CRYOLIPOLYSIS- COOLSLIMMING

SHORT SUMMARY

 

• noninvasive, low risk and no downtime fat reduction technique
• studies indicate 20-25 % reduction of treated subcutaneous fat layer and about 80 % patient satisfaction rate
• the procedure is ideal for the abdomen, love handles and the back, however many other areas can be treated successfully
• more than one session might be necessary to achieve expected results
• fat cells that have been damaged or destroyed are gradually but permanently removed from the body
• it can take up to 6 months to achieve final results
• more than one area of the body may be treated in a single session
• side effects are mild, with the most common being bruising, erythema, swelling, tingling, and numbness, which resolve within weeks
• increased effectiveness of the novel Coolslimming technology is due to innovative preheating mode and advanced freezingapplicator providing 360° refrigeration, meaning that about 60% more tissue is treated compared to traditional two plates cooling system.
• for people who are looking for “spot” fat reduction in specific areas on the body
• it is not a weight loosing method and it is not recommended for people who are significantly overweight or obese.
• more information and results on official website: coolslimming.com.au

 

WHAT IS CRYOLIPOLYSIS?

 

Cryolipolysis also known by the name of the device as Coolsculpitng™ or CoolSlimming™ delivers  precisely controlled cooling to gently and effectively destroy the fat cells underneath the skin. Over time, your body naturally processes the fat and metabolise these dead cells, leaving a more sculpted you. The technology was approved by the U.S. Food and Drug Administration (FDA) in 2010 for noninvasive treatment of the localised adiposities in the flank areas and later in many others regions as well. Several studies have been published demonstrating its efficancy as evident reduction in fat layer thickness up to 25% at 3-month mark. Because of its ease of use and limited adverse effects, this procedure is becoming the leading technology in noninvasive fat reduction and the most popular alternative to liposuction with millions procedures performed so far.

 

HOW IT WORKS?

With cryolipolysis, fat cells (adipocytes) are preferentially destroyed by a controlled thermal reduction. Exposure to below normal, but above freezing, temperatures induces apoptosis - mediated cell death. The adipocytes are more sensitive to the cooling process than other cells, resulting in minimal collateral damage to surrounding tissues. A subsequent inflammatory response beginning on day 3 and peaking around day 14 removes the damaged adipocytes. This process happens gradually and you won’t notice a difference in your day-to-day life. The resolution of inflammation and lipid metabolism is thought to be completed by 3 months after treatment. Unlike with diet or exercise where the fat cells are reduced in size, with cryolipolysis, once the treated fat cells are gone, they're gone for good.

AM I A GOOD CANDIDATE FOR CRYOLIPOLYSIS?

 

Ideal candidates are relatively fit but have small amounts of stubborn body fat that cannot be easily reduced by diet or exercise. It is for someone with realistic expectations who is looking for mild improvements since the results are far less dramatic than after liposuction. Before the procedure the patient should be assessed by experienced plastic surgeon who will be able to propose the most suitable fat removal procedure. If the tissues are thick, firm and non-pinchable they cannot be drawn into the applicator and the cooling panels can only treat the tissue they can access.

                       

The most common treatment areas include:

 

• Upper or lower abdomen
• Anterior or posterior flanks (Love Handles)
• Bra area (Back Area)
• Arms
• Knees
• Inner or outer thighs
• Neck (Double Chin)
• Hips
• Buttocks and under the buttocks (Banana Roll)
• Male Chest (Pseudogynecomastia)
• Under the armpit

 

 

WHO SHOULD NOT HAVE CRYOLYPOLISIS?

 

It should not be performed on areas of skin that are cut or injured, contain severe varicose veins, dermatitis, or other skin lesions.

People who have abnormal cold sensitivity or cold intolerance are not suitable candidates. The procedure is not recommended for people who have the following conditions:

• Raynaud’s phenomenon. A rare condition in which cold temperatures can impede blood flow to the fingers and toes.
• Cryoglobulinemia. A type of vasculitis (inflammation of blood vessels) caused by abnormal proteins that become solid or gel-like in the presence of cold temperatures. It is associated with blocked blood vessels and other problems.
• Paroxysmal cold hemoglobinuria. A very rare autoimmune disease in which red blood cells are damaged during exposure to cold.
• Cold urticaria. A rare condition in which the skin develops red, itchy spots (hives) after exposure to cold temperatures.
• Cold agglutinin disease. A rare type of autoimmune haemolytic anaemia in which the body's immune system mistakenly attacks and destroys its own red blood cells. The condition is often triggered or made worse by cold temperatures.

