Published Apr 28, 2026
1 minute read
The aesthetic industry has historically treated cellulite as a surface-level concern. Patients have cycled through topical creams, lymphatic massage, and energy-based devices that offer temporary improvement.
For many, these approaches do not address the underlying issue.
Cellulite is not simply a skin quality problem. It is a structural condition involving the subcutaneous tissue. Beneath the skin of the thighs and buttocks is a network of fibrous bands, known as septae, that connect the skin to the underlying muscle.
When these bands tighten or contract, they pull the skin downward while surrounding fat pushes upward. This interaction creates the visible dimpling associated with cellulite.
Because of this, effective treatment requires addressing the structural tethering, not just the surface appearance.
Avéli and Cellfina are FDA-cleared, minimally invasive procedures designed to release the fibrous septae responsible for cellulite dimples.
Cellfina uses a vacuum-assisted, motorized blade to release bands at a controlled depth. Avéli utilizes a handheld device that allows the surgeon to identify, engage, and release specific bands in real time.
The key distinction is precision. Avéli allows for the targeted release of individual septae, while Cellfina treats a broader area at a fixed depth.
Feature | Avéli™ | Cellfina® |
|---|---|---|
| Mechanism | Manual Hook & Release | Vacuum-Assisted Motorized Blade |
| Precision | Real-time Verification | Fixed Depth / Automated |
| Downtime | 24–48 Hours | 3–5 Days |
| Longevity | Permanent Release | 3–5 Years (Clinical Data) |
| Primary Indication | Targeted Dimple Release | Multi-Area Smoothing |
| Provider Control | High (Tactile Feedback) | Moderate (Device-Led) |
Published Apr 28, 2026
4 minute read
Understanding the evolution of subcision helps clarify the differences between current treatment options.
Historically, subcision was performed manually using a Nokor needle to release fibrous bands beneath the skin. While effective, results could vary depending on technique and provider experience.
Cellfina introduced a more standardized approach using a vacuum-assisted system. The device draws the skin into a controlled depth and uses a micro-blade to release bands across the treatment area. This allows for consistency, but treats tissue broadly at a fixed depth.
Avéli takes a more targeted approach. The device allows the surgeon to identify and engage a specific band responsible for a visible dimple. By gently tensioning the area, the dimple can be confirmed before the band is released.
The internal blade is then deployed to release that individual septae, rather than sweeping through the surrounding tissue.
“Precision is a requirement in my practice. With Avéli, I re-check the area after release to ensure there is no remaining resistance. If the hook moves freely, the band has been fully addressed.” — Dr. Paul Fortes
Many non-invasive treatments for cellulite rely on radiofrequency or acoustic energy to stimulate collagen and temporarily improve skin texture.
These approaches can soften the appearance of dimpling, but they do not address the underlying structural cause.
Cellulite is created by fibrous septae tethering the skin downward. As long as these bands remain intact, the dimple persists.
Subcision is designed to release these bands directly. Once the septae are released, the tether is removed, allowing the skin to return to a smoother contour.
Determining the underlying cause of contour irregularities is a critical part of the consultation.
Subcision is effective for true cellulite, which is caused by fibrous bands tethering the skin. When these bands are released, the skin can return to a smoother contour.
Skin laxity is a different concern. When the skin has lost elasticity and structural support, releasing underlying bands alone will not correct the appearance and may further emphasize looseness.
Many patients, particularly after significant weight loss, present with a combination of both.
In these cases, Dr. Fortes may recommend structural procedures such as a thigh lift or body lift to address excess skin, combined with targeted subcision to refine persistent dimpling.
Significant weight loss changes both volume and skin behavior. As fat decreases, underlying septae may become more visible, while the skin may not fully retract.
Treatment in these patients focuses on restoring structure and proportion.
Dr. Fortes often integrates subcision into a broader body contouring plan. Procedures such as a body lift address excess skin, while targeted subcision can refine persistent dimpling, particularly in the posterior thighs.
This combined approach allows the final result to appear more balanced and cohesive across the lower body.
Avéli is performed in-office under local anesthesia and typically takes about one hour.
Because the treatment is targeted, the surrounding tissue is preserved, which helps minimize unnecessary trauma.
Patients may feel pressure or pulling during the procedure.
Following treatment, swelling, drainage, and bruising are expected in the early phase. Compression is used to support healing and help the skin conform to the underlying contour.
Most patients return to normal daily activities within a few days, with bruising improving gradually over time.
Avéli is designed as a single treatment that addresses the structural cause of cellulite.
Because it focuses on releasing the underlying septae, results are long-lasting and do not require ongoing maintenance treatments.
Pricing varies based on the extent of treatment and individual anatomy. Financing options are available to help make treatment more accessible.
Dr. Fortes approaches body contouring with an emphasis on proportion and restraint.
In the treatment of cellulite, this means identifying and releasing only the bands that contribute to visible dimpling. Careful planning and precise execution help ensure the surface appears smooth while maintaining natural contour.
The goal is a refined result that does not appear overcorrected.
Effective cellulite treatment requires a measured approach.
Over-treating with subcision can lead to contour irregularities or an overly flattened appearance. Dr. Fortes favors controlled, targeted release using the Avéli device, allowing only the bands contributing to visible dimpling to be addressed.
This approach preserves surrounding tissue while improving overall contour.
As a double board-certified plastic surgeon, Dr. Fortes evaluates each case with an emphasis on anatomy, tissue behavior, and long-term balance. Whether addressing post-weight-loss changes or refining areas of persistent cellulite, the goal is a result that appears smooth, natural, and consistent with the patient’s overall shape.
The most effective outcomes begin with a clear understanding of the underlying structure and a treatment plan designed to address it directly.
