This is the most important subject for any professional who intends to diagnose and treat cellulite, as it is the basis for the diagnosis and treatment of this clinical condition.

When we analyze a pathology, we must identify the histological changes that it causes. Thus, when analyzing histological data of cellulite Godoy & Godoy identified that most of the effects are seen in the interstitial space. Initially fluid accumulates in the interstitial space, then, the concentration of electrolytes increases in this space and eventually fibrotic aspects appear.

An important characteristic of this condition is the dynamic evolution of the process as pathophysiological effects develop. On analyzing the pathophysiological changes of cellulite, we find that this process occurs in the interstitial space. The fluid dynamics of this space have two destinations: about 90% of lymph flows to the venous capillaries where it passes through nanofiltration and about 10% returns through lymphatic capillaries where it is filtered through the lymph nodes.

When we identify the functional structures involved in the formation of cellulite, we see it is the lymphatic system that fails. Thus, Godoy & Godoy describe the pathophysiological basis of the cellulite process as a regional lymphostasis resulting from a functional alteration of this system. Clinical research has confirmed this hypothesis, thereby defining part of the pathophysiology of cellulite.

Other factors observed over recent years are related to the effects of genetic polymorphisms. One study reported a role of the ACE and HIF1A genes in the predisposition to cellulite, which may provide further information about the pathophysiology of this problem. Female smokers with changes in the ACE gene have a higher prevalence of cellulite than non-smokers. The fact that it occurs exclusively in women suggests hormonal effects. Thus, it is found that the pathophysiological aspects of cellulite are multifactorial.

Thus, when using the Godoy & Godoy Method to treat cellulite, we are working on part of the pathophysiological process, which can reverse the clinical picture by interfering with the mechanisms that lead to changes in cutaneous and subcutaneous structures. However, we do not interfere in the pathophysiological dynamics that affect lymphostasis.