Cellulite is not a fat problem — it’s a structural one. The dimpling comes from the relationship between the skin, the fibrous septae beneath it and the underlying fat layer. When those connective-tissue bands tether the skin downward, fat pushes up between them and the surface becomes uneven. This is why very slim patients can have significant cellulite while someone with more body fat may have relatively smooth skin.

I assess which layer is creating the irregularity before choosing anything. Individual tethered dimples, diffuse localized fat, a loose skin envelope and thin, poorly supported skin are four different problems, and they respond to different treatments. The assessment comes first — the treatment plan follows from what I find, not from a fixed menu.

Subcision is a controlled release of the fibrous band that is pulling the skin downward. Where an individual depression is caused predominantly by tethering, releasing that band is what addresses the dimple itself. No amount of surface treatment will lift a depression that is being held down from below.

Because they do two different jobs in the same session. The subcision releases the tethering; the collagen biostimulator is then placed to support the tissue as it heals and to improve the quality and thickness of the skin above it. Releasing a band without supporting the tissue around it addresses only half the problem.

They work at different depths and on different problems. Forza laser lipolysis works beneath the skin, addressing localized fat while producing controlled thermal stimulation in the surrounding tissue — useful when an area is also becoming softer, heavier or looser. A collagen biostimulator works on the skin envelope above, improving dermal support. In some patients both components are present, and I may combine them rather than expecting one treatment to do both jobs.

Local anaesthetic is used, so the treatment itself is generally well tolerated. Most patients describe pressure rather than pain. Sensitivity in the treated area for a few days afterwards is normal.

This depends on the mechanism and the area. Collagen biostimulation is gradual by design and typically requires more than one session spaced several weeks apart. Forza is usually a single treatment for a given area. I give a realistic session estimate at the assessment rather than beforehand.

Collagen biostimulators work progressively — meaningful change is usually seen over several months rather than immediately, as new collagen forms. Results following release of a tethered band tend to be visible earlier, once swelling settles. Longevity varies between patients and is influenced by weight change, ageing and individual tissue quality. No cellulite treatment stops the skin from continuing to age.

Bruising, swelling and tenderness in the treated area are expected and typically settle over one to two weeks. Compression may be advised after Forza. Most patients return to normal daily activity quickly, with exercise reintroduced gradually depending on what was done.

Most commonly thighs, hips and buttocks, and in selected cases the arms and abdomen. Suitability depends on the depth and distribution of the irregularity and the quality of the surrounding tissue.

Bruising, swelling and tenderness in the treated area are expected and typically settle over one to two weeks. Compression may be advised after Forza. Most patients return to normal daily activity quickly, with exercise reintroduced gradually depending on what was done.