20 Maximizing Safety with Cryolipolysis


20 Maximizing Safety with Cryolipolysis

Erez Dayan and Rod J. Rohrich


Cryolipolysis is among the most popular noninvasive treatments for focal adipose excess. The FDA cleared cryolipolysis for reduction of fat deposits in the flanks, abdomen, and thighs between 2010 and 2014; this technology has since emerged as a leader among noninvasive body contouring devices. Cryolipolysis works by preferentially destroying fat cells through a controlled thermal reduction. Exposure to below normal, but above-freezing temperature induces apoptosis of fat cells and takes advantage of adipocyte sensitivity to the cooling process when compared to surrounding tissues.

Key Points

  • Cryolipolysis is based on the concept that lipid-rich tissues are more susceptible to cold injury than surrounding water-rich tissue (▶ Fig. 20.1 ). 1 , 2 , 3 , 4

  • The method involves controlled application of cooling within the temperature range of -11 to 5°C. 1 , 5 , 6

  • Cryolipolysis targets adipocytes while sparing skin, nerves, vessels, and muscles. 7

  • This technology appears to be safe in the short and long term. It has not been shown to have any effect on cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, liver function (aspartate aminotransferase (AST)/alanine aminotransferase (ALT) bilirubin), albumin, or glucose. 7

  • The mechanism for cryolipolysis is not fully understood. Theories include adipocyte apoptosis by cellular edema, reduced Na-K-ATPase activity, elevated lactic acid levels, and mitochondrial free radical release. Ultimately, an inflammatory process leads to adipocyte death and removal by macrophages within 3 months. 8

  • Complications are rare and typically resolve a few weeks after treatment. Adverse events include erythema, bruising, swelling, sensitivity, and pain. No persistent ulcerations, scarring, paresthesias, hematomas, blistering, bleeding, hyperpigmentation/hypopigmentation, or infections have been described. 8 , 9 , 10

  • Few isolated case reports have described paradoxical adipose hyperplasia after cryolipolysis treatment (est 1:20,000). 11 , 12 , 13 , 14 , 15

Fig. 20.1 Effect of cryolipolysis on adipose tissue.

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Jul 18, 2020 | Posted by in Dermatology | Comments Off on 20 Maximizing Safety with Cryolipolysis
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