No matter how much you eat and live right, some of us just cannot get rid of those few pesky pounds here and there. Many methods are available for that purpose, from liposuction to lipolysis. Whether liposuction or lipolysis by laser, ultrasound or radiofrequency assistance, each has various degrees of invasion, efficiency and risk factors.(1) But today we explore a unique, new, FDA cleared advancement that will revolutionize the way we think about body contouring: CoolSculpting™.
CoolSculpting™ by Zeltiq®
Zeltiq® was founded in 2005. The technique was developed by dermatologists Drs. Dieter Manstein, MD, PhD, and R. Rox Anderson, MD, at the Wellman Center at Massachusetts General Hospital in Boston, a teaching affiliate for Harvard Medical School.
The word cryolipolysis is broken down into three parts: “cryo”, Greek for icy cold; “lipo”, Greek for fat; and “lysis”, Greek for to break down. The idea actually came from the effect of cold on children’s fat: When they eat too many popsicles, they develop cheek dimpling. Interestingly enough, this dimpling has a clinical term: popsicle panniculitis! It was also noted newborns with hypothermia develop panniculitis (fat inflammation). (1)
How Fat Cells are Different From Other Cells
Basically, fat cells are more sensitive to cooling than other cells surrounding them (skin, muscle, and nerve cells).(1) Cooling breaks them down in a process known as apoptosis, meaning cell death. Apoptosis in turn leads to the release of inflammatory mediators and the attraction of inflammatory cells.
These inflammatory cells help the body clean up dead fat cells. The lipids once contained inside the cells are eliminated through the lymphatic system.(1) This happens gradually over the course of the two to four months following the procedure, leading to decreased thickness of the fat layer. Because the process is slow, there is no risk of a sudden increase in blood lipid levels or affection of liver function.(4)
How Cold is Coolsculpting?
Studies by Zeltiq® tested temperatures as low as – 7° Celsius (19.4° Fahrenheit).
But more important than the temperature reached is how fast it’s reached. The people at Zeltiq® use the term Cooling Intensity Factor, or CIF, a numerical value which measures the rate at which heat is drawn away from the treated area. The heat is drawn away from the area in a controlled manner that ensures only fat cells are affected, which creators termed “selective lipolysis”.(3)
After your dermatologist declares you are a suitable candidate for the procedure and obtains consent, the following happens:
- Documentation is taken for before and after comparisons. This documentation includes photography, body weight, and circumference of the area to be treated.
- Afterward, you lie down in preparation for the procedure. Bring something to keep you busy, such as a book or an iPad. Or you can ask for the lights to be dimmed and use the time for a mid-day nap!
- A very thin pad is placed on the skin on the targeted area. It’s soaked in “coupling gel.” This is to ensure constant contact between the skin and the applicator during the procedure.
- The device’s cup-shaped “applicator” is applied on top of the pad, and a vacuum is turned on to suck in the targeted area. A C-shaped pillow may be put around the applicator to support it.
- The applicator has two cooling panels on either side of the pinched skin, which start bringing down the temperature of the targeted area. Temperature sensors, also in the applicator, monitor the entire process and give feedback through the device’s display.
- The pad that is applied is soaked in a gel so you will initially feel it cool and wet on your skin.
- The suction and cooling sensations are not at all uncomfortable.
- After the applicator is removed, the area treated will feel very cold and a tad bit hard, as one delightful patient described it, “it feels like a chicken just out of the freezer!” Don’t panic! This is the desired end result and it will fade away within the next couple of hours.
The End Result
- Over the course of two to four months, you will notice a gradual reduction in the circumference of the treated area and a visible sculpting or contouring that looks very natural.(2)
- Reduction has been reported to be anywhere between 1 – 5 cm (0.5 to 2 inches). Patients reported going down a dress size.
- If desired, the procedure can be repeated after two to four months.
- According to the site, results have been shown to be persistent for over six months post procedure. More long term studies are yet to be conducted.
Depending on the target area, prices are anywhere between $600 and $2,000 per area.
- Non invasive: no hospitalization, no anesthesia, no surgery, no stitches, no pain!
- Zero down time: You finish the procedure, and go back to work or get ready for that dinner date!
- Excellent for fit, healthy people or have a fat bulge here or there.
No real disadvantages, just some points:
- The treated area becomes red; this usually disappears by the end of the day.(1,2)
- There’s swelling or bruising due to the vacuum; this disappears within the first week.(2)
- Twenty percent of patients reported temporary numbness in the area treated (dysthesia); this normalizes in one to eight weeks. There have been no reports of lasting numbness, but the sensation can be pretty irritating.(2)
- This procedure is not suitable for patients who are overweight or have considerable skin laxity. (2)
- A single session lasts from one to three hours.
- The device has only one applicator, so if you are targeting two areas (e.g. both love handles) you will need to be there for double the time, as one area is treated at a time.
- Expectations have to be realistic; it’s crucial to understand that the results are not as drastic as a liposuction.
- The CoolSculpting™ makers do not recommend that the procedure be used as a treatment for cellulite.
- As one study points out, the effect of cooling must be evaluated in patients suffering from diseases that are aggravated by the cold, such as cold urticaria or cryoglobulinema.(1) Always tell your doctor of any pre-existing conditions.
Cryolipolysis is still in its early stages, and more studies are needed to fully understand the procedure and its long term effects. Nevertheless, there is no arguing this procedure is a breakthrough in the world of body contouring! Whether it is for you really depends; some would prefer an invasive, more drastic liposuction, some would prefer a non invasive, lunch time or weekend CoolSculpting™ session with more subtle effects.
Also, it is important to keep in mind that “do-it-yourself” cooling techniques, such as applying ice for a long time on your skin, can be damaging.(1) This is because CoolSculpting™ is designed to treat the skin in a controlled, regulated manner.
Thanks for reading! Remember, stop by my blog, Elbashra.com, or tell your friends if interested in reading about skin care in Arabic!
1- B. Zelickson et al. Cryolipolysis for Non Invasive Fat Cell Destruction: Initial Results from a Pig Model. Dermatologic Surgery 2009; 35 (10): 1462-70.
2- A. Nelson et al. Cryolipolysis for Reduction of Excess Adipose Tissue. Seminars in Cutaneous Medicine and Surgery 2009; 28 (4): 244-9.
3- L. Brightman et al. Can Second Treatment Enhance Clinical Result in Cryolipolysis? A Case Report. Cosmetic Dermatology 2011; 24 (2): 85-8.
4- B. Kenneth et al. Non Invasive Cryolipolysis For Subcutaneous Fat Reduction does not Serum Lipid Levels or Liver Function Tests. Lasers in Surgery and Medicine 2009; 41 (10): 785-90.
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