Treatments for Cellulite


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“Cellulite” is a skin condition that gives the appearance of small bumps and ripples under the skin. The bumps are caused by the underlying fat cells growing too large and stretching the natural fiber compartments that hold the skin to the underlying layers of tissues.

"Cellulite" is ordinary fat, but ordinary fat that affects the appearance of the skin. Strands of fibrous collagen tissue connect the skin to the subcutaneous layers and also separate compartments that contain fat cells. When fat cells increase in size, these compartments bulge and produce a rippled appearance of the skin.

Women tend to have cellulite more often than men because they have a vertical pattern of collagen in the underlying layer that holds the fat cells, and when the fat cells become very large, they bulge out of the chambers and appear as cellulite.

In men, the pattern of collagen is tighter, in a diagonal pattern, and they have thicker skin, so there is less bulging of the individual fat cells. Another factor in cellulite is high levels of estrogen, since this hormone has a direct effect on the holding capacity of fat cells through the increase of alpha-adrenoreceptors, the chemical doorways that tell your fat cells to hold on to their contents. Poor diet, bad circulation, and poor lymphatic circulation can all contribute to the appearance of cellulite.

Treating skin with cellulite

There are several extra steps you can take for the treatment of cellulite. Consider your skin care regimen, and fine-tune it to meet the needs of skin that has a tendency to swell with fluids, store fat and have poor circulation.


Although cellulite is a skin condition, it’s closely tied to the storage of excess fat. If you are significantly overweight, you should certainly alter your diet. The dietary enzyme bromelain can improve overall circulation to your skin and adipose tissues by removing the buildup of fibrin on the walls of blood vessels. Treating cellulite requires a two-pronged approach – one being the shrinking of the fat cells themselves, the second being the regeneration of collagen and strengthening of the skin outside of the swollen fat cells.


When cleaning your skin, use your wash cloth or loufah to massage the area where cellulite occurs. At first, use a circular motion and then a brushing motion upwards towards the bowels. This will improve circulation and edema, and help remove toxins and metabolic wastes out of the tissues and interstitial spaces around the collagen and fat cells.

Other Treatments

- Dry Skin Brushing

Learn to dry brush your skin at least twice every day – upon rising and before going to bed. Skin brushing provides many benefits in the treatment of cellulite. First of all, it’s “exercise” for your skin, and strengthens the underlying dermis and pattern of collagen in the subcutaneous layer. It stimulates the growth and repair of the tissues by increasing blood flow to the area. It also helps remove toxins and metabolic wastes out of the interstitial fluids surrounding the tissues for disposal. Dry brushing is good for you skin all over, but if you are suffering from spider or varicose veins, brushing these areas vigorously several times every day, first in a circular motion and then upwards towards the colon, can improve the appearance of cellulite.

- Hormones

Cellulite is often associated with the use of HRT and birth control pills. High levels of estrogen from these medications can cause an increase in the fatty tissues ability to store fats and cause them to bulge, pushing out the skin and causing cellulite. If you are using birth control pills for contraception, you may want to ask your doctor for a lower-estrogen dose formula or a non-hormonal form, such as an IUD. If you are on HRT, you may want to consider switching to a lower dose, adding progesterone cream, or using a weaker formula, such as an estrone cream.

- Habits

Get out of the habit of crossing your legs, knees and ankles. This reduces circulation and increases swelling. Try to keep moving regularly, neither sitting nor standing for long periods.

- Exercise

Regular exercise is necessary for the improvement of cellulite. Not only does it help reduce the appearance of cellulite by burning the fatty acids that are causing the cellulite. It also improves circulation and helps to remove toxin-filled wastes away from the skin. Take up a walking program, or sneaking in a set of exercises in the restroom during breaks.

- Body Wraps

Body wraps, both professional and homemade can improve the appearance of cellulite. Body wraps use a combination of minerals and herbs that stimulate the fat cells to release their contents, they absorb toxins from the skin and reduce swelling. Generally you will find stimulant herbs like kelp or algae that stimulate the fat burning process in the cells. You will find cosmetic clays that will remove toxins and wastes from the pores, and horsetail and horse chestnut that reduce edema (swelling) and provide minerals for strengthening the skin. These formulas are applied to the skin with the use of compression wraps. For recipes for doing home wraps, go to the Botanical Beauty Lab website.

