What is cellulite – and why does it affect almost every woman?
Cellulite is present to some degree in most women after puberty — estimates suggest about 80–90%1. Its development is multifactorial: hormonal, genetic, anatomical and microcirculatory factors can all play a role. It is much less common in men, partly explained by differences in the structure of subcutaneous connective tissue septa2: in women these septa more often run perpendicular to the skin surface, which can facilitate protrusion of fat lobules toward the surface and contribute to the characteristic dimpled appearance. Lifestyle factors tend to influence its visibility and severity rather than being sole causes on their own.
Not a disease — but more than just an aesthetic issue
Cellulite is not a disease, but it is not merely an aesthetic concern: the processes behind it — reduced microcirculation, connective tissue changes, rearrangement of adipose tissue — also affect overall skin condition and tissue health. Home device treatments act on these mechanisms.
How does cellulite develop? – Steps of the process
Cellulite does not appear overnight. Four mutually reinforcing processes contribute to it, which, once initiated, become self-perpetuating cycles. The good news: there are opportunities to intervene at every stage.
The first step is deterioration of the microcirculation. Permeability disturbances develop in the walls of small vessels, and blood and lymph flow slow in the affected areas. This leads to fluid accumulation (oedema) at the border of adipose tissue and skin. The interstitial space swells, which also worsens the nutrient and oxygen supply to the tissues. Cavitation treatments — for example, the low-frequency modes of the Lipozero device family — mainly target this phase, helping to resolve congestion by activating microcirculation.3
As a consequence of circulatory disturbance, low-grade inflammatory processes develop in the tissues. The interstitial space becomes oedematous, which further impairs microcirculation — closing the loop. Oedema also exerts pressure on fat compartments, exacerbating uneven fat distribution. Lymphatic drainage massage can improve lymph flow and reduce this oedematous burden.
Over time, oedema and inflammation alter connective tissue fibers (collagen and elastin). The connective tissue septa may thicken, become stiffer and lose elasticity — this is the fibrotic stage of cellulite. The stiffened septa pull the skin down more strongly, deepening the dimpled appearance. Research indicates that ultrasound treatments can help relax connective tissue structure and restart collagen production.4
Enlarged fat cells are pressed upward between the stiffened connective tissue septa toward the skin, creating the characteristic orange-peel appearance. The low frequencies of cavitation ultrasound (39–150 kHz) may help reduce fat accumulation by applying mechanical pressure to fat cells — creating microbubbles and their collapse — which assists in reducing adipose tissue deposits.3
The types of cellulite — it matters which one you face
Not all cellulite is the same. When choosing a treatment strategy, it is important to know which type you are dealing with — this is influenced by age, hormonal status, lifestyle and the condition of the affected area.
| Type | Characteristics | Most affected areas | Appropriate treatment frequency |
|---|---|---|---|
| Oedematous cellulite | Soft to the touch, dominant fluid stagnation, mild appearance | Inner thigh, ankle area | 526 kHz (NorAd mode), lymphatic drainage |
| Soft (flaccid) cellulite | Flaccid skin, accentuated by movement, reduced muscle tone | Thigh, buttock, upper arm | 150 kHz, 1–3 MHz cosmetic program |
| Fibrotic cellulite | Firm to the touch, painful, deeply fixed connective tissue, long-standing | Outer thigh, buttock | 39 kHz (deep-acting cavitation) |
| Mixed cellulite | A combination of the above, different types on different body areas | Variable | Frequency-changing, combined programs |
Why is classifying the type important?
Different cellulite types may respond best to different ultrasound frequencies. The lower the frequency (e.g., 39 kHz), the deeper the ultrasound penetrates into tissue — ideal for fibrotic, deeply fixed cellulite. Higher frequencies (526 kHz–3 MHz) are more beneficial for superficial layers, skin firmness and metabolism.
Why isn’t a cellulite cream alone enough?
