(Female Evolutive Fibroedema)

Author: Pier Antonio Bacci

270 pages full color
Size: 23x29cm
Published: 2012

Also available in: Italian

It was a pleasure to receive the request to present Pier Antonio Bacci’s book on “cellulitis”. The study and treatment of this disease have represented the first historical appearance of Aesthetic Medicine, introduced by me in Italy. My staff and I have dealt with “cellulitis” since the late 1960s and since then, as regard to research and method, knowledge has quite changed. Since 1982 there has been a distinction between local adiposity and edematous fibrosclerotic panniculopathy, degenerative process of the subcutaneous adipose tissue, favored by several factors. We then described the so-called “false cellulitis”, not pathological, often linked to rapid and excessive weight loss for which the best treatment is often a slight increase in weight and muscle building. In the vast world of medicine and surgery, there are many treatments which now can be used, from mild to more invasive, depending on the gravity of the situation and the patient’s request. Dr. Bacci, who is entitled to be part of “cellulitis’ history” for his continued effort in the study of this disease, examines, in this book, the various aspects of the disease,  beginning with the diagnosis,   going through a careful examination of the therapies, from the oldest  to the newest, ending with the risks and possible complications, complemented with a good number of clinical cases.

Carlo Alberto Bartoletti
President of the Italian society of aesthetic medicine
President of the Scientific Committee of International School of Aesthetic Medicine
International Medical Foundation Fatebenefratelli, Rome


Cellulite is a dramatically social problem, especially when seen through the suffering it causes in women who are willing to put themselves through anything in order to resolve this annoying flaw that cannot be eliminated. Rivers of ink have flowed on this subject in every part of the world, but there are very few publications that confront the problem in its deep and complex aetiology. There are various currents of thought; some don’t believe in cellulite, some believe it is a fatty alteration, some that it is a fibrous sclerosis, others that it is a venous-lymphatic pathology, and even those who believe it is a physiological and non-pathological expression of femininity. In plastic and cosmetic surgery, even from a legal point of view, the norm by which the cosmetic function gains the importance of an organ is well known and thus, its alteration becomes functional damage. For this reason cellulite must be considered an alteration of the function of the organ of relations. Pier Antonio Bacci has long been active at the University of Siena, as a student, a specialist and as a professor of Phlebology and Cosmetic Surgery in the School of Specialization in Surgery and Plastic Surgery. He has promoted and collaborated in the study of symptomatology, searching for causes and for meticulousness in treatment. In his career he has participated in scientific exchanges in around 78 countries, determining in person the development of many methodologies, such as cosmetic phlebology, endolaser coagulation, Endermologie, compressive microvibration, Biodermogenesis for stretch marks, oxygen-ozone therapy, carboxytherapy, and others in widespread use, but it is above all to the study of the complex world of what we call cellulite that he has dedicated his greatest efforts. In 2000 he published his first book on the subject “Cellulite 2000”, then translated into Spanish and English, where he firmly emphasized the importance of the interstitial matrix and its alterations on the mesenchyme and on the evolution of cellulite. Ten years have passed and science has revealed many of its secrets, even the mysterious interstitial matrix has offered answers that have led to new therapeutic solutions, but cellulite always maintains its dramaticism in female suffering, its criticality in often overly superficial therapy, its difficulty in diagnosis and in the management of the patient. Pier Antonio Bacci in his new publication returns to that timid message in order to give a strong boost to the invitation to never subjugate medical ethics to cosmetic and profit motives, always keeping high the nobility of the medical act which, if carried out well, will also allow improvement in outside appearances and in quality of life. Cellulite can also be a complex and many-sided pathology, and if at times a simple massage or cosmetic treatment determines improvement, there is almost always need of sequential, periodic treatments that have a specific aim and protocol determined by a precise diagnosis, and which sometimes require surgery. Today we can make a diagnosis, and it is right to do so, knowing that often it will make up an important moment in preventative medicine for slowing down the evoltion of chronic and degenerative alterations. For all this, especially at a moment in history when all values seem to be crumbling, this new publication on cellulite constitutes a cultural revolution that must not be underestimated. The author does not intend to give certain answers but only to indicate sure and luminous paths to be taken in respect to those patients who ask us to make their lives more serene, in the meantime lessening symptoms and disturbances. Complements to Pier Antonio Bacci for his work and for the humility demonstrated in sharing the knowledge and experience of those who have given years to science.

