The Skin Clinic Fremantle | Dr Sarah Boxley


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What is Fat-freezing??

An insiders guide to Cryolipolysis.

One of the hottest treatments around at the moment, fat-freezing or “cryolipolysis” is an effective, non-invasive method of destroying fat cells. It works best on hard-to-shift pockets of fat that do not respond to diet and exercise but should not be used as a weight-loss technique.

How does fat freezing work?

We have known for a long time that by reducing the temperature of the fat layer in a controlled manner, it is possible to cause selective death of the adipose (fat) cells without harming the skin1, as fat cells are more susceptible than skin to temperature changes. Research has shown that cooling the fat tissue to between -8 and 10°c results in local controlled fat cell death and the release of cytokines and inflammatory mediators2.

The lipids from the fat cells are slowly released over the next few months and are transported by the lymphatic system to be processed and eliminated from the body, reducing the thickness of the fat layer. The loss of fat cells treated in this way is permanent3. Commercial cryolipolysis machines have been around since 2009 and have been shown to be safe & effective. With these devices, it is possible to target specific fat areas by using a vacuum action that sucks the skin into an applicator head. The powerful suction causes a temporary reduction to blood flow through the targeted area, making the fat cells easier to freeze.

Is fat freezing just hype or does it actually work?

Research into cryolipolysis technology has shown that the average fat reduction in a particular area is around 25% after one session4,5, although in real life, results can vary from person to person. Post-procedural massage has been shown to improve results6. For large amounts of fat it is possible to repeat the treatment more than once in the same area. Treatment outcomes can be seen by 2-3 months2, at which time a repeat treatment can be performed if required. There is published evidence to show that the results last for at least 5 yrs3 and it is probable that the effect is sustained beyond that period.

Whilst a reduction in localised fat has been well-documented following cryolipolysis, these non-invasive fat removal procedures do not achieve a significant amount of weight loss, or any improvement in visceral fat (internal fat around organs). They also do not improve the appearance of cellulite. If you are generally overweight, cryolipolysis is not going to make you drop kilos and you will probably be disappointed with the outcome. However, if you have a BMI of <30 with specific areas of fat that you would like to smooth out, and are willing to wait a few months to see results, then you could be an ideal candidate for treatment. A number of cryolipolysis devices are currently available which vary slightly in terms of their treatment parameters of suction strength and temperature. All are indicated for treatment of the abdomen, arms, flanks (muffin tops), thighs and knees.

Are there any contraindications?

Contraindications to cryolipolysis.

Like most medical and aesthetic procedures, there are some situations where it is not possible to use this technology. These include:

  • Pacemakers or heart valve replacements
  • Heart, liver or kidney disease
  • Arterial disease
  • Autoimmune conditions such as cryoglobulinaemia, paroxysmal cold haemoglobinuria or cold urticaria
  • Metal implants in the treatment area
  • Past history of keloid scarring in the treatment area
  • Epilepsy
  • Cancer
  • Pregnancy or lactation
  • Anti-coagulant drugs
  • Recent surgery in the treatment area

What are the down-sides to fat freezing

After cryolipolysis is it usual to have redness and possibly bruising in the treatment area, both of which can take 2 weeks to subside. It is also possible for the skin of the treated area to feel slightly numb for up to a month, although research has shown that the effect on the peripheral nerves is not permanent7. An uncommon (1 in 1500) side effect associated with treatment is severe shooting pain, although this is reported to resolve without any lasting effects after 1-4 weeks8.

There is no effect on blood fat levels or liver function9 and no reported systemic side effects to date. With the increase in popularity of cryolipolysis, the rare (1 in 20,000) side effect of “paradoxical adipose hyperplasia” has emerged10. This results in a delayed enlargement beyond baseline of the fat cells in the treated site. The reason for this remains unclear and there is no effective way to predict who will be at particular risk for this side effect, although it is more common in men.

What is a treatment like?

In general, the cryolipolysis procedure takes about 60 minutes per treatment area. Treatment times vary depending upon body site, type of machine and number of applications. Some of the newer machines in the market have double applicator heads, enabling 2 areas to be treated at once (i.e. both thighs, both muffin-tops, or both upper and lower abdomen), which has seen a significant reduction in the time taken to complete the treatment and therefore is more cost-effective for both the client and the clinic. Some machines have specific applicators for thighs and chins that are a different shape or size to the ones used for abdominal fat.

A glycerine pad is applied to the skin underneath the applicator head after which you simply lie back and relax for an hour. Some clients have a facial at the same time, others prefer to relax and listen to music or watch videos. In our experience, the suction should not be painful, although some clients experience a tickling or a sucking sensation. Surprisingly, the treatment does not actually feel cold, although the area will feel cold to touch for a short time afterwards.

How much does cryolipolysis (fat freezing) cost?

The cost varies according to machine type, number of applications and cost of consumables. At time of writing, average costs in Perth are around $850 per application area. We are able to offer cryolipolysis at $450 per application area as our machine has significantly less consumable and running costs than some of its competitors, with comparable results.
 
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Author: Dr. Sarah Boxley MBBS BSc(Hons) MRCGP FRACGP FSCCA


1. Epstein EH Jr, Oren ME. Popsicle panniculitis. N Engl J Med 1970;282(17): 966–7
2. 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.
3. Bernstein EF. Longitudinal evaluation of cryolipolysis efficacy: two case studies. J Cosmet Dermatol 2013;12(2): 149–52.
4. Dierickx CC, Mazer JM, Sand M, Koenig S, Arigon V. Safety, tolerance, and patient satisfaction with noninvasive cryolipolysis. Dermatol Surg 2013;39(8): 1209–16.
5. Krueger N, Mai SV, Luebberding S, Sadick NS. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Clin Cosmet Investig Dermatol 2014;7: 201–5.
6. Boey GE, Wasilenchuk JL. Enhanced clinical outcome with manual massage following cryolipolysis treatment. A 4-month study of safety and efficacy. Lasers Surg Med. 2014;46(1): 20-26
7. 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): 482–8.
8. Dover J, Saedi N, Kaminer M, et al. Side effects and risks associated with cryolipolysis. Annual Meeting of the American Society for Laser Medicine and Surgery, 2011; Grapevine, TX
9. Klein KB, Zelickson B, Riopelle JG, Okamoto E, Bachelor EP, Harry RS, Preciado JA. Non-invasive cryolipolysis for subcutaneous fat reduction does not affect serum lipid levels or liver function tests. Lasers Surg Med. 2009;41(10): 785–90
10. Jalian HR, Avram MM, Garibyan L, Mihn MC, ANderson RR. Paradoxical adipose hyperplasia after cryolipolysis. JAMA Dermatol. 2014;150(3): 317-9