QUANTITATIVE MODEL OF CELLULITE 119 the visual appearance of cellulite and the perception of severity will further guide the development of effective treatment modalities. ACKNOWLEDGMENTS This work was supported by grants from the Procter & Gamble Company and by USPHS GCRC grant #M0l RR 08084 from the National Center for Research Re­ sources, NIH. The authors wish to acknowledge Donna Buckley and Heidi Kalkwarf of the Cincinnati Children's Hospital GCRC, Jareen Meinzen-Derr of Cincinnati Chil­ dren's Hospital for statistical guidance, Christopher Laffley of Total Contact, Inc., and Patrick Stack of TrueGage for technical assistance. REFERENCES (1) B. M. Kinney, Discussion-Cellulite treatment: A myth or reality: A prospective randomized, con­ trolled trial of two therapies, endermologie and aminophylline cream, Plast. Reconstr. Surg., 104, 1115-1117 (1999). (2) Z. D. Draelos and K. D. Marenus, Cellulite: Etiology and purported treatment, Dermatol. Surg., 23, 1177-1181 (1997). (3) W. P. Smith, Cellulite treatments: Snake oils or skin science, Cosmet. Toiletr., 110, 61-70 (1995). (4) N. Collis, L.A. Elliot, C. Sharpe, and D. T. Sharpe, Cellulite treatment: A myth or reality: A prospective randomized, controlled trial of two therapies, endermologie and aminophylline cream, Plast. Reconstr. Surg., 104, 1110-1114 discussion 1115-1117 (1999). (5) R. M. DiSalvo, Controlling the appearance of cellulite, Cosmet. Toiletr., 110, 50-59 (1995). (6) C. Bertin, H. Zunino, J.C. Pitter, P. Beau, P. Pineau, M. Massonneau, C. Robert, and J. Hopkins. A double-blind evaluation of the activity of an anti-cellulite product containing retinol, caffeine, and ruscogenine by a combination of several non-invasive methods, J. Cosmet. Sci., 52, 199-210 (2001). (7) A. B. Rossi and A. L. Vergnanini, Cellulite: A review,]. Eur. Acad. Dermatol. Venereal., 14, 251-262 (2000). (8) G. W. Lucassen, W. L. N. van der Sluys, J. J. van Herk, A. M. Nuijs, P. E. Wierenga, A. 0. Barel, and R. Lambrecht, The effectiveness of massage treatment on cellulite as monitored by ultrasound imag­ ing, Skin Res. Technol., 3, 154-160 (1997). (9) F. Perin, C. Perrier, J. C. Pitter, P. Beau, S. Schnebert, and P. Perrier, Assessment of skin improvement treatment efficacy using the photograding of mechanically-accentuated macrorelief of thigh skin, Int. J. Cosmet. Sci., 22, 147-156 (2000). (10) W. Hu, E. C. Siegfried, and D. M. Siegel, Product-related emphasis of skin disease information online, Arch. Dermatol., 138, 775-780 (2002). (11) J. S. Artz and M. I. Dinner, Treatment of cellulite deformities of the thighs with topical aminophylline gel, Can. J. Plast. Sttrg., 3, 190-192 (1995). (12) D. M. Hexsel and R. Mazzuco, Subcision: A treatment for cellulite, Int.]. Dermatol., 39, 539-544 (2000). (13) A. Kligman, A. Fagnoni, and T. Stoudemayer, Topical retinol improves cellulite,]. Dermatol. Treat., 10, 119-125 (1999). (14) C. Pierard-Franchimont, G. E. Pierard, F. Henry, V. Vroome, and G. Cauwenbergh, A randomized, placebo-controlled trial of topical retinol in the treatment of cellulite, Am. J. Clin. Dermatol., 1, 369-374 (2000). (15) J. Rao, K. E. Paabo, and M. P. Goldman, A double-blinded randomized trial testing the tolerability and efficacy of a novel topical agent with and without occlusion for the treatment of cellulite: A study and review of the literature,]. Drugs Dermatol., 3, 417-425 (2004). (16) M. Lis-Balchin, Parallel placebo-controlled clinical study of a mixture of herbs sold as a remedy for cellulite, Phytotherapy Res., 13, 627-629 (1999). (17) M. Rosenbaum, V. Prieto, J. Hellmer, M. Boschmann, J. Krueger, R. L. Leibel, and A.G. Ship, An

