Hydrolipodystrophy, commonly known as "cellulite," is characterized by an accumulation of fat in the hypodermis, associated with water retention and periadipocytic fibrosis (thickening and hardening of the collagen network around fat cells). This combination gives the skin its bumpy appearance, often compared to the texture of an orange, hence the term "orange peel skin."
As early as 1929, French physician P. Lageze analyzed cellular tissue and observed that cellulite develops in several stages: first, the tissue in the thighs, buttocks, knees, abdomen, and underarms traps serum outside the capillaries, then fibrous formations appear, creating the dimpled effect visible on the skin's surface. Later, in 1966, Spanish dermatologists Bassas and Grau highlighted water retention in cellulite tissue, and in 1977, Braun Falco and Scherwitz described the dilation of lymphatic vessels and the enlargement of adipocytes (fat cells).
Thus, orange peel skin results from both the accumulation of fat under the skin and the rigidity of collagen fibers that are no longer able to maintain skin integrity, giving it its characteristic uneven appearance.
How does cellulite form?
Cellulite forms in the hypodermis, the deep layer beneath the skin where fat is stored. Fat cells, called adipocytes, naturally have the ability to expand to store energy. When they become too large, they exert pressure on the surface of the skin. Opposite them, the connective tissue, a network of collagen fibers, acts as a support structure. It compartmentalizes fat and connects the skin to the deep tissues. When adipocytes swell, they push the skin upward, while these fibers hold it down. This interplay of "push" and "pull" creates small depressions that are visible on the surface. Cellulite is therefore a mechanical phenomenon beneath the skin, an imbalance between the volume of fat cells and the flexibility of the fibrous mesh surrounding them. This is what gives the skin its "orange peel" appearance.
