Cryolipolysis

Cryolipolysis is a medical treatment used to destroy fat cells. Its principle relies on controlled cooling to near 4 Celsius for the non-invasive localized reduction of fat deposits in order to reshape body contours. The exposure to cooling is set so that it causes cell death of subcutaneous fat tissue without apparent damage to the overlying skin. The procedure is billed as a nonsurgical alternative to liposuction.[1] "Cryolipolysis" is a portmanteau of "cryogenic" and "lipolysis." Generically the process can also be known as "fat freezing".

In Europe cryolipolysis machines have been developed for suitability in aesthetic clinics and spas. Popular brands of devices include CoolSculpting[1] Clatuu, isoLipo, Lipoglaze and 3d lipo.

Evidence

Cryolipolysis is used for removing certain areas of body fat that are just under the skin to contour a person.[2] Evidence supports its effectiveness at three to four months.[3]

It appears primarily applicable to limited discrete fat bulges.[4] According to a 2015 review it shows promise with the average fat reduction, measured by calipers of about 20 percent.[5] 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

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.[4] Typically sensory deficits will subside within a month. The effect on peripheral nerves was investigated and failed to show permanent detrimental results.[6] No serious long-lasting side effects were encountered during follow-up time of six months.

Method of action

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.[1] Popsicle panniculitis is a dermatologic condition that shows that exposure to low temperatures can selectively damage subcutaneous fat while leaving skin intact.[7][8] 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 is determined. Physicians Dieter Manstein and R. Rox Anderson at The Wellman Center at Massachusetts General Hospital originated the concept, explored it in a number of experiments on pigs, and reported their data in 2008.[9][10] 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, a local panniculitis,[9] that gradually over the course of several months results in a reduction of the fatty tissue layer.[6] When exposed to extreme cold, the body's usual response is to restrict circulation to keep the core of the body at the correct temperature. Cryolipolysis makes use of a powerful vacuum which adds to the inflammatory response by drawing blood up to the surface layers of the skin.

Cost and treatment time

Typical cost per treatment area ranges from $750 to $1500 depending on the size of the applicator and the area being treated.[11] Treatment time for general use/application is between 45–60 minutes per site. Some cryolipolysis devices have a pair of applicators that can be used simultaneously reducing the overall treatment time when treating corresponding areas such as the sides of the stomach, back of legs and flanks.[12]

Regulatory approval

In September 2009, Zeltiq received EU CE Mark approval for their cryolipolysis device.[13] In September 2010, the US Food and Drug Administration approved the cryolipolysis device and procedure.[1]

References

  1. 1 2 3 4 Krueger N, Mai SV, Luebberding S, Sadick NS (26 June 2014). "Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction.". Clin Cosmet Investig Dermatol. 7: 201–5. doi:10.2147/CCID.S44371. PMC 4079633. PMID 25061326.
  2. ↑ Ingargiola, MJ.; Motakef, S.; Chung, MT.; Vasconez, HC.; Sasaki, GH. (Jun 2015). "Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms.". Plast Reconstr Surg 135 (6): 1581–90. doi:10.1097/PRS.0000000000001236. PMC 4444424. PMID 26017594.
  3. ↑ Derrick, CD.; Shridharani, SM.; Broyles, JM. (Jun 2015). "The Safety and Efficacy of Cryolipolysis: A Systematic Review of Available Literature.". Aesthet Surg J 35: 830–6. doi:10.1093/asj/sjv039. PMID 26038367.
  4. 1 2 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.
  5. ↑ Ingargiola, MJ; Motakef, S; Chung, MT; Vasconez, HC; Sasaki, GH (June 2015). "Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms.". Plastic and reconstructive surgery 135 (6): 1581–90. PMID 26017594.
  6. 1 2 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.
  7. ↑ Ingargiola MJ, Motakef S, Chung MT, Vasconez HC, Sasaki GH (June 2015). "Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms.". Plast Reconstr Surg. 135 (6): 1581–90. doi:10.1097/PRS.0000000000001236. PMC 4444424. PMID 26017594.
  8. ↑ 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.
  9. 1 2 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.
  10. ↑ 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.
  11. ↑ Zeltiq
  12. ↑ Classys
  13. ↑ "ZELTIQ Announces European CE Mark Approval for Non-Invasive Fat Layer Reduction Using Cryolipolysis".
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