- Massage

Massage, particularly the kind that improves lymph flow, is very good for reducing the appearance of cellulite. It improves the removal of metabolic wastes and toxins from the interstitial tissues around the adipose tissues, and gives the skin a smoother appearance. There are many professionals offering massage for cellulite, including lymphatic massage and endermology, but if that is out of your budget, you may want to try a home massage device. Many are available, from a simple round-prong hand tool to a powered massager that provides heat, massage and suction similar to the professional endermology machines.

​Keeping Your Skin Clean - For Men


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Did you know that men's skin is oilier than woman's skin?

That is a fact gentlemen, and this means dirtier faces. So as you see men have even more need to take proper care of their skin by cleaning it every morning and night. And we are not talking about using body soap to fast clean it, we are talking about deep cleansing here. After finishing a deep skin cleansing session you will look better, healthier, and your pores will be clear.

When choosing a cleansing product, you should go if possible for natural products, or products based in natural ingredients. Try to avoid chemical based cleansers. I also mentioned body soaps before; body soaps are deodorant soaps and you shouldn't use them on your (I don't think your face need deodorant anyway) They contain ingredients that are not meant to use on the face and leave a detergent film behind, irritating and clogging your pores.

For deep cleansing you will also may need a facial scrub, a scrub will get rid of dead cells on the top layers of the skin and will smooth the surface of your face. Be careful not to use a scrub that will damage you because it is too strong. Avoid the ones that contains rough ingredients, because at the end they will damage your skin. If you feel your skin damaged after using it, change it immediately.

Once your skin is all clean, remember to moisturize it with also a natural option. If you shave, do it first, before applying the moisturizer and don't forget to apply the cream also on your neck. We tend to forget the neck, and it is as damaged as the skin. Moisturizing depends on your skin type, so my advice would be to get to know your skin well before buying anything and then go from there. For example if you need intensive moisturizing, you should use Vitamin E or Aloe Vera Oil.

As you see cleaning the face is very important, but at the same time is very easy, just add a couple of minutes to your daily morning ritual and you will assure you'll look great for the next years.

Long-term follow-up on patients treated for abdominal fat


using a selective contactless radiofrequency device

Klaus Fritz MD,
Carmen Salavastru MD

Background and objective

The aim of this study was to evaluate how abdominal circumferential reduction achieved after using a noninvasive radiofrequency device (BTL Vanquish, BTL Industries Inc., Boston, MA) evolves over a 4-year period.


This is a follow-up on patients who were treated in our practice for abdominal fat in an earlier published multicenter prospective study. Patients were recalled for biometric data collection 4 years (±60 days) after the last treatment. Body and weight measurements were compared to the historical data. Digital images of the treated area were taken. Independent panelists were asked to recognize the original baseline images from the 4-year follow-up images.


The evaluation encompasses 13 subjects. In the original study, these patients lost on average 5.88 ± 4.14 cm of waist circumference (P < .001) while losing on average 1.29 kg. After 4 years, the same subjects had an average reduction of 4.42 ± 2.85 cm (P < .001) compared to the baseline, while gaining on average 0.50 kg. In both cases, the waist change was statistically independent of the weight change (P < .01). The patients preserved on average 75.2% of the original body contouring effect after 4 years as measured by circumference. None of the patients grew in circumference when compared to the baseline. Reviewers recognized the baseline patient images from the follow-up patient images in 82.1% cases. No long-term side effects were observed that would relate to the treatments.


in the study group, patients with ordinary weight changes preserved most of the original waist reduction after 4 years.