Supermarkets and pharmacies stock dozens of "anti-cellulite" creams, serums and gels. These products can indeed contain useful ingredients (caffeine, retinol, L-carnitine) that may help stimulate circulation and hydrate the skin surface. However, they have a fundamental limitation:
Cellulite is the result of processes occurring at a depth of 4–8 mm — in the subcutaneous fat layer, connective tissue septa and microvessels. Topically applied active ingredients penetrate only the uppermost skin layers and do not reach deeper tissue structures. Cavitation ultrasound, by contrast, acts directly in the adipose tissue layer.
What do studies show?
A 2018 review concluded that ultrasound appears to be an effective, efficacious and safe method to reduce skin laxity, support lipolysis and decrease the appearance of cellulite — with minimal side effects (sensation during the procedure, transient redness and swelling after treatment).4
Which technologies can help treat cellulite?
The most effective approach for home-device cellulite treatment today is cavitation ultrasound — supplemented by cosmetic ultrasound and iontophoresis for ingredient delivery. Members of the Lipozero device family combine precisely these principles.
Cavitation is a physical phenomenon: low-frequency (39–150–526 kHz) ultrasound generates microbubbles in adipose tissue. These bubbles undergo cyclic compression and expansion until they collapse — and that collapse releases mechanical energy near fat cells. The fat cell membrane is disrupted, their triglyceride content is released into the interstitial space and then into the lymphatic circulation, from where the body eliminates it naturally.3
Important: cavitation is effective only at frequencies below 600 kHz — at higher frequencies microbubbles cannot form in adipose tissue. The lower the frequency, the deeper the wave penetrates (39 kHz can reach depths of 5–8 cm).
The higher-frequency (1–3 MHz) ultrasound works not by cavitation but via thermal and mechanical micromassage effects. It mildly raises tissue temperature in layers close to the skin surface, which can activate collagen synthesis and support skin tightening.4 This method also enables ultrasound-assisted ingredient delivery (sonophoresis): absorption of cosmetics can increase up to 20-fold compared with conventional application.
The 526 kHz frequency on Lipozero G150 and G39 devices has a special property: some studies suggest this frequency may promote noradrenaline (norepinephrine) release in adipose tissue. Noradrenaline plays a key role in regulating adipose tissue metabolism — triggering lipolytic activity in fat cells. This so-called NorAd-526 mode is particularly applicable for oedematous areas and abdominal fat pads.
After cavitation treatment, liberated fatty acids leave the treated area via the lymphatic circulation. Therefore, maintaining treatment efficacy requires adequate fluid intake (2–2.5 liters of water daily) and — where available — combining with lymphatic massage (manual or mechanical). Lipozero G150 and G39 include lymphatic activation protocols as part of their cavitation program completions.
The Lipozero device family – choose the one that fits your cellulite type
Medimarket distributes the Lipozero product family from the manufacturer Globus — the Italian manufacturer brought its medical electrotherapy experience to cosmetic ultrasound. The main differences between the three models are cavitation frequency range and number of programs: lower frequencies penetrate deeper, and more programs allow finer customization.
Lipozero Excel – Entry-level cosmetic ultrasound
The Lipozero Excel is the home cosmetic entry model in the device family. The 3 MHz ultrasound can be used for ingredient delivery (sonophoresis), skin tightening and treating the superficial layer of cellulite. Thanks to its beauty-care programs, it can easily be incorporated into a daily body-care routine. It has no cavitation function — if you are looking for cavitation depth effects, the G150 and G39 models provide that.
Ideal for: Soft, oedematous cellulite; supporting skin surface elasticity; prevention and adjunctive treatment.
Lipozero G150 – Cavitation and cosmetic ultrasound combined
The Lipozero G150 already operates across four frequency ranges (3 MHz, 1 MHz, 526 kHz, 150 kHz), offering both cosmetic ultrasound and true cavitation treatment. The 150 kHz cavitation frequency is particularly suitable for oedematous and soft cellulite, while the 526 kHz NorAd mode may help support fat breakdown by activating metabolism. 26 cavitation and 16 beauty-care programs make the treatment protocol flexible.
Ideal for: Oedematous and soft cellulite; thigh, abdomen and buttock areas; suitable for both home and professional use.