120 JOURNAL OF COSMETIC SCIENCE exploratory investigation of the morphology and biochemistry of cellulite, Plast. Reconstr. Surg., 101, 1934-1939 (1998). (18) E. H. Rose, L. M. Vistnes, and G. Ksander, A microarchitectural model of regional variations in hypodermal mobility in porcine and human skin. Ann. Plast. Surg., 2, 252-266 (1978). (19) F. Nurnberger and G. Muller, So-called cellulite: An invented disease, j. Dermatol. Surg. Oncol., 4, 221-229 (1978). (20) G. E. Pierard, J. L. Nizet, and C. Pierard-Franchimont, Cellulite: From standing fat herniation to hypodermal stretch marks, Am. J. Dermatopathol., 22, 34-3 7 (2000). (21) B. I. Dickinson and M. L. Gora-Harper, Aminophylline for cellulite removal, Ann. Pharmacother., 30, 292-293 (1996). (22) http://www.predev.com, Surface Metrology Guide (2003). (23) C. Walton, B. Lees, D. Crook, M. Worthington, I. F. Godsland, and J. C. Stevenson, Body fat distribution, rather than overall adiposity, influences serum lipids and lipoproteins in healthy men independently of age, Am. J. Med., 99, 459-464 (1995). (24) J. Serup, J. Keiding, A. Fullerton, M. Gniadecka, and R. Gniadecki, "High-Frequency Ultrasound Examination of Skin: Introduction And Guide," in Handbook of Non-Invasive Methods and the Skin, J. Setup and B. E. Jemec, Eds. (CRC Press, Boca Raton, FL, 1995), pp. 239-256. (25) M. K. Dobke, B. DiBernardo, C. Thompson, and U. Hakan, Assessment of biomechanical skin properties: Is cellulitic skin different? Aesthet. Surg. ]., 22, 260-267 (2002). (26) K. Denecker, P. De Neve, S. Van Assche, R. Van de Walle, I. Lemahieu, and W. Philips, Psychovisual evaluation of Lossy CMYK image compression for printing applications, Computer Graphics Forum, 21, 5-17 (2002). (27) J. L. Leveque, EEMCO guidance for the assessment of skin topography (European Expert Group on Efficacy Measurement of Cosmetics and Other Topical Products),]. Eur. Acad. Dermatol. Venereal., 12, 103-114 (1999). (28) S. Akazaki, H. Nakagawa, H. Kazama, 0. Osanai, M. Kawai, Y. Takema, and G. Imokawa, Age­ related changes in skin wrinkles assessed by a novel three-dimensional morphometric analysis, Br. J. Dermatol., 147, 689-695 (2002). (29) J. M. Lagarde, C. Rouvrais, D. Black, S. Diridollou, and Y. Gall, Skin topography measurement by interference fringe projection: A technical validation, Skin Res. Technol., 7, 112-121 (2001). (30) T. W. Fischer, W. Wigger-Alberti, and P. Elsner, Direct and non-direct measurement techniques for analysis of skin surface topography, Skin Pharmacol. Appl. Skin Physiol., 12, 1-11 (1999). (31) U. Jacobi, M. Chen, G. Frankowski, R. Sinkgraven, M. Hund, B. Rzany, W. Sterry, and]. Lademann, In vivo determination of skin surface topography using an optical 3D device, Skin Res. Technol., 10, 207-214 (2004). (32) P. M. Friedman, G. R. Skover, G. Payonk, A. N. Kauvar, and R. G. Geronemus, 3D in-vivo optical skin imaging for topographical quantitative assessment of non-ablative laser technology, Dermatol. Surg., 28, 199-204 (2002). (33) J. P. Moss, S. F. Ismail, and R. J. Hennessy, Three-dimensional assessment of treatment outcomes on the face, Orthod. Craniofac. Res., 6(Suppl 1), 126-131 discussion 179-182 (2003). (34) R. J. Hennessy, A. Lane, A. Kinsella, C. Larkin, E. O'Callaghan, and J. L. Waddington, 3D morpho­ metrics of craniofacial dysmorphology reveals sex-specific asymmetries in schizophrenia, Schizophr. Res., 67, 261-268 (2004). (35) E. Rohmer, S. Mac-Mary, D. Marsaut, J. Sainthillier, T. Ghabri, and P. Humbert, Fringes projection and cellulite, Skin. Res. Technol., 10, 1-16 (2004). (36) J. Whitestone, G. Geisen, and B. McQuiston, Three-dimensional anthropometric techniques applied to the fabrication of burn masks and the quantification of wound healing, SPIE (San Diego, CA, 1996). (3 7) S. S. Traikovich, Use of topical ascorbic acid and its effects on photodamaged skin topography, Arch. Otolaryngol. Head Neck Surg., 125, 1091-1098 (1999). (38) B. Mole, P. Blanchemaison, D. Elia, M. Lafon tan, J. Mauriac, M. Mauriac, S. Mimoun, and J. Raison, High frequency ultrasonography and celluscore: An improvement in the objective evaluation of cellulite phenomenon, Ann. Chir. Plast. Esthet., 49, 387-395 (2004).