The Pathophysiology of Cellulite: Can the Puzzle Eventually Be Solved?

The pathophysiology of cellulite is still largely unknown. Here, we propose a new pathophysiology that connects the development of cellulite with several newly-discovered hallmarks of white adipose tissue. According to this theory, cellulite appears in hypertrophic fat tissue that is associated with overproduction of low molecular weight hyaluronan (HA). This can induce different types of fibrosis, producing inhomogeneous spatial tension in the tissue. This pathophysiology serves to explain the most well known peculiarities of cellulite appearance as well as to formulate the theoretically optimal cellulite treatment strategy.