Body contouring or body sculpting is a medical or surgical procedure that aims to reshape an area of the body by removing extra skin or eliminating excess fat. It doesn’t help the individual lose weight. It rather helps shape specific areas of the body, such as the stomach or the thighs, where weight loss cannot provide adequate results and visible differences or in cases where significant weight loss has led to extra skin that hides the actual body size and image. Non-surgical body contouring is called lipolysis. The most common methods include cryolipolysis, where freezing temperatures are used for fat cells to be destroyed; injection lipolysis, where deoxycholic acid is put locally to target the fat cells of the respective area; laser lipolysis, where fat cells are destroyed via laser application; and radiofrequency lipolysis that uses ultrasound waves and heat to target fat cells. On the other hand, surgical body contouring involves procedures like lifts and tucks for excess fat and extra skin removal and liposuction, which suctions out fat deposits.
Of all lipolysis methods, surgical and non-surgical, the most popular and widely used is cryolipolysis, which will be the topic of the current article. Cryolipolysis, also known as ‘’fat-freezing,’’ involves the use of controlled cooling to freeze, thereby destroying fat cells without harming the surrounding skin or tissues. When exposed to extremely low temperatures, fat cells undergo a metabolic process called apoptosis or programmed cell death. The body’s natural processes then eliminate the dead fat cells. As a result, the fat in the treated area is reduced.
The mechanisms of cryolipolysis involve several steps. Firstly the targeted body area is placed between two cooling panels and is exposed to cold temperatures (controlled cooling) through a specialized device. This device uses suction to draw the fat tissue between the panels. The device is regulated to reach temperatures cold enough to trigger fat cell death without causing damage to the surrounding tissues. The temperature range is typically between -5℃ to -11℃, and the application lasts 35 to 60 minutes. As the fat cells freeze, ice crystals form within them, a process known as crystallization. The ice crystals gradually derange the fat cell membrane, eventually destroying it (apoptosis). Following cryolipolysis, the body initiates an inflammatory response where phagocytes, a class of white blood cells, engulf dead cells and transfer them to specialized cell organelles called lysosomes. In lysosomes, dead fat cellular components are degraded for reuse while their remnants are finally processed by the liver and excreted from the body as waste products (fat clearance). Given that the cleared fat is not replaced by new fat cells, the thickness of the fat layer in the treated area gradually decreases after 1-2 treatments.
Cryolipolysis’ main benefit is the reduction of localized fat deposits in certain body areas, such as the thighs, abdomen, back, under the jaw, and upper arms. It has many advantages over other lipolysis methods; thus, most people who wish to get rid of redundant localized fat go for it. Firstly, it is a non-invasive procedure that does not require incisions, sutures, or anesthesia. Therefore, it is considered much safer than surgical lipolysis procedures such as liposuction. Secondly, since it is non-invasive, it typically involves minimal, if any, recovery, and most people can immediately resume their schedule and activities.
Furthermore, cryolipolysis selectively targets and reduces fat cells in specific body areas where fat deposits are really stubborn and cannot be efficiently managed with diet and/or exercise. The targeted fat tissue is permanently eliminated through cryolipolysis; hence the results are potentially long-lasting. However, the individuals who undergo this procedure should follow a healthy lifestyle, including regular exercise and a balanced isocaloric diet, to maintain the results over time and prevent the remaining fat cells from expanding back.
Cryolipolysis is generally well-tolerated, and most people experience minimal discomfort. Some minimal temporary side effects may include redness, bruising, or numbness, but they typically resolve on their own within a few days or weeks. However, consulting with a healthcare professional or licensed aesthetician before cryolipolysis application is essential to determine if this is the optimal treatment for you, based on your current health and specific treatment goals.
People should not see cryolipolysis as a weight loss solution or, even worse, an obesity treatment. It should only be used to target specific areas of stubborn fat that are resistant to diet and/or exercise. Therefore, the best candidates for cryolipolysis are individuals who do not wish to necessarily lose weight or at least a significant amount of kilos and just want to get rid of localized fat pockets.
Overall, cryolipolysis is a non-surgical cosmetic procedure that effectively reduces local excess fat from targeted areas that are not responsive to diet and/or exercise. It works by controlled cooling of the targeted fat tissue, which eventually is eliminated through apoptosis and fat clearance. It is safe and well-tolerated but should not be used by people who wish to lose weight or treat obesity since it can only be effective for localized fat pockets in body areas where weight loss already attained through diet and exercise has left flaws behind.
– Avram MM, Harry RS. CryolipolysisTM for subcutaneous fat layer reduction. Lasers Surg Med. 2009;41(10):703-708
-Derrick CD, Shridharani SM, Broyles JM. The safety and efficacy of cryolipolysis: A systematic review of available literature. Aesthet Surg J. 2015;35(7):830-836
-Garibyan L, Sipprell 3rd WH, Jalian HR, Sakamoto FH, Avram M, Anderson RR. Three-dimensional volumetric quantification of fat loss following cryolipolysis. Lasers Surg Med. 2014;46(2):75-80
-Krueger N, Mai SV, Luebberding S, Sadick NS. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Clin Cosmet Investig Dermatol. 2014;7:201-205
-Lee SJ, Jang HW, Kim H, Suh DH, Ryu HJ. Non-invasive cryolipolysis to reduce subcutaneous fat in the arms. J Cosmet Laser Ther. 2016;18(3):126-129