By Zara Haider
Cryolipolysis is the process of using cold temperatures to destroy fat cells. Too many patients in the US, this is known as “Coolsculpting”, the company that created the process and the equipment to execute it.
How it Works
A clinician uses a hand-held device that suctions the targeted area before lowering the temperature of the device and the skin attached to it to 0-4 degrees Celsius (32-39 degrees Fahrenheit). The device will stay at that temperature for 30-60 minutes before the clinician removes it and massages the area to help further the breakage of fat tissue. Depending on the patient’s BMI (body mass index), their expected outcomes, and the clinician’s recommendations, multiple appointments with the clinician may be needed.
Patients going through the procedure are warned of feeling undesirable sensations ranging from tingling to aching to cramping.
After a procedure, an inflammatory response occurs that results in apoptosis, a naturally occurring process where the body breaks down dead cells. The lymphatic system works to remove the dead adipose cells, taking 4-16 weeks for all of it to be removed. Patients 4 months post-treatment often lose 10-28% of fat, depending on the targeted area.
The treatment can be applied to the following areas:
Stomach
Thighs
Buttocks
Back and sides
Bra line
Upper arm
Chin/jawline
Origins
In 1970, researchers from the New England Journal of Medicine defined the concept of “Popsicle Panniculitis” after they observed children who frequently consumed popsicles develop dimples, a sign of fat loss. This phenomenon is common in infants because their subcutaneous fat contains a higher proportion of saturated fatty acids, which are prone to crystallization and changes resulting from inflammation.
In 1999, this prompted dermatologists Dieter Manstein from Massachusetts General Hospital and Rox Anderson from Harvard Medical School to start researching and developing the first edition of the equipment used in today’s Coolsculpting procedures.
After eight years of development, they conducted pig testing and achieved a reduction of half an inch of fat. Two years later, Coolsculpting became FDA-approved, paving the way for human treatments.
Risks and Concerns
Despite the prospects Coolsculpting offers, it is not recommended for those with loose skin, poor skin tone, or any cold-related diseases/illnesses. These conditions include cold agglutinin disease, an autoimmune disease exacerbated by cold temperatures that destroy red blood cells; cold urticaria, which causes hives in response to cold exposure; Raynaud’s syndrome, characterized by the constriction of blood vessels in the extremities due to the cold; and cryoglobulinemia, vascular inflammation caused by abnormal proteins that solidify in cold temperatures.
Additionally, there’s a risk of patients developing a side effect called paradoxical adipose hyperplasia (PAH), where fat cells are stimulated rather than eliminated. This side effect gained significant media attention in 2015 when it affected Canadian fashion model Linda Evangelista, leading to a huge scandal and a lawsuit.
PAH is more likely in men and those of Hispanic/Latinx descent, though genetics also plays a role. While a 2014 study conducted by JAMA Dermatology estimated that PAH occurs in 1 out of 20,000 patients (0.005%), recent findings by the manufacturer of Coolsculpting, Allergan, found PAH detected in 1 out of 3,000 (0.033%) patients this year. The updated statistical report urges patients to exercise increased caution and to consult with a healthcare provider for personalized advice about the matter.
Debunking DIY Coolsculpting
If Coolsculpting uses freezing temperatures to eliminate fat, can’t an ice pack used for a long duration give the same results?
The answer is no. Applying ice directly to the skin can cause numbness, pain, frostbite, and in extreme cases, permanent tissue damage. Additionally, fat cells tend to move away from cold sources, preventing any effective penetration. Plus, the ice pack’s temperature rises due to heat transfer, making any attempt at a DIY “Coolsculpting treatment” too brief to have any real effect.
The Future of Coolsculpting
Cryolipolysis offers patients a non-invasive option when it comes to removing stubborn fat. As we progress into the second decade of the 21st century, Coolsculpting has made significant progress with its technology. At the beginning of 2021, the company released its latest model: Coolsculpting Elite. The new machinery’s dual C-shaped applicators are designed to fit all body types, offering comfort, while also allowing treatment in two areas Additionally, its suction cup is said to be 18% larger than the older models, increasing its effectiveness and enhancing results.
As its creators emphasize, the treatment is not guaranteed to result in weight loss, but Coolscupting’s capabilities still offer patients a way to improve their physical health.
Sources
Arora, Dr. R., Nandhagopal, Dr. T., & Raza, Dr. S. (2012, February). Popsicle Panniculitis. Consultant360.com; HMP Communications. https://www.consultant360.com/article/popsicle-panniculitis#:~:text=The%20underlying%20mechanism%20is%20thought
Ask the Doctors. (2022, April 8). Cryolipolysis is the Process of Freezing Fat. Uclahealth.org; UCLA Health. https://www.uclahealth.org/news/article/cryolipolysis-is-the-process-of-freezing-fat
Cleveland Clinic. (n.d.). Fat Freezing (Cryolipolysis). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/21060-fat-freezing-cryolipolysis
Coolsculpting. (n.d.). Learn About CoolSculpting® & CoolTone®. Www.coolsculpting.com. https://www.coolsculpting.com/discover-our-story/
Ellis, R. R. (2024). CoolSculpting for Fat Loss: Is It Safe? WebMD; WebMD. https://www.webmd.com/beauty/coolsculpting
Hobbins, K. (2021, January 27). Allergan Announces CoolSculpting Elite Device. Dermatology Times; Dermatology Times. https://www.dermatologytimes.com/view/allergan-announces-coolsculpting-elite-device
Kalos Medical Spa. (2024, May 20). How Worried Should I Be About Paradoxical Adipose Hyperplasia? - Kalos Medical Spa. Kalos Medical Spa. https://www.kalosmedicalspa.com/paradoxical-adipose-hyperplasia-coolsculpting/
Maras, R. (2023, July 17). Where does the Frozen Fat from Coolsculpting Go? The Cosmetic Skin Clinic. https://www.cosmeticskinclinic.com/blog/where-does-frozen-fat-from-coolsculpting-go/#:~:text=When%20CoolSculpting%20is%20performed%2C%20the
MSHS, N. N., MD. (2020, March 12). The Skinny on Freezing Fat. Harvard Health Blog. https://www.health.harvard.edu/blog/the-skinny-on-freezing-fat-2020031218990
NJ Center for Coolsculpting. (2020, July 8). Do Ice Packs Reduce Belly Fat? NJ Center for CoolSculpting; PracticeBloom . https://www.njcenterforcoolsculpting.com/do-ice-packs-reduce-belly-fat/
Park Meadows Aesthetics. (2020, December 23). Can Ice Packs Reduce Belly Fat? Park Meadows Aesthetics; Park Meadows Cosmetic Surgery Aesthetics. https://www.parkmeadowsaesthetics.com/blog/can-ice-packs-reduce-belly-fat/
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