Cryolipolysis

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Cryolipolysis
A non invasive body contouring treatment used to reduce fat cell volume by freezing.
A depiction of cryolipolysis procedure.

Cryolipolysis is a non-invasive body contouring treatment used to reduce fat cell volume by freezing.[1][2][3]

The method involves controlled application of cooling within the temperature range of +5 to -11 °C for the non-invasive, localized reduction of fat deposits, intending to reshape the contours of the body.[1][2] The degree of exposure to cooling causes cell death of subcutaneous fat tissue, without apparent damage to the overlying skin.[2][4] The method has a low rate of complications, and is deemed to be safe and effective for fat reduction by about 20% at certain body sites.[1][2]

As a medical procedure, cryolipolysis is a nonsurgical alternative to liposuction.[3] Etymologically, the term cryolipolysis (freezing of fat) is derived from the Greek roots cryo, meaning cold; lipo, meaning fat; and lysis, meaning dissolution or loosening. Cryolipolysis is used in aesthetic clinics and spas with the technology used exclusively in CoolSculpting branded devices.[3] Zeltiq, purchased by Allergan in 2017, is the exclusive licensee to the patents relating to cryolipolysis that are owned by Massachusetts General Hospital.[5][6][7]

Evidence[edit]

Cryolipolysis is used for removing certain areas of body fat that are just under the skin to contour a person.[1] Evidence supports its effectiveness at three to four months.[2]

It appears primarily applicable to limited discrete fat bulges.[8] According to a 2015 review, it shows promise with the average fat reduction, measured by calipers of about 20 percent.[2] With the small number of people treated, clinical data remain scarce, thus it is not known how long the treatment effect will last, or when and if later treatments would be necessary to maintain the result.

Side effects[edit]

Side effect data are based on a limited experience. Transient local redness, bruising and numbness of the skin are common side effects of the treatment and are expected to subside.[8] Typically sensory deficits will subside within a month. The effect on peripheral nerves was investigated and failed to show permanent detrimental results.[4] No serious long-lasting side effects were encountered during follow-up time of six months.

Research on mechanism[edit]

Lipolysis procedures attempt to "dissolve" fat cells by nonsurgical means. A number of methods have been attempted, including the use of laser, ultrasound, and radio frequency current.[3] Popsicle panniculitis is a dermatologic condition that shows that exposure to low temperatures can selectively damage subcutaneous fat while leaving skin intact.[9] Based on the premise that fat cells are more easily damaged by cooling than skin cells, cryolipolysis was developed to apply low temperatures to tissue via thermal conduction. In order to avoid frostbite, a specific temperature level and exposure are determined, such as 60 minutes at −5 °C (23 °F).[10]

Initial studies to establish cryolipolysis methods were performed on pigs.[11][12] While the process is not fully understood, it appears that fatty tissue that is cooled below body temperature, but above freezing, undergoes localized cell death followed by a local inflammatory response called local panniculitis[11] that gradually over the course of several months results in a reduction of the fatty tissue layer.[4] When exposed to cold, the body's usual response is to restrict circulation to keep the core of the body at the correct temperature.

Cost and treatment time[edit]

Typical cost per treatment area varies depending on location. Price in the US ranges from $750 to $1500,[13] with UK prices about £750 per area to be treated.[14] Treatment time for general use/application is 35–60 minutes per site, depending on the applicator used.[15]

Regulatory approval[edit]

In September 2000, Zeltiq received EU CE Mark approval for their cryolipolysis device.[citation needed] In the U.S., the CoolSculpting procedure is FDA-cleared for the treatment of visible fat bulges in the submental area, thigh, abdomen and flank, along with bra fat, back fat, underneath the buttocks (also known as banana roll), and upper arm. It is also FDA-cleared to affect the appearance of lax tissue with submental area treatments.[3]

References[edit]

