Coolsculpting, reducing fat permanently using Cryolipolysis
Article by Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
Coolsculpting was conceptualized by Dr. Rox Anderson and Dr. Dieter Manstein of the Wellman Center of Photomedicine which is associated with Harvard Medical School and The Mass General Hospital. The two knew of a phenomenon called “popsicle panniculitis” which is loss of fat in the cheek area after a child freezes it while sucking on a popsicle. They also found a case report of a women riding a horse naked in cold weather which resulted in fat lose of her inner thighs, after they became extremely cold. They postulated that cooling fat can lead to fat loss – “Cryo = cold, lipolysis = breaking up of fat.”
Back in the lab, the 2 physicians found that fat was more sensitive to cold than muscle, nerves, skin, and vessels. They were able to find an optimum temperature to maximize the destruction of fat, while leaving all of the other structures unharmed. The concept of cryolipolysis was created. After the fat was exposed to cold for certain amount of time, it was terminally injured, and would gradually die. Over time, the body would remove the dying cells, with no increase in lipid or cholesterol levels in the blood.
With further research, it was found that about 25% of the abdominal fat treated was reduced in one treatment. Further treatments have been shown to further reduce the fat by about the same amount.
Coolsculpting was FDA approved in 2009 and was used off label for fat reduction initially. It was incorporated into the Aesthetic Clinique’s practice in December 2009. We were the 2nd in Florida to treat with Coolscupting, and one of the first 20 in the country.
The areas which have been treated at our office, The Aesthetic Clinique:
Abdomen, upper and lower
Flanks (love handles)
Treatments are based on cycles. Each cycle is 1 hour. How many cycles you will need depends on the amount of fat and the area treated. Sometimes on the abdomen, a larger handpiece can be used which is the size of 2 handpieces and can reduce the time of a treatment.
Side effects are minimal and there is no downtime. Some of these are:
Moderate pain (0.04% of patients, lasting for a couple weeks)
No visible results
Enlargement of the fat – 5 cases (0.001%)
These stats are based on 303,000 treatments
The procedure is relatively painless, and most people work on their computer or watch movies during their treatments.
(I must digress and explain a competing technology which has confused clients. At about the same time Coolsculpting came to market, Zerona did as well. Coolsculpting was initial called Zeltiq which made things even more confusing. Zerona uses about 5 lasers, similar in power to the red laser pointers you can find at Office Depot. The company claims that the laser will reduce inches from arms, waist, hips, and thighs by shining these lasers on your skin. It is controversial as to whether these lasers actually go deep enough to affect the fat cells. All the studies with this laser only go to 2 weeks from the last treatment. There are no long term studies. They are also done while the patient simultaneously is on a modification of his diet. The company now states that the results are only temporary. Zerona is not a weight loss laser and claims of weight loss are false and misleading. As of writing this blog, Zerona has a 42% was it worth it rating from Realself.com and Coolsculpting has a 72%. Looking at Ebay today, there are 5 Zerona lasers for sale, there are no Coolsculpting machines being sold.)
There is now a new technology for fighting fat called Liposonix. It uses high frequency ultrasound, similar to Ulthera, but deeper. The technology seems promising, but side effects, pain, and results are still being evaluated. It is too soon to tell whether Liposonix will gain any significant market share from Coolsculpting. It is being sold by the company that makes the Fraxel laser.
Currently, Coolsculpting is almost 3 years old and has proven itself as being safe, comfortable and effective.