More than 10 million cosmetic procedures are performed annually in the United States, costing greater than 11 billion dollars. That’s an increase in demand of 250 percent for surgical and minimally invasive procedures over the last two decades. The number of surgical procedures has actually declined by 16 percent since 2000, with a rise of 137 percent in the number of minimally invasive procedures.
Our culture is obsessed with the artificial “beauty” of images ubiquitous in the media. Both women and men are demanding quick, affordable, safe, and less-invasive treatments to counteract age-related changes in appearance, seen by our culture as less attractive than the appearance of youth. These procedures are often called “lunch-time procedures” because they often have little or no time away from usual activities and can be completed in less than 2 hours. For decades, liposuction was the only approved procedure for body contouring, but it’s facing increasing competition from minimally invasive methods that involve no anesthesia, no operating room, or incisions of the skin. The results may be less immediately dramatic, but are free of the level of risk and side effects associated with surgical procedures.
CoolSculpting (Cryolipolysis)
CoolSculpting is a unique treatment modality, using the principle that adipocytes (fat cells) are damaged by cooling more than other skin cells. The Mayoral Dermatology physicians are highly knowledgeable, skilled, and experienced in CoolSculpting.
Application of cold kills adipocytes (fat cells), which are engulfed and digested by macrophages – part of the body’s arsenal of weapons for fighting disease. No immediate change in subcutaneous fat is apparent. The destruction of fat cells triggers an influx of inflammatory cells, starting within 3 days of treatment, and peaking at 14 days. At 14-31 days after treatment, the macrophages surround and digest the fat cells as part of the body’s response to injury. The inflammation lessens and the adipocyte volume is decreased. At 2-3 months after treatment, the fat volume is sufficiently decreased to see the desired cosmetic results.
Coolsculpting Before and After
Coolsculpting Device Approved by FDA
In 2010, the United States Food and Drug Administration (FDA) cleared a cryolipolytic device: CoolSculpting – ZELTIQ, for reduction of flank and abdominal fat. In 2014, it was also cleared for use on thighs.
About the Coolsculpting Treatment Session
An area of skin is enclosed by two panels, which are set at the desired low temperature. The area is treated for 45 minutes, then the skin massaged for 2 minutes after the panels are removed, to improve clinical outcome. Normal activities are resumed immediately.
Some areas require 2 or more treatments. Sessions should be spaced 8 weeks apart to allow the inflammatory process to resolve.
Numerous studies which have been done on the use and safety of cryolipolysis have found no adverse effects 2 months and 6 months after treatment. Researchers report that 86 percent of subjects showed improvement in contouring. It was most effective on the abdomen, back and flank.
In a patient survey, 73 percent of patients were satisfied, and 82 percent would recommend the procedure to a friend. They were satisfied with the duration of a treatment session. The majority described minimal to tolerable discomfort during the procedure.
The long-term duration of effect has not been evaluated as yet, but there is no evidence that fat lost after cold exposure could regenerate.
No Significant Adverse Side Effects
Numerous studies, including reviews of all published material on the topic have shown no significant adverse effects. Expected side effects are redness, bruising and temporary numbness that resolve within 14 days of treatment. The most common complaint is that two weeks after treatment there may be some pain, although why is unknown. It fades without treatment.
Mayoral Dermatology physicians have performed their share of the 85,000 procedures which have been performed worldwide, with only 850 problems reported. In 33 cases, additional fat grew at the site of treatment; why is unknown. Sensory loss has been reported in 9 subjects.
About Cryolipolysis
There is a wide variety of modalities for body contouring. Cryolipolysis is a nonsurgical method, considered safe and effective, with 73 percent of patients satisfied with just one treatment. That’s comparable to high-intensity focused ultrasound and acoustic wave therapy (62.3 percent and 64 percent, respectively.) These methods are associated with either a higher rate of adverse events and pain, or a high number of treatments necessary to achieve the desired result.
Candidates for Coolsculpting Device Body Contouring
Cryolipolysis is safe for all skin types, with no reported changes in pigmentation, and repeated treatments are safe.
The best candidates are people within 30 pounds of their ideal weight range, and who exercise regularly. They eat a healthy diet, and have noticable fat bulges on the trunk. They have realistic expectations, and are willing to maintain the results with a healthy, active lifestyle.
Continued Research to Improve Results
More research is needed, with a sufficient number of subjects, and standardized ways to measure results to evaluate short-term and long-term benefits and side-effects.
References
- Krueger N, Mai SV, et al. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Clin Cosmet Investig Dermatol. 2014; 7:201-205
- Diericky CC, Mazer JM, Sand M, Koenig S, Aregon V. Safety, tolerance, and patient satisfaction with noninvasive cryolipolysis. Dermatol Surg. 2013 Aug; 39(8):1209-16
