothys Body Contour Serum + Anti-Eau Body Concentrate
Price: $168 (comes with a gift, Soft Peeling cream), usual price is $239.
Where To Get It: Palais Renaissance and Paragon.
What Does It Do: The serum is supposed to slow down the formation of cellulite, stimulate waste elimination, smoothen and streamline the body contours. The concentrate is supposed to reduce water retention, stimulate and activate cellular exchange and relieve tiredness and swelling sensations.
How To Use It: Twice a day.

Sisley Phyto Sculptural Anti-Cellulite
Price: $177
Where To Get It: Sisley outlets in Robinsons Centrepoint, Seiyu Bugis, and Metro Paragon.
What Does It Do: Anti-cellulite-slimming, firming, and moisturising and softening.
How To Use It: Product to be used regularly, morning and night.

Nectarscell Lipo Reducteur (Day and Night)
Price: $139.90
Where To Get It: At Guardian and Watsons.
What Does It Do: Helps accelerate the body's fat breakdown and drainage capability, specifically in the thighs and hips. Upon application, an instant cooling and refreshing sensation is felt.
How To Use It: For the day formula, apply onto the thigh and hip areas after your morning shower. For the night formula, spray onto targeted areas after warm shower.
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