Loose or less firm skin is something almost everyone notices at some point. It can look like dimpling on the thighs, softening of the arms or abdomen, or sagging in areas where skin once felt taut. These changes aren’t a failure of effort or self-care – they’re linked to the natural structure of skin and connective tissue.
How Cellulite Forms
Cellulite isn’t simply “fat.” It’s the result of changes in collagen-rich septae (fibrous bands that connect skin to deeper tissue).
In women especially, these septae are oriented vertically, making it easier for superficial fat lobules to push upward.
This creates the familiar dimpled or rippled look, while the fibrous bands pull downward [1].
The Role of Collagen Breakdown
As collagen weakens and septae lose structure, skin becomes less able to contain fat beneath the surface. Research shows septal disorganization and collagen degradation are central to cellulite development, creating uneven skin texture and visible dimples [2; 3].
Over time, dermal thinning also contributes to sagging and a less supported feel [4].
Hormones, Circulation, and Inflammation
Hormonal shifts – such as those during pregnancy, menopause, or hormone therapy – play a key role in body firmness.
Estrogen in particular influences fat storage, connective tissue health, and circulation, which is why cellulite often worsens in women during hormonal changes [1].
Low-grade inflammation and vascular changes also contribute to tissue swelling, stiffness of fibrous bands, and the persistence of cellulite dimples [5].
Why It’s Different From Person to Person
Cellulite and sagging are not evenly distributed. Genetics, body fat distribution, skin thickness, and lifestyle all influence whether firmness changes appear more prominently.
Imaging studies confirm that the number, thickness, and orientation of septae determine how and where dimpling occurs [6].
Gender Differences in Cellulite and Firmness
Cellulite is much more common in women – affecting up to 80-90% after puberty, compared to only 2-10% of men.
his difference isn’t about effort or lifestyle; it comes down to how skin, fat, and connective tissue are structured, and how hormones influence them.
| Factor | Women | Men |
|---|---|---|
| Prevalence | 80-90% experience cellulite post-puberty | 2-10% experience cellulite |
| Fat Distribution | More subcutaneous fat stored in thighs, hips, buttocks (gynoid pattern) | More visceral fat stored in abdomen (android pattern) |
| Septal Orientation | Fibrous septae run vertically, creating channels for fat to protrude | Septae arranged in crisscross pattern, stronger containment |
| Fat Lobule Architecture | Fewer, larger lobules; weaker connective tissue; more prone to bulging | More numerous, smaller lobules; stronger septal connections |
| Skin Structure | Thinner dermis, less collagen density; rapid decline post-menopause | Thicker dermis, higher collagen content, gradual thinning with age |
| Hormonal Influence | Estrogen increases subcutaneous fat and influences connective tissue; cellulite worsens with pregnancy, contraceptives, menopause | Testosterone increases collagen density and dermal thickness; DHT blocks subcutaneous fat growth |
| Age-Related Changes | Accelerated collagen loss after menopause (up to 30% in 5 years) | Steady collagen decline, slower visible skin laxity |
Key Takeaway: Cellulite and body firmness changes are not just about lifestyle – they reflect structural and hormonal differences. Women’s connective tissue is more vulnerable to fat protrusion, while men’s crisscrossed septae and thicker dermis protect against dimpling until much later in life.
