Written by Dr. Paul M. Graham
Many of you have heard about Coolsculpting, otherwise known as cryolipolysis, from television commercials, internet ads, or by recommendation/personal testimony from your friends, but do you know how this popular procedure actually works? With over 10 million cosmetic procedures performed each year, noninvasive body contouring treatments such as cryolipolysis holds its place in the ranks. In this article, we will discuss everything you need to know about this safe and effective procedure and discuss, in depth, on how it works to eliminate stubborn body fat. Are you a candidate for this groundbreaking fat eliminating procedure?
What Is Cryolipolysis?
For many decades, invasive surgical options were the only available procedures for the treatment of unwanted body fat. Unfortunately, these procedures came with risk and prolonged downtime in comparison to its noninvasive counterparts. Cryolipolysis has changed the game in body contouring and cuts many of the risk involved with more invasive cosmetic procedures. Additionally, no operating room, surgical scars, or skin anesthesia are required. However, this procedure offers less dramatic and delayed results in comparison to more invasive surgical procedures, but without the risk and adverse effects and downtime.
In 2010, the FDA cleared the CoolSculpting cryolipolysis device for the treatment of abdominal and “love handle” fat deposits. From 2014-15, the FDA cleared the use of this device on the thighs and submental (under chin) fat, further expanding the number of eligible candidates. The most important take-home point is that the fat destruction is permanent. If subsequent weight gain occurs in the future, the areas treated with cryolipolysis will have minimal likelihood of reaccumulating fat tissue.
How Does It Work?
Cryolipolysis is a novel modality that works under the premise the fat cells are the most susceptible cell to cold injury versus any other skin cell in the body. With the precise placement of the cooling applicator, fat cells in the body can be deliberately targeted, triggering fat cell rupture and elimination over time. The process works by relying on the body’s own inflammatory process to remove damaged fat cells. From approximately 3-14 days, the inflammation becomes prominent and usually diminished by 4 weeks post-treatment. It is the inflammatory response that is very important in this procedure. Without the response of inflammatory cells, the damaged fat cells would never be eliminated, hence the need for a healthy immune system prior to treatment. Interestingly, upon skin biopsy 4 weeks after the procedure, researchers found that the existing fibrous strands and bands that were associated with the fat cells were significantly thickened, comprising the majority of the fat tissue volume.
What to Expect During the Procedure
The procedure is simple and well tolerated. After completing a comprehensive evaluation to determine if you are a good candidate for this procedure, the area will be prepped and cleaned prior to the treatment. The cup-shaped applicator is applied to the treatment area and a moderate vacuum is used to draw the fat tissue into applicator housing. Two cooling panels within the applicator housing are cooled to -5°C to -10°C for a duration of 35-60 minutes depending on the device model. Following the procedure, the treated area is massaged for several minutes or treated with a shockwave device (ZWave) to help facilitate further fat cell disruption. Immediately after the treatment, normal activities may be resumed with no restrictions. The number of treatment cycles varies depending on the treatment area and density of fat tissue. Subsequent treatment sessions are typically performed 8 weeks apart to allow time for treatment-induced inflammation to resolve.
What are the side effects of the procedure?
Immediately following the procedure, the skin will be cool, red, and firm to the touch with a look similar to a stick of butter at the treatment site. This will diminish over several hours as the skin begins to thaw, returning to a normal appearance by 12 hours post-treatment. Expected side effects are self-limited and include redness, bruising, temporary numbness at the treatment site, and slight treatment site discomfort. These all tend to resolve within 14 days following treatment. A rare but notable side effect is a paradoxical increase in fat tissue at the treatment site. Although we do not know the true reason for this, it typically occurs at approximately 6 months following treatment. Fortunately, this has only been reported in 33 cases and can be treated with cannula directed liposuction to the treatment area.
Clinical Research Data
One study published in 2009 demonstrated that cryolipolysis reduced the density of fat by 25% in the treatment area after just one treatment. Dierickx et al. reported that 86% of 518 patients studied demonstrated improvement after the procedure. They also demonstrated that 73% of the study group reported being satisfied and 82% would recommend the treatment to a friend. Additionally, Ferranro et al. reported a significant reduction in waist circumference by 6.7 cm and up to 4.5 cm in fat thickness 12 weeks after 3-4 treatment sessions.
Cryolipolysis is considered to be a safe and effective body-contouring procedure demonstrating high patient satisfaction (up to 73% after one treatment), minimal to no associated downtime, and measurable clinical results. Many treatment modalities exist on the market today to treat fat tissue, but this procedure minimizes the risk and associated pain of other more invasive treatment options. Additionally, cryolipolysis is safe for all skin types. The ideal candidates for this treatment are those individual with ideal body weight that have well-demarcated collections of fat tissue, employ regular exercise, and have a healthy diet. This procedure is well tolerated and proven in the literature to give results. If you or someone you know is interested in this procedure, please schedule an appointment with your local board-certified cosmetic dermatologist for a comprehensive evaluation.
- Patricia Froes Meyer, Rodrigo Marcel Valentim da Silva, Glenda Oliveira, et al., “Effects of Cryolipolysis on Abdominal Adiposity,” Case Reports in Dermatological Medicine, vol. 2016, Article ID 6052194, 7 pages, 2016. doi:10.1155/2016/6052194
- 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. http://doi.org/10.2147/CCID.S44371
- Kilmer SL, Burns AJ, Zelickson BD. Safety and efficacy of cryolipolysis for non-invasive reduction of submental fat. Lasers Surg Med. 2016 Jan;48(1):3-13. doi: 10.1002/lsm.22440.