The fatty crisscross, orange peel effect on some women's thighs and buns lacked a name until a self styled French exercise expert dubbed it cellulite in the 1960's. According to Nicole Ronsard, originator of the cellulite theory, cellulite was fat trapped in connective tissue. The typical dimpled appearance of cellulite, Ronsard said, arose from fat that had hardened in connective tissue because of poor waste removal.

The poor waste removal, she continued, resulted from such unhealthful habits as ingesting alcohol, chocolate and fried foods, smoking cigarettes, breathing polluted air, suffering from constipation and fatigue, poor breathing, too much tension, and living a sedentary existence.

The cure for cellulite, according to Ronsard, consisted of a total program incorporating plenty of exercise, a balanced diet, massage (to break up the connective tissue that held the trapped fat deposits), sauna (to help the body dispose of the poisons that accumulated in cellulite), and yoga. The medical community was highly critical of Ronsard's cellulite theory.

The question arises: If cellulite is truly just ordinary fat, then why doesn't cellulite show up in men? Only women suffer from this hell. A visit to any beach will quickly verify the lack of cellulite in even grossly over weight men. Yet even rather slim women often have cellulite marring an otherwise good body. The answer lies in the way men and women store fat in the body and in the way skin is attached.

In women, the skin attaches to underlying muscle by thin parallel cords, similar to the construction of a mattress. These cords don't have much give. Any fat that women gain fills in the valleys between the cords, then bulges out enough to show through the skin, creating the orange peel effect that people call cellulite.

In men, the muscle skin connectors are a tightly crisscrossed maze of strands. When men store fat, it's in one smooth layer because - unlike women - there aren't any valleys or ridges for it to collect in or spill over. So cellulite is ordinary fat, but packaged differently in women. Because of the strand like connective tissue that holds the fat in place, it usually bulges out more than men's fat deposits. In this case, cellulite is indeed real, even if labeled somewhat commercially.

If cellulite is really ordinary fat, then it stands to reason that the techniques that get rid of other types of fat should work equally well for cellulite deposits. But here again, nature has thrown the female a tricky curve. Many women have discovered through frustrating experience that eradicating this fat on the hips and thighs isn't easy. To some, it seems impossible.

Again, the stubbornness of cellulite stems from surprisingly noble motives of nature. That tenacious fat in the female lower body is there to perpetuate the human race, to aid in pregnancy. But why must a woman carry it for life if she needs it for only 9 months?

The human body stores 3 types of fat

1. Subcutaneous fat, found just under the skin

2. Storage fat, the deeper, heavier fat deposits that form around various organs in the body, and are interspersed with muscle fibers (intramuscular)

3. Essential fat, as in the fat that supports the kidneys and, in women, the fat in the breasts and, yes, the fat on the hips and thighs. In over weight women not all breast and hip/glute fat is essential fat.

A properly designed exercise and diet regimen will rid the body of most subcutaneous and storage fat deposits, but won't touch essential fat unless you use a very stringent program. To the body, essential fat represents an emergency energy supply. For example, the fat deposits in women's breasts are to supply energy for lactation. The fat in female hips and thighs acts as an emergency energy reservoir for sustaining pregnancy. These fat deposits in women are also known as 'sex specific fat' because they are unique in women.

The connection between nature and cellulite stems from the evolution of women's sex specific fat deposits to guarantee the continuation of the human species. It takes about 80,000 calories to produce a human baby, and nature in its wisdom has seen to it that if a woman suffers food deprivation, she'll at least have enough calories via fat on her hips to sustain a pregnancy to term.

Until a few years ago, no one knew why the fat on women's hips and thighs was so difficult to get rid of. Then research showed that the fat cells found in women's sex specific areas contained a preponderance of alpha receptors. Fat cells have either alpha or beta receptors on the surfaces. Beta cells, which respond to the hormone epinephrine, release fat rapidly; alpha cells, such as those found in women's hips and thighs, do not release fat so easily.

