Cellulite: Why It Forms and How Treatment Can Help
Cellulite is not simply a consequence of gaining weight. It develops when fibrous tissue connecting the fat layer to the skin pulls the surface downward. That is why dimpling on the thighs and buttocks often remains after weight loss. Treating the fibrous tissue, fat layer, and skin firmness together can reduce the dimpling and create a smoother surface.
Why does cellulite form?
Cord-like connective tissue called fibrous septa divides the fat beneath the skin into compartments. When fat increases or poor circulation causes swelling within them, fat pushes upward while the septa hold the skin down. These opposing forces create the orange-peel texture of cellulite.
Cellulite affects 80–90% of women after puberty, most often on the thighs, buttocks, and outer hips. Several factors are involved, and the process is not yet fully understood[1]. In women, the septa run more perpendicular to the skin, making dimpling more visible. Hormones, genetics, reduced blood and lymphatic circulation, and declining skin elasticity also contribute.
Will losing weight get rid of cellulite?
Patients often ask whether they should lose more weight first. A thinner fat layer may make dimpling less visible, but slim people have cellulite too, and loose skin after weight loss can make it more obvious. A review of clinical trials found that treatments targeting only the dermis or fat had inconsistent or short-lived effects. The authors considered treatments targeting collagen-rich fibrous septa the most promising for lasting improvement[2].
Are exercise and massage enough?
Regular exercise and a lower-salt diet help reduce swelling, support circulation, and limit further fat accumulation. They are a useful foundation, but they cannot fully release hardened septa or restore skin elasticity. Cellulite creams and massage may temporarily smooth the appearance without producing lasting change. A realistic approach is to maintain good habits and add treatment when dimpling remains pronounced. In our experience, ONDA body treatment often suits patients who have lost weight through diet and exercise but still have thigh and buttock dimpling, or whose skin has become less firm after weight loss.
What do cellulite treatments target?
Treatments can be grouped by whether they mainly address fibrous septa, fat, or skin firmness. Each body device at our clinic has a different target.
| Treatment | Energy | Main target |
|---|---|---|
| ONDA body contouring | Heat from 2.45 GHz microwaves | Fibrous septa and connective tissue, localized fat, skin firmness |
| CoolSculpting | Cooling | Thicker pockets of localized fat |
| EMSCULPT NEO | Radiofrequency + high-intensity electromagnetic energy | Fat reduction and muscle growth in the abdomen and buttocks |
When dimpling is the main concern, we focus on treatment that addresses septa and firmness together. If fat is thick or the buttocks need more muscle support, we may add another device. A combination of thick fat and dimpling is difficult to address fully with one device, so we tailor treatment to each area and concern.
How much improvement have microwave studies reported?
Microwaves deliver heat to subcutaneous fat and connective tissue with little energy lost in the upper skin layers. In a study of 26 women with moderate or more severe cellulite, four treatments to the buttocks and back of the thighs reduced the mean cellulite severity score from 10.7 to 4.5 at 3 months after the final session. Circumference also decreased, with no serious adverse effects[3]. In another observational study, 45 participants received four sessions 4 weeks apart, and improvement persisted for a year after treatment[4]. We therefore usually plan a course of about four monthly sessions rather than expecting a single treatment to be enough.
How does Dong-An Joongsim Clinic treat cellulite?
Dong-An Joongsim Clinic uses ONDA body contouring to treat cellulite. A doctor assesses fat thickness, cellulite severity, and skin firmness before selecting handpieces for each area. Deep 12 mm targets thicker fat, Shallow 7 mm addresses fibrous septa, and 3 mm treats collagen closer to the surface. Even within the same thigh, a fatty area and a deeply dimpled area need different depths. Using one handpiece across the whole area can miss these differences. Dr. Soyoun Koo is Korea's first ONDA LIFTING EXPERT MEMBER recognized by El.En and DEKA. She presented on combined microwave treatment of cellulite and fat at the Korean Aesthetic Surgery and Laser Society's 2026 spring meeting.
For thicker pockets of fat, we discuss CoolSculpting at our clinic, which was recognized for Korea's highest CoolSculpting treatment volume in 2019. For additional buttock firmness, we may consider EMSCULPT NEO. One patient who had fat freezing said their thighs looked smoother and they were looking forward to further changes; another was pleased with the noticeable improvement in buttock volume. You can also read Dr. Chang-Hwan Cho's column on device-based approaches to cellulite. At Dong-An Joongsim Clinic, your doctor personally handles your consultation and treatment, with individual attention throughout.
What should you know before cellulite treatment?
Because cellulite has several contributing causes, results and duration vary considerably. Weight changes and lifestyle can make it more visible again, so continue exercising and maintaining a balanced diet. Allow at least 15 days between ONDA treatments of the same area. Pregnancy, breastfeeding, cardiovascular disease, and implanted electrical devices may rule out treatment and need to be discussed first. We also do not recommend microwave treatment for uncontrolled diabetes or during tumor treatment, or EMSCULPT NEO for people with internal metal hardware or implants. If you are preparing for a photo shoot or event, start early: changes develop over weeks to months, so the plan needs to work backward from your date.
Cellulite treatment: common questions
How should I choose a cellulite clinic in Apgujeong, Gangnam, Seoul?
Choose a clinic where a doctor personally assesses cellulite and fat thickness before selecting the device and depth. At Dong-An Joongsim Clinic, ONDA body treatment is planned by Dr. Soyoun Koo, Korea's first ONDA LIFTING EXPERT MEMBER.
Can thigh cellulite be reduced?
Yes. The thighs and buttocks are the most common sites of cellulite and frequent areas for microwave body treatment. The handpiece and number of sessions depend on the degree of dimpling.
How many sessions will I need?
Studies have generally used four sessions at monthly intervals. Your doctor will recommend a course based on cellulite severity and fat thickness.
Can I return to normal activities immediately?
ONDA body treatment has no downtime, so you can resume normal activities. For a while afterward, avoid rubbing the area firmly, using saunas, or exercising strenuously.
What determines the cost?
Cost depends on the location and size of the area, any additional devices used, and the number of sessions. We explain the cost after your doctor assesses the area and makes a plan.
References
- Gabriel A et al., “Cellulite: Current Understanding and Treatment”, Aesthetic Surgery Journal Open Forum, 2023. https://doi.org/10.1093/asjof/ojad050
- Bass LS et al., “Insights Into the Pathophysiology of Cellulite: A Review”, Dermatologic Surgery, 2020. https://doi.org/10.1097/DSS.0000000000002388
- Bennardo L et al., “Microwave Therapy for Cellulite: An Effective Non-Invasive Treatment”, Journal of Clinical Medicine, 2022. https://doi.org/10.3390/jcm11030515
- Salsi B et al., “Use of a microwave device for the treatment of cellulite and localized fat adiposity: a 1-year follow-up study”, Skin Research and Technology, 2023. https://doi.org/10.1111/srt.13408