Cryolipolysis, commonly called CoolSculpting, has become increasingly popular as a noninvasive method of reducing localized areas of subcutaneous body fat. It is free of the risks of surgical methods such as liposuction and offers the additional benefit of no recovery time.

Physicians have long used cryotherapy – the use of cold for therapeutic purposes – to remove skin lesions, as well as in certain surgical procedures. It’s been common knowledge that cold temperatures can damage body tissues, but it was noted by various physicians that fat cells were more vulnerable to damage from cold than was skin. In the mid-2000’s, reports were published in professional journals about a noninvasive procedure to selectively destroy adipose tissue by applying a device to a targeted area, set at a precise temperature for a specified period of time. This approach targets fat cells while sparing skin and other underlying tissues.

The mechanism by which CoolSculpting works is not entirely understood. It has been observed that the cryolipolysis causes an inflammatory response in the body, causing gradual destruction of the treated fat cells. Studies have indicated that this response reaches a peak at different intervals, varying from 15 to 45 days after treatment. This is then followed by a gradually decreasing response. Once these fat cells die, they are removed by the body’s natural mechanisms for removal of dead cells, eventually being processed by the liver and removed as waste. Microscopic studies have demonstrated that after 3 months, macrophages, a type of white blood cell, are primarily responsible for clearing of damaged tissue and cellular debris.

This process of removal of the destroyed fat cells by the body raised concern that it could possibly have a detrimental effect on blood lipid levels and liver enzymes. It has subsequently been established via multiple studies that cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, total bilirubin, albumin, glucose, and liver functions remained within normal limits following CoolSculpting.

The results of CoolSculpting have been evaluated by clinicians using various objective methods, including skin calipers, ultrasound, before and after photographs, and three-dimensional imaging. Subjective methods have also been used, such as patient satisfaction surveys. Studies using these outcome measurements have consistently shown a significant decrease in fat volume in the treated areas.

An unexpected benefit of cryolipolysis has been observed by some investigators: a firming of formerly flaccid skin, even in those who had significant reduction in fat. The skin retained this new firmness several months after the procedure, conforming well to the body’s new contours. The mechanism through which this new-found firmness occurred is not fully understood, but it is theorized that it may stimulate collagen production, new formation of elastin, or compression of tissues.

More good news is that the fat loss in the targeted area(s) appears to be permanent. It usually takes two to four months to see a noticeable decrease in fat, but once those cells are destroyed, it is unlikely they will return to the treated area. The best results are obtained by those who also have a healthy eating plan and maintain a constant weight.

In short, the cosmetic procedure of CoolSculpting when combined with proper nutrition and exercise is a safe and effective method of eliminating trouble spots of unwanted fat. Patients are able to return to their normal activities the day of the procedure and various studies indicate a high level of patient satisfaction with the results.

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