Other conditions that pose a risk include:

• Pregnancy or breast-feeding
• Nerve disorders, such as diabetic neuropathy
• Inflammatory skin disorders
• Skin conditions caused by immune system disorders, such as eczema or psoriasis

 

HOW TO PREPARE FOR THE PROCEDURE?

 

No special preparation is necessary. Before the procedure, a doctor will review the patient's medical history. This is the time for the doctor and patient to discuss expectations, potential risks and outcomes of the procedure. Recent studies have focused on maximising the reduction of adipose tissue by adjusting treatment protocols.

 

HOW THE PROCEDURE IS DONE?

The procedure is performed in a clinical setting without aesthetics or analgesics. The tissue containing the focal fat deposit is drawn into an applicator with the assistance of a vacuum after the gel pad (anti-freeze membrane) has been applied to protect the skin from frostbites. There will be a slight sucking sensation as applicator adheres to your body, followed by cooling effect. During the treatment the tissue temperature in central part falls as low as 9 degrees C and you may feel sensations of mild pinching, intense cold, pulling, tingling, stinging, aching, and cramping. These sensations subside as the treatment area becomes numb. The procedure lasts between 40 and 60 minutes. The procedural setting is so relaxed that patients can bring laptops to do work, enjoy a movie, or simply nap while the machine goes to work. After the applicator is detached, your provider will do a brief massage on the area to break up the treated fat cells and enhance the fat reduction. The temperature in the treated region returns to base line within 60 minutes after device removal. The patient is able to immediately return to regular daily activities with no restrictions and minimal discomfort. Following the treatment, some temporary side effects including redness, swelling, blanching,firmness, itching, bruising, tingling, stinging, tenderness, cramping, aching or skin sensitivity, and sensation of fullness in the back of the throat after submental or submandibular can be present.

 

ARE THERE ANY SIDE EFFECTS AFTER A TREATMENT?

 

Cryolipolysis is considered a rather safe procedure with commonly reported minimal side effects such as oedema, bruising, erythema, numbness, transient neuralgia and slight skin discolouration that are self-resolving over a few weeks after the treatment. A systemic literature review evaluating the safety and efficacy of cryolipolysis for body contouring showed that only 0.82% reported adverse effects last greater than 4 weeks, with decreased sensation being most common.

There was concern that adipocyte damage would lead to abnormal lipid levels or liver function studies. Both animal and human studies have shown that there are no significant changes in these measurements.

Rare side effects may also occur. Paradoxical adipose hyperplasia (PAH), characterised by visibly enlarged tissue volume in the treated area, may develop two to five months after treatment and requires surgical intervention (liposuction) for correction. It’s not known why this happens, but it appears to be more common in men than in women. According to published literature it is seen in 0,5- 2 % of cases. Macroscopically PAH is characterised by the formation of a large, painless, firm, partially mobile mass that develops at the treatment site where the applicators of the cryolipolysis machine were applied on the body. The higher incidence of PAH has been linked to: male sex; larger handpieces; abdominal region and genetic predisposition. While rare, it’s worth being aware of this possible side effect.

HOW EFFECTIVE IS CRYOLIPOLYSIS?

 

Cryolipolysis is most effective with an experienced doctor, proper planning, and several sessions to maximise results and reduce the risk of side effects.

The results of clinical studies based on objective evaluating methods indicate that 20-25 % reduction of treated fat layer can be expected after one or two sessions.  Clinical trials also indicate about 80 % patient satisfaction rate. First results are seen several weeks after treatment, but it may take as long as 6 months for the final results.

Post treatment manual massage has the potential to improve the efficacy of cryolipolysis. Multiple treatments in the same anatomic area may lead to further fat reduction, although the efficacy of cryolipolysis appears to be attenuated with successive treatments and in areas that have been treated previously with liposuction. More than one session may be needed to achieve a person’s desired results. If more than one treatment sessions is needed, the next session can’t be performed until 6 to 8 weeks after the first session. This is because it can take this long for damaged fat cells to be eliminated from the body. If you gain weight after your cryolipolysis treatment, you may gain fat back in the treated area.

 

HOW CRYOLIPOLYSIS WAS DEVELOPED?

