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For maximum effectiveness, about 14 treatments are recommended over a seven-week period, followed by monthly maintenance visits. Without follow-up, cellulite reappears after one month or two months. The cost, which can be more than $100 per session, isn't covered by insurance. Endermologie came to the United States from France more than a decade ago and is approved by the Food and Drug Administration. Endermologie makes the skin appear smoother possibly by stimulating blood flow and lymphatic drainage or by thickening collagen, though no one can say for sure. Critics, like the American Society of Plastic Surgeons, say it is of "unproven medical value."