The severity of cellulite is ranked according to a universal scale (Table 16.2). While this scale serves as a clinical evaluation of cellulite, there is also a broad spectrum of noninvasive and invasive methods available to assess this condition. A description of these tools follows:
Grade I: No or minimal cellulite-based on observation on gluteal muscle contraction, the ‘pinch test’, or standing.
Grade II: Irregular skin topography. Cellulite is enhanced by gluteal contraction or pinching. Skin pallor or decreased temperature and sensation often evident.
Grade III: Classic orange peel dimpling, “peau d’orange,” at rest on observation. Small subcutaneous nodularities may be present and palpable.
Grade IV: Characteristics of Grade III, as well as more severe puckering and palpable nodules on inspection.
*The Cellulite Grading System is used to classify the severity of cellulite in patients with this condition. More severe forms of cellulite can cause tissue alterations, such as lipodystrophic and fibrosclerotic degeneration.