With aging, the dermis (skin) begins to deteriorate, meaning the microcirculatory system (blood vessels and capillaries) that ‘feeds’ the skin, slowly begins to break down and the septa (fibrous bands) begin to weaken.
This allows the subcutaneous fat cells to retain more fat, often swelling 2-3 times their original size.
The fat cells may also clump together, isolating the blood vessels even further and therefore causing fluid to accumulate in the tissue.
The fat then pulls on the septa, causing the fascia (or connective tissue) to tighten and protrudes into the dermis, causing the dimpling effect.
Over time, as the microcirculation continues to deteriorate, the cell metabolism also deteriorates, causing protein synthesis and the repair process to drastically reduce.
Protein deposits begin to form around fat cell clusters and the fat cells, septa and fascia begin to harden. As the superficial fascia becomes more thick and fibrous, adhesions (also referred to as scar tissue or knots) can form in the fascia and emphasise the dense and or dimpled appearance of the skin.