  1. ^ a b c d Ingargiola, M. J; Motakef, S; Chung, M. T; Vasconez, H. C; Sasaki, G. H (2015). "Cryolipolysis for Fat Reduction and Body Contouring: Safety and Efficacy of Current Treatment Paradigms". Plastic and Reconstructive Surgery. 135 (6): 1581–1590. doi:10.1097/PRS.0000000000001236. PMC 4444424Freely accessible. 
  2. ^ a b c d e f Derrick, C. D; Shridharani, S. M; Broyles, J. M (2015). "The Safety and Efficacy of Cryolipolysis: A Systematic Review of Available Literature". Aesthetic Surgery Journal. 35 (7): 830–6. doi:10.1093/asj/sjv039. PMID 26038367. 
  3. ^ a b c d e Krueger, N; Mai, S. V; Luebberding, S; Sadick, N. S (2014). "Cryolipolysis for noninvasive body contouring: Clinical efficacy and patient satisfaction". Clinical, Cosmetic and Investigational Dermatology. 7: 201–205. doi:10.2147/CCID.S44371. PMC 4079633Freely accessible. 
  4. ^ a b c Coleman, SR; Sachdeva, K; Egbert, BM; Preciado, J; et al. (2009). "Clinical efficacy of noninvasive cryolipolysis and its effects on peripheral nerves" (PDF). Aesthetic Plastic Surgery. 33 (4): 482–8. doi:10.1007/s00266-008-9286-8. PMID 19296153. 
  5. ^ "Allergan Successfully Completes ZELTIQ® Aesthetics Acquisition". 28 April 2017. Retrieved 12 April 2018. 
  6. ^ "Can Fat-Freezer Zeltiq Aesthetics Heat Up Profits?". 24 October 2014. Retrieved 12 April 2018. 
  7. ^ Jalian, H. R; Avram, M. M; Garibyan, L. M; Mihm, M. C; Anderson, R. R (2014). "Paradoxical Adipose Hyperplasia After Cryolipolysis". JAMA Dermatol. 150 (3): 317–19. doi:10.1001/jamadermatol.2013.8071. PMC 4171727Freely accessible. PMID 24382640. 
  8. ^ a b Nelson, AA; Wasserman, D; Avram, MM (2009). "Cryolipolysis for reduction of excess adipose tissue". Seminars in Cutaneous Medicine and Surgery. 28 (4): 244–9. doi:10.1016/j.sder.2009.11.004. PMID 20123423. 
  9. ^ Avram, MM; Harry, RS (2009). "Cryolipolysis for subcutaneous fat layer reduction". Lasers in Surgery and Medicine. 41 (10): 703–8. doi:10.1002/lsm.20864. PMID 20014262. 
  10. ^ Meyer, Patricia Froes et al. (2016). "Effects of Cryolipolysis on Abdominal Adiposity". Case Reports in Dermatological Medicine. 2016: 1. doi:10.1155/2016/6052194. 
  11. ^ a b Manstein, D; Laubach, H; Watanabe, K; Farinelli, W; et al. (2008). "Selective cryolysis: A novel method of non-invasive fat removal". Lasers in Surgery and Medicine. 40 (9): 595–604. doi:10.1002/lsm.20719. PMID 18951424. 
  12. ^ Zelickson, B; Egbert, BM; Preciado, J; Allison, J; et al. (2009). "Cryolipolysis for noninvasive fat cell destruction: Initial results from a pig model". Dermatologic Surgery. 35 (10): 1462–70. doi:10.1111/j.1524-4725.2009.01259.x. PMID 19614940. 
  13. ^ "Can you freeze your fat away?". 24 December 2015. Retrieved 25 August 2016. 
  14. ^ "CoolSculpting is only cold-based treatment cleared by US FDA for fat loss". 21 March 2016. Retrieved 25 August 2016. 
  15. ^ Hilton, Lisette. "The Skinny on fat reduction, cellulite devices". dermatologytimes.modernmedicine.com/. Dermatology Times. Retrieved 3 January 2018.