Over the past decade, the esthetic medicine market has been continuously shifting from invasive procedures to noninvasive treatments. Based on the ASAPS statistics, in 2016 noninvasive cosmetic procedures have grown at a double pace, year over year, compared to surgical procedures.[1] Contrary to surgical approaches, noninvasive body shaping treatments offer modest results. However with advancing technologies, the esthetic changes that can be achieved noninvasively are dramatically improving. The major concern has remained the longevity of the results of noninvasive treatments, as surgical procedures, such as liposuction, are believed to have long-lasting results unless dramatic lifestyle changes occur.[2]
As of today, 5 major noninvasive technologies widely used for the reduction in subcutaneous fat are recognized. These are radiofrequency (RF), low-level laser therapy (LLLT), hyperthermic laser treatment, high-intensity-focused ultrasound (HIFU) and cryolipolysis.[3, 4] All these technologies aim to either temporarily or permanently reduce the volume of adipose tissue, while the exact mechanisms of action differ. They vary from induction of apoptosis (RF),[5, 6] coagulative necrosis (HIFU),[7] release of lipid contents by creating cell membrane pores (LLLT),[8] lipolysis (laser), to fat cell disruption caused by local panniculitis (cryolipolysis).[9]

It has been proven that the number of fat cells stays constant in adulthood and that the fat mass in adult humans is primarily determined by changes in lipid storage in existing adipocytes.[10] A massive weight loss does not reduce the number of adipocytes, only their size. Similarly, significant weight gain results in body fat increase, driven by an increase in adipocyte volume; not their number. Most people combat body size fluctuations in adulthood, because frequent approaches such as food intake control and weight management programs only provide temporary changes in fat cell volume. This suggests that to achieve long-term control over fat mass in a specific body part, the number of adipocytes needs to be reduced.

There is clinical evidence both on animals and humans that significant increase in apoptotic index in adipose tissue can be achieved by applying noninvasive RF device treatments.[5, 6] Apoptosis is defined as programmed cell death[11] which results in cell decomposition and removal. RF may thus be used to reduce the adipocytes by number, not by size.[12] As such, the treatments can potentially cause long-lasting changes in the body's contour and fat mass volume, because the remaining adipocytes are unlikely to expand in size enough to restore the original body contour before treatments. However, very little scientific evidence is out there that would clearly document how body shaping achieved after noninvasive RF treatment develops over time.

An earlier multicenter prospective ethical committee-approved study was published in a peer-reviewed journal, presenting results on patients who had been treated for abdominal fat using a contactless noninvasive radiofrequency device (BTL Vanquish; BTL Industries Inc., Boston, MA, USA). Subjects received 4 weekly treatments and were evaluated at a 1-month follow-up. Significant circumferential reduction was achieved, supported by recognizable before and after digital images. In total, 20 subjects from the original study were recruited and treated in our practice. It is the goal of this study to investigate how the body contour changes originally achieved on those patients have evolved over time.


2.1 Study Design
Twenty patients (18 female, 2 male) qualified for this trial. These are the patients who had been treated in our practice as part of the earlier multicenter clinical study.
Patients were called in for a 4-year (±60 days) follow-up. Exclusion criteria were as follows: current pregnancy, any fat reduction or body shaping procedure (invasive or noninvasive) received after the original series of treatments, or use of medication or any medical condition known to affect weight levels and/or to cause bloating or swelling, >10% weight deviation (loss or gain) compared to the historical follow-up.

2.2 Outcome measures

To ensure consistency and allow for objective evaluation, the same outcome measures were used as those applied to the 1-month follow-up visit in the original study. Subjects were called in for collection of their biometric data. Weight was recorded. Circumference of abdomen was measured using a spring-loaded tape. Standardized photographs were taken with a single-color background.

On top of that, randomized patient photographs from the baseline and the 4-year follow-up were given to 3 independent reviewers for recognition, to see whether the body contour changes are still visible.
Circumference was compared to the historical data to evaluate how the original body shaping effects after RF treatments evolved over time. Weight data were used as a control indicator. Student's t test was used for statistical evaluation.
All patients were consented for taking their biometric data and to the use of their photographs without limitation for the purpose of this clinical study.


