Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction

Nils Krueger, Sophia V Mai, Stefanie Luebberding, Neil S Sadick, Nils Krueger, Sophia V Mai, Stefanie Luebberding, Neil S Sadick

Abstract

In recent years, a number of modalities have become available for the noninvasive reduction of adipose tissue, including cryolipolysis, radiofrequency, low-level laser, and high-intensity focused ultrasound. Each technology employs a different mechanism of action to cause apoptosis or necrosis of the targeted adipocytes. Among these technologies, cryolipolysis has not only been commercially available for the longest time, but has also been best researched including in vitro and animal models and randomized controlled clinical trials in humans. The principle behind cryolipolysis exploits the premise that adipocytes are more susceptible to cooling than other skin cells. The precise application of cold temperatures triggers apoptosis of the adipocytes, which invokes an inflammatory response and leads to slow digestion by surrounding macrophages. In clinical studies, cryolipolysis was shown to reduce subcutaneous fat at the treatment site by up to 25% after one treatment. Improvements were seen in 86% of treated subjects. At 73%, the patient satisfaction rate is higher than with other technologies used for noninvasive lipolysis. Cryolipolysis has been proven to be a very safe method for body contouring, and is accomplished with only minimal discomfort. Expected side effects are temporary erythema, bruising, and transient numbness that usually resolve within 14 days after treatment. With a prevalence of 0.1%, the most common complaint is late-onset pain, occurring 2 weeks post-procedure, which resolves without intervention. Although no procedure has been accepted as the gold standard for noninvasive body contouring as yet, cryolipolysis is considered to be both safe and efficient with a high patient satisfaction rate.

Keywords: body contouring; cryolipolysis; nonsurgical fat reduction; patient safety; patient satisfaction.

Figures

Figure 1
Figure 1
Indications cleared by the US Food and Drug Administration (blue) and off-label indications (pink) for cryolipolysis as mentioned in peer-reviewed publications.

