Cryolipolysis

Cryolipolysis is the non-invasive cooling of adipose tissue to induce lipolysis – the breaking down of fat cells – to reduce body fat without damage to other tissues. The scientific principles of Cryolipolysis were discovered by Dermatologists Dieter Manstein, MD, PhD and R. Rox Anderson, MD, of the Wellman Center for Photomedicine at Massachusetts General Hospital in Boston, a teaching affiliate of Harvard Medical School.

The physicians and their team conducted research that demonstrated that under carefully controlled conditions, subcutaneous fat cells are naturally more vulnerable to the effects of cold than other surrounding tissue. Their initial work, published in Lasers in Surgery and Medicine in November 2008, showed that:

• Exposure to cooling via energy extraction causes fat cell apoptosis – a natural, controlled cell death, which leads to the release of cytokines and other inflammatory mediators that gradually eliminate the affected cells.
• Inflammatory cells gradually digest the affected fat cells in the months after the procedure, reducing the thickness of the fat layer.
• Lipids from the fat cells are slowly released and transported by the lymphatic system to be processed and eliminated, much like that of fat from food.

Based on their research findings, the investigators concluded “prolonged, controlled local tissue cooling can induce selective fat cell reduction and subsequent loss of subcutaneous fat, without damaging the overlying skin.” This discovery, called “selective Cryolipolysis,” led to the development of the patented technology behind the non-invasive CoolSculpting procedure.

The CoolSculpting procedure using Cryolipolysis is fundamentally different from other non- or minimally invasive modalities. Other methods of fat removal primarily involve necrotic cell death by damaging fat with heat, high-intensity focused ultrasound, or chemical injections. Each approach poses potential technical challenges, particularly with respect to targeting the right tissue depth and unintended damage to other structures close to or within the fat layer. Predictability of efficacy using these other techniques is also uncertain. In contrast, the CoolSculpting procedure using Cryolipolysis® induces apoptosis only in fat cells to gently and gradually reduce the fat layer while preserving all other tissue.

Cryolipolysis is based on the principle that fat cells are more vulnerable to energy extraction (cooling) than surrounding tissues. A non-invasive applicator is attached to the targeted procedure area to extract energy from the underlying fat tissue, while protecting the skin, nerves, muscles and other tissue. The cooled fat cells undergo apoptosis (controlled cell death) and are gradually eliminated, reducing the thickness of the fat layer.

Clinical studies demonstrate that the Cryolipolysis procedure provides noticeable, measurable fat reduction in properly selected patients over the course of two to four months after the procedure. Additional procedures may be administered two to four months after the initial procedure to achieve greater fat reduction.

During the procedure, exposure to cooling causes fat cell apoptosis, which leads to the release of cytokines and other inflammatory mediators. Inflammatory cells gradually digest the affected fat cells in the months after the procedure. Lipids from the fat cells are slowly released and transported by the lymphatic system to be processed, much like fat from food. Because the lipid clearance process is gradual there is no harmful change in blood lipids or liver function.

Lipids in fat cells crystallize at warmer temperatures than other water-containing cells. This is how Cryolipolysis targets only fat cells for destruction and spares other tissue such as skin, muscle, and nerves. The CoolSculpting system controls the rate of energy extraction or cooling during the procedure.

The Cryolipolysis procedure is completely non-invasive, which allows immediate return to normal activities such as work or exercise. Redness may appear in the treated area, and may last from a few minutes to a few hours. Some localized bruising or swelling may occur, which clears within a few weeks. Many patients experience a temporary dulling of sensation in the treated area, lasting one to eight weeks.