What Is Coolsculpting Or Cryolipolysis?
By, Bruce Y. Lee
How cool is “Coolsculpting,” otherwise known as cryolipolysis or “fat freezing?” Well, placing what looks like a big vacuum cleaner on your fat folds doesn’t look very cool but is being touted as the non-invasive alternative to liposuction. (Please keep in mind that putting a regular vacuum cleaner on your fat folds does nothing.) But does cryolipolysis really work, and is it safe ?
Can cryolipolysis take the “suck” out of liposuction?
Anyone who has seen liposuction performed realizes that it is not a gentle procedure. Tumescent liposuction, the most common type, involves injecting a fluid that includes salt water, lidocaine to reduce pain and epinephrine to constrict the blood vessels. Then, the surgeon inserts through incisions in the skin a suction tube to literally suck the fat through the tube. To facilitate fat break-up and removal, some surgeons will use ultrasound-assisted liposuction (UAL), which entails inserting a metal rod that delivers ultrasound to the fat. Another option is powered liposuction in which the suction tube vibrates rapidly back and forth, almost like a jackhammer. A fourth option is laser-assisted liposuction, which is exactly what it sounds.
The post-procedure pain, bruising, numbness and swelling (which typically can last up to several weeks) can…well…“suck.” More serious risks include fat or blood clots that can travel through blood vessels to places such as the brain leading to a stroke. If the surgeon is not careful, he or she could damage an organ under or around the fat. Liposuction could actually make the area look worse. Moreover, liposuction, as with many other invasive procedures, has potential risks, such as infection, bleeding and problems associated with anesthesia. Liposuction is by no means the safest surgical procedure that you can get. Some studies have found the risk of death from liposuction (20 and 100 deaths per 100,000 procedures) to be higher than the risk of death from a car accident. So people have been experimenting with and trying other options that do not require incisions to attack the fat, such as using lasers, sound waves and harsh words.
Use of liposuction has become relatively widespread. Rumors have suggested that numerous celebrities have had liposuction. (Yes, I know, shocking…that there are rumors about celebrities.) And when celebrities do something, you know others are doing it as well. According to a 2011 International Society of Aesthetic Plastic Surgeons (ISAPS) survey, plastic surgeons worldwide performed 1,268,287 liposuctions (otherwise known as lipoplasties). This number likely underestimates the true number.
How popsicles and pigs led to the way cryolipolysis works
Enter the Coolscultping system, manufactured and sold by ZELTIQ Aesthetics, Inc., after receiving approval for use in Europe in September 2009 and in the United States by the US Food and Drug Administration (FDA) in September 2010. The theory behind cryolipolysis is that fat cells are more sensitive to cold temperatures than other types of surrounding body cells. This theory stemmed from an observed medical phenomenon called popsicle panniculitis in which infants and young children get swelling and redness in their cheeks 6 to 72 hours after sucking on a popsicle or ice cube. In some cases, popsicle exposure led to dimples. Adults probably don’t exhibit this phenomenon because they have fewer fatty acids in their cheeks. (Part of what you pinch when pinching babies’ cheeks.) Two dermatologists at Massachusetts General Hospital, Dieter Manstein, MD, and R. Rox Anderson, MD, then began experimenting on applying cool treatments to pigs (which consisted of more than just giving pigs popsicles), eventually leading to the development of “coolsculpting.”
Cryoplipolysis entails putting a vacuum device on fat bulges and exposing the fat to cold (above freezing but lower than body temperature) for up to an hour. The cold is supposed to selectively destroy fat cells. Cold can cause blood vessels to constrict and reduce blood flow, but the vaccuum may pull blood flow and accompanying inflammatory cells to the fat layers to help with the destruction of the fat. Common side effects after the treatment include redness, numbness, and bruising lasting for a few hours. Another side effect is a lighter wallet, by $750 to $2,000 per area treated. Sometimes side effects can last longer but so far they tend to be confined to no longer than a month. A patient typically will be able to resume all regular activities that same day. Decreases in fat bulges do not occur immediately but instead usually take multiple treatment sessions and two to four months.
Is cryolipolysis a weight loss treatment?
So is cryolipolysis an obesity treatment? Can it help you lose weight? Can the procedure help prevent the health effects that stem from being obese or overweight? Is this an alternative to improving your diet and physical activity? Are you still envisioning pigs eating popsicles? No. No. No. No. And maybe. This is a purely cosmetic procedure that cannot deal with most of the fat in the body that affects your health. The procedure mainly is for reducing smaller fat bulges that are closer to the skin. In fact, coolsculpting will not completely replace liposuction, which can reach fat areas that are deeper under the skin. If you want to find weight loss measures, look elsewhere…and no, cryotherapy is not a proven weight loss measure either.
How effective and safe is cryolipolysis?
How long does the fat reduction last? Unclear. The procedure has not been around long enough to know. More studies are necessary to establish how permanent the effects may be.
Is the procedure truly safe? So far, no long-lasting serious effects have emerged, assuming that the procedure is performed correctly. (For example, the vacuum device should not go in your mouth.) But more studies are needed to determine the possibility of longer-term and more serious effects (especially from repeat treatments) and answer questions such as: What are the long-term effects of the fat being broken down in such a manner and then being handled by the liver, and could the broken-down fat travel to different parts of the body and cause problems?
Also, remember: Cosmetic procedures depend heavily on who is doing the procedure. Just look at how many celebrities have botched plastic surgeries. In the safety studies that led to FDA approval, skilled and closely observed physicians performed the procedure under controlled settings. Now that the procedure is available widely, you could see more misuse and damage from the procedure. If you want the procedure, choose your doctor carefully.
So, remember that coolsculpting is purely a cosmetic procedure..and does little to improve your health …unless that small fat bulge is causing you undue mental anguish and diarrhea. And since the procedure is still relatively new, there is limited information on its long term effectiveness and safety. If want to actually lose weight and improve your health, try giving up popsicles instead.