Three subjects out of the original group of twenty have not responded to the recall action. Two subjects were excluded because they received additional fat reduction treatments after the original study. Two patients were discarded based on exclusion criteria due to >10% weight loss/gain (1 subject lost 7.0 kg, another 1 gained 10.2 kg compared to the original study). The results are thus based on the remaining 13 patients.
In the original study, these subjects lost on average 5.88 ± 4.14 cm of waist circumference (baseline 98.65 cm to 92.77 cm at 1 month; significance of change P < .001) while losing on average 1.29 kg (73.05 kg to 71.75 kg). At 4 years, the same subjects had an average reduction of 4.42 ± 2.85 cm (baseline 98.65 cm to 94.23 cm at 4 years; significance of change P < .001) while gaining on average 0.50 kg (73.05 kg to 73.55 kg). In both cases, the waist change was statistically independent of the weight change (P < .01, two-sample t test with unequal variances). This means that at 4 years, the study group preserved on average 75.2% of the original body contouring effect as measured by circumference (4.42 cm of 5.88 cm). The results are not affected by the elimination of 2 subjects with >10% weight change, as their inclusion would change the ratio of preserved waist reduction from 75.2% to 74.9%. None of the patients grew in circumference when compared to the pretreatment measurements. Subject ID8 got back to the baseline waist size.

Complete overview of biometric data is presented in Table 1.

Table 1. Changes in patient biometric data over time

At 4 years, the average absolute weight deviation was 1.93 ± 1.43 kg compared to the baseline, with the standard deviation exceeding the arithmetic mean (0.50 ± 2.35 kg). This shows that over the course of the years, subjects' weight evolved inhomogeneously up or down, with the average weight slightly increasing. Despite putting on 3.1 kg, Patient ID3 lost additional 1 cm from her waist size, while Patient ID7 decreased in weight by 1.3 kg but only preserved 66% of the original contouring effect.

On average, the reviewers recognized the baseline image from the 4-year follow-up image in 82.1% cases, suggesting that the contour change is still visible in most patients. Images of 8 subjects were uniformly recognized by all 3 reviewers, images of 3 subjects were recognized by 2 reviewers, and photographs of 2 subjects were recognized by only one evaluator. See Figures 1-4 for examples of the images.

None of the subjects has reported any long-term side effects that would have connection with the treatments.


The primary goal of this study was to investigate how changes in body contour originally induced by a noncontact RF device (BTL Vanquish; BTL Industries Inc.) develop in the long term.

Four years after the last treatment, the subjects preserved on average 75% of their original waist reduction effect as measured by circumference. No data were collected about subjects' lifestyle and/or dietary habits. However, the prevailing waist reduction proved to be highly statistically significant and independent of any weight changes. Weight of the patients evolved inhomogeneously compared to the baseline, with the average change being insignificant (BMI + 0.18 kg/m2).
The prevailing changes in abdominal contours were further confirmed by a relatively high recognition rate of before and after photographs, reaching 82% based on 3 reviewers.
Based on results of 13 individuals, this study suggests that treatments with the investigated device can cause long-lasting changes in abdominal body contours. As seen in the data, the treatments cannot prevent any future weight gains. However, it concludes that in the investigated study group, patients with ordinary weight changes preserve most of the original effects after 4 years.

Although certain noninvasive body shaping procedures based on thermal effects are widely accepted to be causing permanent fat cell disruption, there is lacking evidence on how the results evolve over a longer period of time. Most published clinical studies incorporated a follow-up evaluation 3-12 months after the actual procedures.

This study discloses data on 13 subjects from 4 years after the original treatments. Though on a smaller patient group, this represents the first indication of how the waist changes may evolve in time. It is unclear whether the long-lasting waist reduction in this group is primarily caused by previous reduction in the number of adipocytes in the treated area. However, this theory is in compliance with other scientific evidence,[10] as the remaining adipocytes might be unable to expand in size enough to restore the original appearance before treatments.
All the patients were treated using the early generation of the device. Hayre et al[13] concluded in a study on 36 subjects that the upgraded device can provide better results. Moreover, the 1-month follow-up period from our earlier study might not have been enough to capture the original treatment results fully. It is not well understood how fast the process is, before a complete disposal of apoptotic cells and cell debris from the body occurs.

Additional scientific research and studies with larger patient groups are necessary to bring more evidence, before any findings of this kind can be generalized.