Carlo D’Aniello
Professor of Plastic Surgery at the University of Siena. Director Department of General and Specialized Surgery. Director School of Specialization in Plastic, Reconstructive and Cosmetic Surgery. Director of Master’s program in Cosmetic Surgery. Past President of the SICPRE (Italian Society of Plastic, Reconstructive and Cosmetic Surgery).


Skin dimpling, caused by irregularities of the dermal-adipose tissue, has been termed cellulites. This is an inappropriate term, since there is in fact no inflammatory reaction. Although this defect may be viewed with slight importance, cellulites is a major cause for aesthetic treatment, especially in the female population. Different medical and non-medical specialties have been involved with the research and solution of this problem, with questionable results. This book, by Pier Antonio Bacci, brings to the reader a vast amount of information regarding the approach to skin dimpling. It is an interesting addition to our medical literature, and shows the long and persistent search that the author has dedicated to this issue. Dr. Bacci´s work will prove to be a valuable contribution to the ever-expanding field of plastic surgery.

Ivo Pitanguy
Head Professor of the Post-Graduate Courses in Plastic Surgery of the Pontifical Catholic University of Rio de Janeiro and the Carlos Chagas Post-Graduate Medical Institute. Member and patron  of the Brazilian Society of Plastic Surgery. Member of the Brazilian National Academy of Medicine, and the Brazilian Academy of Letters. Visiting professor, ISAPS, FACS, FICS.


prof. pier antonio bacci

Pier Antonio Bacci, as well as studying diseases of the veins and lymphatics, since 1977 has been dedicated to the problems of plastic and cosmetic surgery and medicine, participating in Fellows classes and short courses in Brazil, Argentina, France, Israel, Canada and the U.S.A.

A specialist in Cardiovascular disease and in Surgery, he was adjunct professor of “Surgical Techniques” at the School of Plastic Surgery of the University of Siena (1998-2000) and of “Cosmetic Surgery” at the School of Specialization in Sur- gery of the University of Siena (1999-2010). He also teaches “cosmetic pathology of the adipose tissue” in the Master course of Cosmetic Medicine at the Autonomous University of Barcelona and in the Master course of Cosmetic Medicine of the University of Siena.

He has presented at numerous national and international conferences studies on surgery for varicose veins and large legs, studies on cosmetic phlebology for capillaries and pig- mentation, spa methods and methods of cosmetic physiothe- rapy and of wellbeing, surgical techniques for the correction of cosmetic flaws of the buttocks, the face and the lips, but above all studies relative to the world of cellulite, on which he has published works translated into Spanish and English. He is an expert in problems connected to cosmetic flaws of the legs and is considered a pioneer and opinion leader in mini-invasive surgical techniques of the face and the buttocks, with personal methods and presentations in over 40 countries. He is an honorary member of different scientific societies and the author of many scientific publications, articles and television interviews.

He is a regular member of the Italian Surgical Society, a mem- ber of the Italian Society of Plastic Surgery, a regular member of the Italian Society of Cosmetic Medicine, a past advisor of the Italia College of Phlebology, President of the Italian Academy of Beauty of Arezzo, coordinator of the Wellbeing sector in the Risk Management Forum of Arezzo (2008-2010) and scientific director of Rome International Aesthetics 2011 at the Rome Fair.

He lives in Arezzo and also has offices in Florence and Rome. In Arezzo he is a surgical consultant at the Centro Chirurgico Toscano; in Florence he is Director of Surgery at the Maria Teresa Hospital Clinic.