Why treatments try to remove cells surgically

Most scientists really do not know what causes cellulite. They have studied fat metabolism and deposition and had many and varied findings. Most areas of fat deposits are the result of two factors
the number of fat cells - adipocytes
the amount of fat inside the adipocytes
Current evidence suggests that the original number of fat cells in any area of the body is controlled by one's original genetic make up. There are no factors or substances that increase the number of cells in a body region but rather they do not multiply unless the other fat cells get filled to capacity.
Occasionally there are reports that cellulite fat has more proteoglycans that lead to more water retention or that there are more or less receptors for various physiologic hormones or proteins, but it does not appear that these are the causative factors. Cellulite fat will respond to calorie restriction just as any other fat cell, but it is the stored fat that goes away; the cell is still present and can refill if calorie excess resumes. That is why most treatments of cellulite are directed at removal of the cells surgically.