 

The theory that cold could destroy fat cells was developed based on observations in critically ill newborns. The histopathological analysis of nodules that developed after prolonged surface cooling with ice showed findings consistent with subcutaneous fat necrosis. Further data on the response of adipocytes to cold were derived from a study designed to assess whether adipocytes were of best quality for autologous fat transfer when they were fresh or frozen. These observations led to the concept that lipid-rich tissues are more susceptible to cold injury than the surrounding water-rich tissue. With these historical observations in mind, a novel noninvasive method for fat reduction was introduced with freezing in 2007, termed cryolipolysis.

WHAT IS THE DIFFERENCE BETWEEN CRYOLIPOLYSIS AND LIPOSUCTION?

 

 While liposuction remains the gold-standard for surgical removal of stubborn fatty deposits, nonsurgical treatment options such as cryolipolysis continue to gain popularity among patients seeking effective but less invasive measures. Both medical procedures are designed to permanently reduce isolated deposits of subcutaneous fat and improve body contour, but are in fact very different. However neither is intended for weight loss and neither can significantly improve cellulite or lose skin.

During a liposuction procedure long, narrow suction instrument called a cannula is inserted through small incision(s) and functions to remove fat from the targeted treatment area. Depending on the number of body areas treated and the amount of fat removed, liposuction may be performed under general anaesthesia, local anaesthesia or under sedation. On the other hand cryolipolysis is non-invasive treatment painlessly performed without anaesthesia. A cryolipolysis device uses a vacuum applicator to deliver controlled cooling at the surface of the skin. By exposing fat cells to a low temperature it induces cell death in targeted fat cells. The cells are gradually removed from the body by a natural process taking couple of months.

When choosing between liposuction and cryolipolysis, the decision mostly depends on your treatment goals and recovery period.

For patients seeking a nonsurgical method to moderately reduce fat in a localised area, such as in the love handles or abdominal region, cryolipolysis may be the appropriate treatment. Patients undergoing a cryolipolysis procedure should expect mild to moderate improvement (up 25% fat reduction) in the area being treated. It is important to note that multiple treatment sessions may be necessary to achieve the best results. The number of necessary treatment cycles is dependent on the treatment area. It is not the best option for regions where subcutaneous fat is thick, firm and hard to pinch. Additionally, patient should understand that the results of cryolipolysis are not immediately evident. Changes in the treated area may become apparent as early as three weeks after the procedure, and the most obvious one to three months after treatment. According to published literature the procedure has about 80% satisfaction rate. Cryolipolysis is offers patients a quick recovery, minimal associated discomfort and a low risk of complications. Patients can resume normal activities immediately following the treatment.  Rare side effects include redness, minor bruising, tingling, numbness or discomfort in the treated area. These signs and symptoms can be expected to resolve within few weeks.

For patients looking to treat excess fat over a larger area of the body or for patients desiring a more dramatic change in body contour, liposuction may be the more suitable choice. Liposuction is a more aggressive treatment option and allows for more fat to be removed during a single session. Further, liposuction can be performed in conjunction with other surgical procedures, namely autologous fat transfer, for patients that desire more extensive body contouring. The fat that is extracted during liposuction can be reinjected into areas of the body where more volume is desired, commonly the breasts, buttocks and face. As opposed to cryolipolysis, an overall reduction in fullness and improved contour can be dramatic and results are noticed immediately, however it may take several months to see the final outcome. It is the only reasonable option to remove fat deposit in the regions where fat thick, firm and hard to pinch. Following liposuction patients can typically return to work and resume most normal activity within a week of surgery. Swelling, bruising and numbness are common after liposuction and will subside over the weeks to months following surgery. It is important to note that the recovery is dependent on the amount of fat removed and the number of areas treated.

Ultimately, the choice of which is best treatment option depends on your aesthetic goals and individual preferences. What issues are the most important, and how aggressive you want to be in removing the fat. If avoiding surgery is a key fact, and you are ready to accept modest, less dramatic results in order to do so, then cryolipolysis might be your best option. On the other hand, if you’d rather get as much fat off as possible and would rather do this in one session instead of several, then liposuction may be your best bet.

When considering removal of stubborn fat deposits undoubtedly the best way to go is consultation with an knowledgable plastic surgeon who is experienced in both techniques. During consultation at our clinic, you will have enough time to discuss your aesthetic objectives, expected results, possible complications and recovery period. Afterwards the decision will be much easier.