Whether brown or white, all adipose cells consist of a large lipid droplet surrounded by a thin layer of cytoplasm and a plasma membrane. Each cell also contains organelles including a nucleus, Golgi apparatus, endoplasmic reticulum, ribosomes, and mitochondria. Brown fat cells contain more mitochondria than white fat cells do, which is what gives their lipid droplets their darker colour.

Fat Cell Development

  • During growth, fat cells increase in number
  • When energy intake exceeds expenditure, fat cells increase in size
  • When fat cells have enlarged and the energy intake continues to exceed energy expenditure, fat cells increase in number again
  • With weight loss, the size of the fat cells decreases but not the number.

Subcutaneous Fat

Subcutaneous adipose tissue was once thought to be nothing more than a storage device with a predetermined number of cells and of limited purpose. Now it is recognised as a complicated organ in its own right with essential endocrine and metabolic functions. 

 A person’s fat level is really a balancing act. For example an increase or decrease in adipose tissue mass seen in those with anorexia or obesity has significant effects on multiple systems of the body such as the immune or reproductive system.

There are two types of adipocyte cells. These are brown and white cells that not only vary in colour but also in function and each has different vascular and nerve supplies.

It has been well-accepted that subcutaneous fat is an important component of the skin. However  all that we know about fat’s physiology is still poorly understood by dermatologists. 

Release of Hormones

Adipose tissue is more than just an energy-storing mass. It also functions as an endocrine organ. This means it synthesises and releases hormones. The influx of these hormones influence a wide range of biological processes within our bodies, including the regulation of food intake and the control of sensitivity to insulin.

Distribution of Fat

The demand for fat removal, redistribution or manipulation of fat cells is as popular as ever. There are many conditions that affect the distribution of fat cells within the body. It is common knowledge that there is a link between obesity and high death rates due to cardiovascular disease and diabetes. 

Something to consider in treatments is that men and women carry fat very differently. Men carrying fat in the upper mid-section of the body is called android or male type obesity also referred to as visceral obesity. 

Whereas women store fat on the lower parts of the body known also as the gluteofemoral region, referred to as gynoid or female obesity. The excess of this can be associated with higher grades of cellulite. 

The structure of fatty tissue is divided into two layers separated by a superficial fascia. The external layer (areolar layer) comprises vertically orientated globular large adipocytes. The deeper layers are known as the lamellar layer. Horizontally arranged, the cells are smaller in size but with much larger and many  more blood vessels. The areolar layer is much thicker in women and children and thus is more-thicker in the gynoid areas. 

During puberty the development of fatty tissue is more robust in women than in men. This is due to an increase in estragon that stimulates the replication of adipocytes. These adipocytes are much more stable metabolically and also unfortunately more resistant to lipolysis. There are only a few hormones  capable of affecting lipolysis in adipocytes and these are known as catecholamines (epinephrine and norepinephrine which are lipolytic) and insulin (which is antilipolytic)


Cellulite is a condition of human adipose tissue. Characterised by a padded and nodular appearance on the skin. Cellulite is often found in areas like the thighs and buttocks. 

Cellulite is most common in women and is caused by a change in the skin’s typography. This change occurs through the herniation of subcutaneous fat cells within connective tissues. Cellulite is different from obesity and is seen in women with any body mass index (BMI). Cellulite is a result of various factors such as:

  • Gender – Cellulite predominantly affects women
  • Ethnicity – Asian women are less likely to suffer from cellulite than European women
  • Diet – A high carbohydrate diet causes hyperinsulinemia and promotes lipogenesis that can increase in total body fat and enhance the appearance of cellulite
  • Sedentary lifestyle – Prolonged periods 
  • Pregnancy – Hormones and increased 

Cellulite is characterised by the presence of fatty protrusions through the dermo hypodermal junction. 

There are 3 grades of cellulite ranging in severity 

Grade 1: Cellulite in smooth skin with no visible signs of dimpling when lying down or standing up. The skin however, when pinched, shows a mattress type configuration.

Grade 2: Cellulite with a dimpled appearance present standing but will disappear when your  client is lying down.

Grade 3 Cellulite can be seen in clients who show visible signs of dimpling when both standing up or lying down

Skin laxity and underlying extracellular matrix also play a role in the appearance of cellulite. This should be taken into consideration when devising your treatment plan. Remember that every client is different and will require a different approach.