The authors have no commercial interest in BTL and received no compensation for this study. Klaus Fritz and Carmen Salavastru have no relevant conflicts to declare.

​Natural Weight Loss


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When you combine intention with patience, exercise and a healthy varied diet, weight loss IS possible! Whether your goal is to loose 10 pounds, 20, or 100—you CAN do it.

It can be difficult to always eat well, whether stress or boredom strikes, or any number of other emotional triggers. My weaknesses are bread, cheese, cookies, chocolate, candy bars, you name it. I live in Manhattan and can get a deli or restaurant delivery to my door in 10 minutes.....any time of day or night, my buzzer rings and it's here quick. Beautiful, healthy foods I had eaten that day, whether it was oatmeal for breakfast, organic salads or healthy soups or sandwiches, green tea--10 o'clock or midnight hits and I'm starving!

To me, strict diets and fad diets are a buzz load of baloney. Weight loss will happen when you shift your diet towards the wholesome and maintain an active lifestyle. If you slip and eat way too many cookies, and it's happened to me before, it's a good thing. Why on earth would I say that? Because you’ll eventually get sick and tired of that food coma you put yourself into and when you feel energized again, when you've just come home from that walk or aerobics class, your body will be craving healthy food it needs -- vegetables, fruits, wholesome soups and proteins, etc. You'll remember how run down and groggy you felt after over eating and your body will crave celery, leafy greens, citrus fruits, rice, fish, red wine, or the numerous other healthy foods you enjoy.

Hoodia can help curb your appetite, try it along with green tea. It works for me very nicely especially at night when I need it. Hoodia is a potent diet supplement that is extracted from a spiny, cactus-like succulent plant, and has been used for generations by nomadic South African Bushmen as an appetite suppressant during long hunting trips through the Kalahari Desert which is 362,500 square miles! From the CBS broadcast on 60 Minutes which praised Hoodia, Lesley Stahl says, "Imagine not being hungry all day without feeling side effects typical of most diet pills, like a racing heart or queasy stomach." If you are having trouble loosing weight Hoodia could be your best bet.

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​Body Contouring


From Wikipedia, the free enciclopedia

Photo Credit: By Tim Gouw on Pexels, CC0 License.

Body contouring is a procedure that alters the shape of the human body. It includes procedures that eliminate or reduce excess skin and fat that remains after previously obese individuals have lost a significant amount of weight, in a variety of places including the torso, upper arms, chest, and thighs.

Obesity is in epidemic proportions in the US and many parts of the world. It is defined as a condition where a person's body mass index (BMI) is 30 or greater. BMI is calculated by dividing the patient's weight in kilograms by their height in meters, squared. Normal weight individuals have a BMI that ranges from 18 to 25. Overweight people have a BMI from 26 to 30, with 30 and above people considered obese. Once the BMI reaches 35 and above, patients are considered morbidly obese. From a BMI of 30 and above a person's life span is shortened. In addition, obesity negatively affects the economic health of a society as well as other aspects of adult and child health, often for life. Childhood obesity is on the rise in Europe as well.

Nonsurgical methods

Nonsurgical body contouring is a rapidly growing field. Common methods used include low-level laser therapy (LLLT), cryolipolysis, radiofrequency energy, suction massage, and high-frequency focused ultrasound.

Now, doctors are able to use non-invasive technology to achieve a reduction in size of certain body areas, increased tone in lax or redundant skin and a diminished appearance of cellulite.

Usual results

While considered major surgery, the outcome of body shaping can require several months to see the full effects of the procedure.

When researchers at the University of Pittsburgh enrolled 18 bariatric patients just before the subjects decided to undergo body contouring, their average age was 46, plus or minus ten years. The researchers studied the patients’ body perception, quality of life and mood at three and six months after the body contouring procedures. They found the subjects’ quality of life improved and significantly enhanced their moods which had remained stable at the six-month point. Most body lifting patients return to non-strenuous work in about two to three weeks.

Except for brachioplasty, virtually all body shaping procedures require the patient to wear a support or compression garment for two to six weeks. The garment speeds and aids in healing.

Patients can usually drive again within one to three weeks, depending on the extent of the surgery, their health and general robustness.