Scientists postulate that nature imbued women's hips and thighs with alpha receptors to prevent fat release, thus guaranteeing a supply of calories under adverse conditions, such as starvation. By the way, the large supply of beta fat cells in men's abdominal area can contribute to a rapid release of fat that is transported to the liver. The liver then converts the fat into cholesterol, which helps explain why heavy abdominal fat deposits in men (or women) increase the chances of heart attack fivefold.

A woman may be able to lose some cellulite if she has enough patience. Because of the tenacity of lower body fat, a woman will not begin to burn fat in her lower body until she's burned off most of the fat in her upper body. This takes time. The best method involves a combination of weight training, aerobics and a very low fat diet. The weight training, by promoting muscle development, raises the resting metabolism. This is important to sustain weight loss. Since fat burns only in the presence of oxygen, the necessity of aerobics in fat reduction is obvious. For fat reduction purposes, its best to go for time. The longer the exercise session, the more fat burned.

A low fat diet lowers estrogen production in women. Estrogen, the predominantly female hormone, promotes fat buildup, particularly in subcutaneous and storage areas. It also stimulates water retention and hunger. The best diet plan calls for a diet high in complex carbohydrates, medium in protein and low in fat. Low fat protein sources, such as chicken and fish, are good choices.

The Surgical Alternative

Some women, even after extensive exercise and dieting, still can't rid themselves of cellulite. According to Covert Bailey, author of 'The Fit or Fat Woman', cellulite shows up on most women when their body fat exceeds 22%. He suggests using a low fat diet and aerobics to lower the body fat level. But he also notes: Women who still have cellulite after reducing their total body fat to less than 22% are the best candidates for surgical removal.

Liposuction (surgical removal of fat cells by suction) by itself won't necessarily eradicate the cellulite look. In fact, some cosmetic surgeons say flat out that you can't get rid of cellulite, not with current medical knowledge and technology, although experimental approaches are being tried.

Liposuction for cellulite removal has recently become more sophisticated. Two distinct types of cellulite exist. The first, the type described earlier, is cause by fat bulging through strands of connective tissue. Some surgeons refer to this as young cellulite, since its onset in the female occurs around age 15. The second kind, old age cellulite, shows distention and relaxation of the skin in many areas, producing a wavy, rippled skin appearance.

New medical research shows that old age cellulite, found, as the name implies, in older women, results from a defect in the superficial fascia system (SFS) of the skin. In older women, this fascia, which supports the skin surface, relaxes too much. The superficial fascia system is a large sheet of connective tissue that surrounds under lying muscle structures. Ropelike attachments extend from the SFS to the skin, holding the skin in place.

The SFS divides fat into two areas: one situated above it, just under the skin, and the second below it. The second SFS layer is especially prominent in certain areas of women's bodies, such as the hips, buttocks, inner thighs, abdomen and back of the arms.

Liposuction reduces fat under the superficial fascia, but doesn't give acceptable results above the fascia. Used above the fascia, liposuction often produces skin depressions, thus making the skin look as if the cellulite were still there. There is a two part solution to this problem. With a specially designed sharp, square ended cannula (tube shaped instrument), the surgeon frees the skin by cutting certain ligaments. As the dual purpose cannula fress the skin, it also injects fat into the area (taken from another part of the body), thus filling the empty pocket created by the relaxation of the skin from its deeper area.

While some injected fat eventually disappears due to lack of blood circulation, enough remains to plump up the area completely, thus providing a smooth, dimple free look. This approach breaks the adhesions that give the typical cellulite look to the skin, and fills the resulting depression with fat taken from the patient's own body.

Not all women are good candidates for this procedure. Results can vary depending on speed of healing and of the skin re-attaching. Also, if the skin re-attaches to quickly, results may not be as good. As with any surgery, complications are possible. The skill of the surgeon is critical to achieving the desired result.

With the options of diet, exercise and improved surgery, the only dimples a woman needs to see are those on her smiling face.