Fat Removal with Controlled Cold Therapy
A dermatologist/physicist Dr Rox Anderson, at Harvard University, discovered that fat cells were more sensitive to cold than skin, muscle, nerves and blood vessels. He found that that cooling caused a selective destruction of fat cells but no damage to the other tissues or organs. The cooling only goes to a controlled depth.
This treatment has just been approved by the FDA after extensive research (The FDA intensively reviews testing of medical devices eg lasers, injectables, fillers, and botulinum toxins in the United States). Cryolipolysis is a device that has been fully tested; there were more than 7000 patients studied, which makes it a thoroughly researched system. People in the research study were examined for blood cholesterol, triglyceride i.e. fat levels, and there was no increase. The fat is gradually cleared over several weeks without risk to heart or blood vessels.
One initial problem was developing the ability to treat large enough areas; early cryolipolysis machines were only able to treat small areas. The latest machines can treat larger areas, i.e. the front of an average abdomen. In some people a second treatment is needed to treat nearby areas. Newer developments may enable us to treat larger areas at a time and smaller treatment tips may enable us to treat smaller areas e.g. double chins. Cryolipolysis is the first fat removal system where research has shown fat reduction on a lasting or permanent basis.
Other Options for Fat Reduction
Other fat removal systems include laser lipolysis which is essentially a development of liposuction, but instead of just using a cannula (hollow tube) to remove the fat you add a laser that helps to dissolve the fat. It works but has similar potential problems as liposuction. I used to perform liposuction until few years ago when I realised that it really was not the answer for many people. With liposuction it is difficult to achieve a consistently smooth contour; it was difficult to get fat removal just right - if too much was removed you could get hollows, if you did not do enough then the person justifiably was not happy. Whenever you add extra 'gadgets' to liposuction e.g. ultrasound, ultrasonics and lasers, they add to the complication rate, with burning and heating of the tissue under the skin and skin burns. Another system that has been recently and is still under development is not approved by the US Food and Drug Administration yet is liposonyx, which is a high frequency ultrasound that sends sonic waves to break up the fat. It can be quite painful, the treatment tips are quite small, so it can take a long time to treat large areas. Other systems have involved vacuum and low frequency laser systems or superficial radiofrequency which do not give long lasting fat reduction.
What about skin tightening and cellulite?
In our clinic we use monopolar radiofrequency called Thermage with Comfort Plus Technology. This is a new system developed to be comfortable and more effective to tighten the skin and the tissues under the skin. It can be used to treat superficial cellulite and to tighten skin after fat removal in some patients.
Were any side effects seen following Cryolipolysis?
Is there any nerve injury from the cold treatment? Ten subjects treated with cryolipolysis were studied by sensation testing of the local nerves. A temporary reduction in sensation occurred in six out of nine subjects, but all returned to normal after an average of 3.6 weeks after treatment, so do not be surprised if you get a little temporary numbing.
What happens when the fat actually has been removed is it will not come back into that area, this is the same that happens with liposuction. It is thought you get some skin tightening by fibrous tissue where the fat removal occurred which prevents the fat coming back into that area.
One problem is that if you put on weight, your fat will go somewhere else; e.g. instead of your abdomen it goes to the back or chest. Women may have areas of fat on their abdomen, their thighs and their hips because these are the fat stores needed for survival in times of hardship and famine, so women were better able to survive and support the family. These fat pads are therefore of historical importance which may explain why they are so difficult to get rid off by exercise.
Cryolipolysis is a major treatment advance in controlled removal of unwanted fat that is safe, fully tested and effective.