Lipozero G39 – Professional cavitation, five frequency ranges
The Lipozero G39 is the flagship model of the device family: it works on five frequencies (3 MHz, 1 MHz, 526 kHz, 150 kHz and 39 kHz). The 39 kHz ULTRA-CAV mode is the deepest cavitation range — it can deliver outstanding results for fibrotic, hard, long-standing cellulite and thick fat deposits. 49 preset programs (including 30 customizable) allow you to tailor the treatment protocol precisely to the cellulite type, body area and treatment depth. Two different-sized applicators (Ø 50 mm and Ø 42 mm) ensure both large body areas and smaller zones can be treated effectively.
Ideal for: Fibrotic, hard cellulite; treatment of thick fat deposits; for cosmeticians and demanding home users.
| Feature | Lipozero Excel | Lipozero G150 | Lipozero G39 |
|---|---|---|---|
| Cavitation | ❌ | ✅ (150 kHz, 526 kHz) | ✅ (39, 150, 526 kHz) |
| Cosmetic ultrasound | ✅ (3 MHz) | ✅ (1, 3 MHz) | ✅ (1, 3 MHz) |
| NorAd-526 mode | ❌ | ✅ | ✅ |
| Depth of penetration (max.) | Surface layer | Medium depth | Deep layer (39 kHz) |
| Number of programs | Beauty-care programs | 26 cav. + 16 beauty | 49 programs (30 customizable) |
| Recommended cellulite type | Oedematous, soft, prevention | Oedematous, soft | Fibrotic, mixed, deep fat pads |
Before you start treatment – who should not use it?
Cavitation ultrasound can be used at home safely, but as with any device-based treatment, there are conditions and circumstances in which the treatment is contraindicated. Read the list below carefully and consult your physician if in doubt.
- Pregnancy and breastfeeding – cavitation ultrasound must not be used during pregnancy
- Implanted metal devices in the treatment area – prosthesis, metal plate, screw; ultrasound cannot be used near implants
- Pacemaker and cardiac rhythm devices – ultrasound treatment is forbidden near pacemakers
- Venous thrombosis, thrombophlebitis, phlebitis – ultrasound may cause embolic dislodgement
- Active cancer, malignant disease – ultrasound must not be applied to tumorous tissues
- Acute infection or inflammation in the treatment area – skin infections, wounds, ulcers are contraindications
- Coagulation disorders, anticoagulant therapy – not recommended in cases of increased bleeding tendency
- Radiation therapy on the affected area (within 6 months) – irradiated tissues should not be treated
- Severe cardiovascular disease – consult a physician
- Osteoporosis, growth plate involvement – not to be used near bone
Important note
The Lipozero devices are beauty-care tools — intended as a supplement to daily body-care routines. They do not replace medical treatment, and in cases of severe obesity they are not an alternative to medical or surgical approaches. Treatment outcomes depend heavily on lifestyle: healthy nutrition, adequate fluid intake and regular exercise are essential prerequisites.
Scientific background – what do studies say?
Cellulite prevalence and pathophysiology – 2015 review
In their 2015 evidence-based review, Luebberding and colleagues report that cellulite affects 85–90% of women and that estrogen, microcirculatory insufficiency and changes in connective tissue structure all contribute to its development. The authors emphasize that no single treatment modality provides a lasting solution without lifestyle changes.1
Cavitation and adipose tissue – histological study
Palumbo and colleagues (2014) demonstrated in ex vivo skin samples and in vivo biopsies that ultrasound-induced cavitation statistically significantly reduced adipocyte size (p < 0.001), created micropores in adipocyte membranes and triggered triglyceride release — without damaging intact skin structures (vessels, stroma, epidermis). Clinically measured outcome: a significant reduction in abdominal circumference in the treated group.3
Ultrasound for skin tightening and cellulite reduction – 2018 review
Werschler and colleagues' 2018 review found that ultrasound appears to be an effective, efficacious and safe modality for correcting skin laxity, supporting lipolysis and reducing the appearance of cellulite. Side effects were minimal: sensitivity during the procedure, subsequent redness and mild swelling.4
Non-invasive body contouring – systematic review, 2017
Derakhshan and colleagues (2017) screened 2,024 studies from Cochrane and PubMed databases. They concluded that high-intensity focused ultrasound and cavitation devices show clinically relevant reductions in adipose tissue, although optimal protocols and long-term maintenance require further study.5
Practical tips – how to achieve good results?
