Your skin is tied to your muscles and deeper tissues by small bands of tissue called "dermal ligaments". These dermal ligaments run from the deep fascia and muscles to the skin (much like the ropes that support a tent). As fat is deposited under the skin it pushes the skin upwards. The dermal ligaments can not stretch and resist this where they are attached, holding the skin down. The fat bulging up around these areas where the skin is bound down by dermal ligaments is called cellulite. The random pattern of the dermal ligaments creates the characteristic irregular patterns of cellulite.

New technologies are finally achieving significant results in treating cellulite.

Subscision with special needles can help cellulite by cutting the dermal ligaments tying the skin down. After the skin is released the skin rebounds and the cellulite dimpling is improved. The patients own fat is then injected to prevent the dermal ligaments from re-attaching to the skin. This treatment can achieve good results but is best used in moderation as cutting the ligaments also removes the support structure for the skin.

Cellulite may also be treated with Liposolve by injecting it into the bulging fat deposit. The Liposolve shrinks the fat deposits reducing the upward pressure on the skin and eliminating the bulging fat without cutting or stretching the dermal ligaments. This method preserves the attachment system of the skin to the deeper tissues.

Several machines on the market like Endermologie and Synergie stretch the skin and dermal ligaments with rollers and vacuum force. As the ligaments are stretched they lengthen, relaxing the "dimple". The overall effect is to give a smoother appearance to the skin. There are some creams that can help with cellulite. These are usually available only through a physician and generally used with other treatments. Results with the “vacuum” machines and over-the-counter creams are minor at best.