References

    1. The American Society for Aesthetic Plastic Surgery Plastic Surgery Statistics Report Annual Statistics. 2012. [Accessed May 17, 2014]. Available from: .
    1. Fatemi A, Kane MAC. High-intensity focused ultrasound effectively reduces waist circumference by ablating adipose tissue from the abdomen and flanks: a retrospective case series. Aesthetic Plast Surg. 2010;34(5):577–582.
    1. Shalom A, Wiser I, Brawer S, Azhari H. Safety and tolerability of a focused ultrasound device for treatment of adipose tissue in subjects undergoing abdominoplasty: a placebo-control pilot study. Dermatol Surg. 2013;39(5):744–751.
    1. Jewell ML, Baxter RA, Cox SE, et al. Randomized sham-controlled trial to evaluate the safety and effectiveness of a high-intensity focused ultrasound device for noninvasive body sculpting. Plast Reconstr Surg. 2011;128(1):253–262.
    1. Zelickson BD, Kist D, Bernstein E, et al. Histological and ultrastructural evaluation of the effects of a radiofrequency-based nonablative dermal remodeling device: a pilot study. Arch Dermatol. 2004;140(2):204–209.
    1. Franco W, Kothare A, Ronan SJ, Grekin RC, McCalmont TH. Hyperthermic injury to adipocyte cells by selective heating of subcutaneous fat with a novel radiofrequency device: feasibility studies. Lasers Surg Med. 2010;42(5):361–370.
    1. Manuskiatti W, Wachirakaphan C, Lektrakul N, Varothai S. Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study. J Eur Acad Dermatol Venereol. 2009;23(7):820–827.
    1. Franco W, Kothare A, Goldberg DJ. Controlled volumetric heating of subcutaneous adipose tissue using a novel radiofrequency technology. Lasers Surg Med. 2009;41(10):745–750.
    1. McRae E, Boris J. Independent evaluation of low-level laser therapy at 635 nm for non-invasive body contouring of the waist, hips, and thighs. Lasers Surg Med. 2013;45(1):1–7.
    1. Avci P, Nyame TT, Gupta GK, Sadasivam M, Hamblin MR. Low-level laser therapy for fat layer reduction: a comprehensive review. Lasers Surg Med. 2013;45(6):349–357.
    1. Adatto MA, Adatto-Neilson R, Novak P, Krotz A, Haller G. Body shaping with acoustic wave therapy AWT(®)/EPAT(®): randomized, controlled study on 14 subjects. J Cosmet Laser Ther. 2011;13(6):291–296.
    1. Manstein D, Laubach H, Watanabe K, Farinelli W, Zurakowski D, Anderson RR. Selective cryolysis: a novel method of non-invasive fat removal. Lasers Surg Med. 2008;40(9):595–604.
    1. Zelickson B, Egbert BM, Preciado J, et al. Cryolipolysis for noninvasive fat cell destruction: initial results from a pig model. Dermatol Surg. 2009;35(10):1462–1470.
    1. Nelson AA, Wasserman D, Avram MM. Cryolipolysis for reduction of excess adipose tissue. Semin Cutan Med Surg. 2009;28(4):244–249.
    1. Avram MM, Harry RS. Cryolipolysis for subcutaneous fat layer reduction. Lasers Surg Med. 2009;41(10):703–708.
    1. US Food and Drug Administration 510(k) clearance K133212. 2014. [Accessed May 17, 2014]. Available from: .
    1. Jalian HR, Avram MM. Cryolipolysis: a historical perspective and current clinical practice. Semin Cutan Med Surg. 2013;32(1):31–34.
    1. Stevens WG, Pietrzak LK, Spring MA. Broad overview of a clinical and commercial experience with CoolSculpting. Aesthetic Surg J. 2013;33(6):835–846.
    1. Coleman SR, Sachdeva K, Egbert BM, Preciado J, Allison J. Clinical efficacy of noninvasive cryolipolysis and its effects on peripheral nerves. Aesthetic Plast Surg. 2009;33(4):482–448.
    1. Dierickx CC, Mazer JM, Sand M, Koenig S, Arigon V. Safety, tolerance, and patient satisfaction with noninvasive cryolipolysis. Dermatol Surg. 2013;39(8):1209–1216.
    1. Garibyan L, Sipprell WH, Jalian HR, Sakamoto FH, Avram M, Anderson RR. Three-dimensional volumetric quantification of fat loss following cryolipolysis. Lasers Surg Med. 2014;46(2):75–80.
    1. Ferraro GA, De Francesco F, Cataldo C, Rossano F, Nicoletti G, D’Andrea F. Synergistic effects of cryolipolysis and shock waves for noninvasive body contouring. Aesthetic Plast Surg. 2012;36(3):666–679.
    1. Bernstein EF. Longitudinal evaluation of cryolipolysis efficacy: two case studies. J Cosmet Dermatol. 2013;12(2):149–152.
    1. Jalian HR, Avram MM, Garibyan L, Mihm MC, Anderson RR. Paradoxical adipose hyperplasia after cryolipolysis. JAMA Dermatol. 2014;150(3):317–319.
    1. Klein KB, Zelickson B, Riopelle JG, et al. Non-invasive cryolipolysis for subcutaneous fat reduction does not affect serum lipid levels or liver function tests. Lasers Surg Med. 2009;41(10):785–790.
    1. Smeets R, Noah EM, Seiferth NY, et al. Bioelectric impedance analysis and quality of life after body-contouring procedures in plastic surgery. J Plast Reconstr Aesthet Surg. 2009;62(7):940–945.
    1. Milder IEJ, de Hollander EL, Picavet HS, Verschuren WM, de Groot LC, Bemelmans WJ. Changes in weight and health-related quality of life. The Doetinchem Cohort Study. J Epidemiol Community Health. 2014;68(5):471–477.

Source: PubMed

3
Iratkozz fel