Treatment protocol – what to follow
For best results, plan a treatment series: 8–12 sessions, 1–2 times per week. Allow at least 48 hours between sessions so liberated fatty acids can leave the treated area. Drink 1–1.5 liters of water before each session — good hydration is fundamental for cavitation bubble formation and removal of fatty acids via the lymphatic system.
Treatment technique
Never keep the applicator stationary — glide it over the treated area with circular motions at approximately 1–2 cm/s. Gel is essential: without gel ultrasound energy is not effectively transmitted to the skin. Recommended amount: 4–5 g (about one teaspoon) per session. You may hear a slight crackling sound in your ear during cavitation — this is normal.
Aftercare
For 1–2 hours after treatment avoid hot baths and intense sun exposure. On the treatment day, drink at least 2–2.5 liters of water to help eliminate liberated fatty acids. Light activity (e.g., a 30-minute walk) after treatment can help sustain metabolic processes.
Important: treatment is effective with realistic expectations
The cellulite-reducing and body-shaping effects of cavitation treatments are scientifically supported — but they are not a miracle cure. Results are gradual and achieved through a series of treatments, and without lifestyle changes (fluid intake, exercise, balanced diet) they are not maintained long-term. In severe obesity, device treatment is an adjunct method, not primary therapy.
Frequently asked questions
Individual experiences vary — typically the first visible change appears after 4–6 treatments. The result is usually evaluated after completing the full treatment series (8–12 sessions). Skin texture and firmness often change earlier than visual appearance. The course can be repeated if necessary.
If you primarily want to support skin firmness and ingredient delivery, the Lipozero Excel is suitable. If you are looking for cavitation effects for oedematous or soft cellulite, the G150 is ideal. If you have fibrotic, hard, long-standing cellulite or need to treat thick fat pads, the deeper frequencies of the G39 work more effectively.
Only ultrasound gel or a cosmetic gel suitable for this purpose (non-greasy, water-based) should be used. Ultrasound gel ensures exclusion of air bubbles between the applicator face and the skin and enables efficient transfer of ultrasound energy. Greasy creams and oils are unsuitable because they impede ultrasound transmission.
Yes. Cavitation treatment pairs well with lymphatic massage (preferably on the same day, after ultrasound), dry brushing (before treatment) and targeted body-care products (after treatment, leveraging improved absorption). A combined approach usually yields better results than single methods alone.
Typically 8–12 sessions are recommended per series, 1–2 times per week. To maintain results, 1–2 maintenance sessions per quarter are suggested, combined with lifestyle changes. Without lifestyle changes (fluid intake, exercise, dietary modification) adipocytes can regenerate and improvements will not be lasting.
Summary – Quick overview
Sources
- Luebberding S, Krueger N, Sadick NS (2015). Cellulite: An Evidence-Based Review. Am J Clin Dermatol. PubMed: 25607807
- Bass LS, Kaminer MS (2020). Insights into the pathophysiology of cellulite: a review. Dermatol Surg. PubMed: 32004193
- Palumbo P, Cinque B, Miconi G et al. (2014). Histological and Ultrastructural Effects of Ultrasound-induced Cavitation on Human Skin Adipose Tissue. Plast Reconstr Surg Glob Open. PMC: 4174158
- Werschler WP, Werschler PS (2018). A Review of the Use of Ultrasound for Skin Tightening, Body Contouring, and Cellulite Reduction in Dermatology. J Clin Aesthet Dermatol. PubMed: 29846343
- Derakhshan N, Rahimi-Movaghar V (2017). Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat. World J Plast Surg. PMC: 5236497
