Cellulite affects up to 90% of women, even those who exercise regularly, eat healthy, and maintain their ideal weight. While fitness can shape your thighs and buttocks, it can’t change the connective tissue bands that pull the skin down from below.
This is why treating cellulite can be so frustrating. The dimples seem like a surface issue, so many treatments in the past have only targeted the skin. This fails to address the underlying cause of the cellulite, which is the fibrous connective tissue band that is pulling the skin down. Avéli works differently by releasing the fibrous bands underneath the skin that cause some cellulite dimples.
Skin is held in place by connective tissue bands called septa, which anchor it to deeper layers. In areas with cellulite, some septa pull the skin down while fat cells push up around them. This push and pull creates a dimple.
This effect is similar to the tufting on an upholstered chair, where the fabric dips at each button because something underneath is pulling it down. In cellulite, the tether is a septa, or connective tissue band just under the skin.
Losing fat can change how full the area around a dimple looks, but the tether stays in place. Exercise can build muscle and improve the shape, but it can’t release the band. Even people at a healthy weight with strong legs can still have cellulite on their buttocks or thighs. Factors like body type, hormones, skin thickness, genetics, and age all contribute.
Creams have the same limitation. They can moisturize and temporarily make skin look firmer. Massage might reduce puffiness or change the appearance for a few hours. However, neither can reach the fibrous bands that cause dimples.
This doesn’t mean creams or massages are useless. It just means the results depend on how deep the treatment goes. Surface care can help the skin, but it can’t reach structures that are deeper underneath.
Someone might call any uneven area on their thighs cellulite, even if the texture is actually from loose skin, fat pockets, or a combination of issues. Real cellulite usually shows up as clear dimples that you can see as individual spots. Loose skin looks different, often appearing crepey, saggy, or rippled over a bigger area. Extra fat changes the shape and outline of the body, but it does not create the same kind of tether that true cellulite does.
The differences can be hard to spot. Sometimes a deep shadow looks like a dimple in one position but disappears when the skin moves. Losing weight can reduce fat but leave the skin looser, which might make the area look even more uneven. Past surgery or scars can also cause depressions that look like cellulite.
Avéli is designed to treat dimples caused by septa bands. It doesn’t tighten loose skin, remove fat, or change the shape of the thighs. If there are other issues, releasing the bands may help the dimples, but loose skin or fullness may still be there.
An online photo doesn’t always give a clear answer, and even a pinch test at home has its limits. The best way to check is to examine the area while standing, since that’s when dimples are most visible. At PURE Cosmetic Center in Boston, board-certified plastic surgeon Dr. Dave Lee looks at the skin, fat, and underlying structure to decide if Avéli is the right treatment.
A careful assessment can help you avoid paying for a treatment that isn’t right for your needs. If loose skin is the main issue, a cellulite treatment may not solve this problem.
Avéli targets the root cause of specific cellulite dimples. The handheld device goes under the skin through small entry points to reach the bands that cause the dimples. The provider can find a band, release it, and make sure the skin is no longer pulled down before treating the next spot.
This method is known as targeted, verifiable subcision. The provider can test the band before releasing it and confirm the release afterward. Treatment is based on the marked dimples rather than a broad pass over the whole area.
The Avéli procedure is performed in office under local anesthesia. The patient stands while the dimples are marked, since lying down can make them harder to see. After the area is numb, the provider guides the device beneath the skin and treats each planned dimple. The appointment takes about an hour in many cases, though a complex pattern may take longer.
Avéli can address targeted dimples across the buttocks and thighs in a single session. For most patients, the plan calls for just one treatment instead of a package of repeat appointments.
Recovery after treatment with Avéli is typically considered fairly straightforward however there will be some limitations and it will take time for things to look their best. This is because Avéli involves making small openings in the skin and the physical release of tissue beneath it.
Mild bruising, swelling, soreness, and tenderness are expected. Mild pain is most common during the first 24 hours. In the clinical study, bruising and tenderness tended to resolve within about a month, while small areas of firmness could take longer.
Many patients return to normal activities within 24 to 48 hours. The manufacturer’s formal safety language gives a wider range: some patients returned within one day, and most returned within a week. Those statements describe what patients felt able to do, they don’t promise that the bruising was gone.
A patient may feel fine working at a desk while the thighs still look bruised. She may be comfortable running errands but prefer to wait before wearing shorts or a swimsuit. Functional recovery and visible recovery run on different schedules.
Timelines for exercise require the same common sense. Walking puts less stress on healing tissue than running, cycling, or heavy lifting. Strenuous exercise can make swelling and soreness worse. The right return date depends on the number of dimples treated, their location, and how the patient is healing.
This is worth considering for anyone planning treatment before a vacation or summer event. A few days may be enough to resume daily life. Several weeks will give bruising and swelling more time to settle.
Avéli makes the most sense when you can point to clear, individual dimples on the buttocks or thighs. If your weight is stable and your skin still has good elasticity, releasing the bands beneath those dimples may help the area look smoother.
If the texture looks more like broad rippling or sagging, loose skin may be playing a bigger role. Fullness from a fat pocket can also make the area look uneven. Avéli may still help with any true cellulite dimples that are present, but it won’t tighten the surrounding skin or reduce the fat. Another treatment like liposuction or excess skin removal may make more sense.
It also helps to have a realistic picture of the result. Some dimples may smooth out quite a bit, while deeper ones may become less noticeable without disappearing. Your skin will still look like skin, with natural folds, pores, and texture.
Regardless of your concerns, Dr. Dave Lee will be sure to explain exactly what is going on with each individual patient’s anatomy and the best treatment option during your consultation. As a board certified plastic surgeon, Dr. Lee is very experienced combining treatments to achieve the best results. Avéli on its own may be the best treatment option or combining Avéli with liposuction and/or skin removal may make more sense.
Your beauty is a symphony. Don’t trust it to anyone less than a true performer and a master at his craft. Chelmsford and Boston plastic surgeon, Dr. Dave Lee brings the virtuosity of a concert pianist and the artistry of a renowned plastic surgeon to each procedure. Schedule a consultation today to discover why patients across New England are singing the praises of Dr. Lee and his staff at PURE Cosmetic Center.
Boston Office
400 Commonwealth Ave, 2nd Floor
Boston, MA 02215
Chelmsford Office
15 Village Square
Chelmsford, MA 01824
