Evolution of cryolipolysis
Dr Farid Kazem traces how cryolipolysis has evolved, from its inception to today’s new innovative treatments
The potential for cryolipolysis—controlled cooling to selectively target undesirable subcutaneous fat—was first recognised by researchers R. Rox Anderson, MD, and Dieter Manstein, MD, PhD, from the Wellman Center for Photomedicine at Massachusetts General Hospital, a teaching affiliate of Harvard Medical School. Based upon case reports of cold-induced panniculitis, they investigated controlled cooling and realised that lipid-rich fat cells are more susceptible to cold injury than surrounding water-rich cells. The cryolipolysis technology was exclusively licensed to ZELTIQ Aesthetics in 2005 and the CoolSculpting system was developed to non-invasively reduce subcutaneous fat. CoolSculpting received FDA clearance in the US for non-surgical reduction of fat in the flank area in 2010. FDA clearance followed for the abdomen in 2012, for the thighs in 2014, and for the submental area in 2015. CoolSculpting is approved for fat reduction in over 70 countries worldwide, throughout Europe, and including Canada, Brazil and Australia.
After more than 15 years of research and development and over 60 clinical publications in peer-reviewed journals, CoolSculpting has been established to be safe, effective, well-tolerated, and long lasting. Today, CoolSculpting has grown in popularity, but there are many counterfeit systems entering the market. These counterfeits claim to be as safe and effective as CoolSculpting, yet they’re sold mainly to beauticians and beauty salons. Some counterfeit systems have advantages such as having no disposables and consumables and being lower cost.
The greatest differentiation between CoolSculpting and counterfeit cryolipolysis systems is safety and consistent efficacy. This is due to the significant research and development that went into CoolSculpting before it was introduced to market. Educating our patients is very important, so they can make the right decision. I have seen patients injured by counterfeit cryolipolysis systems, seeking help for serious freeze burns. These counterfeit device injuries have also been reported in the literature by Dr Grant Stevens and Dr Brian Biesman. For proven safety and efficacy, CoolSculpting is the only choice for non-surgical body contouring.
Non-surgically fat reduction
When we first started with CoolSculpting, we began by treating discrete areas, such as “love handles” on the flanks and abdominal bulges. With additional clinical experience, we realised that patients don’t just want to treat individual bulges, they want to have a total transformation. We moved on to Treatment to Transformation, multiple CoolSculpting cycles delivered to multiple treatment areas, to achieve the dramatic results our patients were seeking.
There are now numerous CoolSculpting applicators, which allow treatment of different body areas. Treatment focus began with the abdomen and flanks using the CoolCore, CoolMax, and CoolCurve+ applicators, then the CoolFit applicator was developed for treating the inner thighs, and the CoolSmooth applicator was introduced for reducing fat on outer thighs. We also treat the arms with the CoolFit applicator and male breasts with the CoolCurve+ applicator.
CoolSmooth PRO has recently been introduced. Compared to the CoolSmooth applicator which takes about two hours to complete a treatment cycle, CoolSmooth PRO reaches colder temperatures and thus takes a shorter duration, only 75 minutes, to achieve the equivalent effect.
The CoolMini Applicator has just been introduced, mainly for the submental area, or double chin. This small volume applicator will also be useful for reducing fat above the knees and around the axilla. I am also interested in CoolMini for treating the area parallel to the nasolabial fold and reducing fat in the cheek.
Clinical studies on submental treatment were carried out in the US and in Mexico. A CoolMini European pilot evaluation has been carried out, too. Kazem Aesthetica was one of the pilot sites. Preliminary results show the submental area, the area just above the knee, and the axillary puffs can all be safely and effectively treated with the new CoolMini applicator.
A changing market
By offering CoolSculpting, we’re drawing even more patients to our practice, patients who normally would not consider plastic surgery. These patients are interested in non-invasive aesthetic technology. Dr Grant Stevens published how his practice has grown dramatically since he started offering CoolSculpting for non-surgical body contouring. He now has eight CoolSculpting systems. If I look at my practice with three CoolSculpting systems, I see similar trends. We have about 60% new patients coming in for CoolSculpting and of that 60%, about 40% would consider doing other surgical procedures, even breast enlargements.
I believe the aesthetic market is changing and we have to adapt as surgeons. Looking back at 1997, about half of our procedures were surgical and the other half were non-surgical. If you look at the trends now, we see that there are about 80% non-surgical and only 20% surgical procedures. Whether clients choose liposuction or CoolSculpting, we can achieve beautiful, natural body contouring results.
Dr Farid Kazem is a Plastic Surgeon. In 2000, he founded a private practice for aesthetic plastic surgery near Amsterdam in Leimuiden, the Netherlands. Dr Kazem has extensive experience in aesthetic breast surgery, oculoplastic surgery, and many non-invasive procedures, such as laser and skin tightening procedures. He is well known for his interest in innovative technology.