Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr;143(4):1077-1086.
doi: 10.1097/PRS.0000000000005407.

Structural Gender Dimorphism and the Biomechanics of the Gluteal Subcutaneous Tissue: Implications for the Pathophysiology of Cellulite

Affiliations

Structural Gender Dimorphism and the Biomechanics of the Gluteal Subcutaneous Tissue: Implications for the Pathophysiology of Cellulite

Christina Rudolph et al. Plast Reconstr Surg. 2019 Apr.

Abstract

Background: This study was performed to investigate gender differences in gluteal subcutaneous architecture and biomechanics to better understand the pathophysiology underlying the mattress-like appearance of cellulite.

Methods: Ten male and 10 female body donors [mean age, 76 ± 16.47 years (range, 36 to 92 years); mean body mass index, 25.27 ± 6.24 kg/m (range, 16.69 to 40.76 kg/m)] were used to generate full-thickness longitudinal and transverse gluteal slices. In the superficial and deep fatty layers, fat lobule number, height, and width were investigated. The force needed to cause septal breakage between the dermis and superficial fascia was measured using biomechanical testing.

Results: Increased age was significantly related to decreased dermal thickness, independent of sex (OR, 0.997, 95 percent CI, 0.996 to 0.998; p < 0.0001). The mean number of subdermal fat lobules was significantly higher in male body donors (10.05 ± 2.3) than in female body donors (7.51 ± 2.7; p = 0.003), indicating more septal connections between the superficial fascia and dermis in men. Female sex and increased body mass index were associated with increased height of superficial fat lobules. The force needed to cause septal breakage in male body donors (38.46 ± 26.3 N) was significantly greater than in female body donors (23.26 ± 10.2 N; p = 0.021).

Conclusions: The interplay of dermal support, septal morphology, and underlying fat architecture contributes to the biomechanical properties of the subdermal junction. This is influenced by sex, age, and body mass index. Cellulite can be understood as an imbalance between containment and extrusion forces at the subdermal junction; aged women with high body mass index have the greatest risk of developing (or worsening of) cellulite.

PubMed Disclaimer

References

    1. Hexsel D, Camozzato FO, Silva AF, Siega C. Acoustic wave therapy for cellulite, body shaping and fat reduction. J Cosmet Laser Ther. 2017;19:165–173.
    1. Soares JL, Miot HA, Sanudo A, Bagatin E. Cellulite: Poor correlation between instrumental methods and photograph evaluation for severity classification. Int J Cosmet Sci. 2015;37:134–140.
    1. Hexsel D, Hexsel C, Weber M. Goldman M, Hexsel D. Social impact of cellulite and its impact on quality of life. In: Pathophysiology and Treatment (Basic Clinical Dermatology). 2010:2nd ed. Boca Raton, Fla: CRC Press; 1–5.
    1. Rawlings AV. Cellulite and its treatment. Int J Cosmet Sci. 2006;28:175–190.
    1. Nürnberger F, Müller G. So-called cellulite: An invented disease. J Dermatol Surg Oncol. 1978;4:221–229.

MeSH terms

LinkOut - more resources