Thermal fat removal is well documented and effective, but temperatures at the other end of the spectrum produce comparable results. Dr Ravi Jain describes how cryoadipolipolysis can provide an alternative for patients seeking non-invasive fat reduction
Before we discovered the concept of cryolipolysis, or fat freezing, in our clinic, we focused mainly on facial aesthetics and Vaser liposuction. The use of Vaser with liposuction to remove fat is effective; patients were impressed with the results. However, many people didn’t realise that Vaser is an invasive procedure, so we lost a number of patients who were seeking a non-surgical way of removing fat. We also tried non-invasive procedures which didn’t meet mine nor my patients’ expectations. Patients would expect liposuction results without going through surgery.
However, fat freezing has delivered results—you can see visible changes and measurements aren’t generally necessary; the patients are generally happy. Another reason I looked into fat freezing was because it doesn’t require much of my time. Apart from the initial assessment, I can allow my assistants or nurses to deliver the treatment because it’s very, very safe. Fat freezing allows us to treat multiple areas at the same time and has a very good return on investment.
The treatment is based on the concept of cold panniculitis, a pathological process which occurs on exposure to extreme cold. With fat freezing, we’re targeting fatty acids which melt and change their state at a temperature below ten degrees. Linoleic, palmitoic and oleic acid all start melting at these temperature levels.
The Cooltech system which I use, has two detachable hand units, so you can treat both love handles the same time. As we can treat multiple areas at the same time, we can effectively give a virtual liposuction effect. This also makes the treatment more cost effective for both patients and for the clinic.
I tend to get better results in a 70 minute treatment period, as opposed to the previously recommended 60 minutes. The system’s applicator cups are graduated, so the energy is delivered in a feathered way—we tend to get smoother results compared to some of the other products out there.
The Cooltech system works by pulling the fat up into the applicator cup. There is secure, even contact. Complications occur with any of these systems when you have poor contact between the skin and the cup. Once the fat has effectively frozen, we get a reduction of fat cells over the next two months.
We first measure the fat thickness using the skin callipers and then program that measurement into the system. The amount is usually between three and five centimetres.
We then apply a protective Coolpad membrane which increases the contact between the treated area and the plates inside the cup. When we press the button, it draws the fat into the cup and the vacuum secures the cup to the area for the next 70 minutes.
It takes around two to four minutes to get down to the target temperature which, using our system, is -8 degrees. It then takes between 60–65 minutes from the start to end of treatment.
At the end of the procedure, we release the vacuum. The patient’s aren’t in pain. They always have a sense of anticipation about the results. Afterwards, the area feels frozen; like ice-cold jelly. The patients are usually surprised that anything has happened because they are pain-free throughout procedure.
A small study was carried out in Spain, following 20 patients; 14 were female and six were male. They were predominantly treated in the abdomen area. Some patients received one treatment, while others received two, with the second treatment carried out at eight weeks.
They had manual lymphatic drainage afterwards and their measurements were repeated at three months. Results showed a mean reduction of fat across the board—everybody got a reduction. For those having the second treatment, further reductions were noted.
As the second treatments were carried out at eight weeks, the patients still had the effects of the first treatment. Generally speaking, after three months there is no further reduction.
Following an audit of 12 cases at my practice, we found that out of 12 cases, we had a mean reduction of two and a half centimetres at four weeks. So there are some significantly high reductions in treatment after only one month.
We don’t instruct people to change their diet or lifestyle because we only choose those whose diet and lifestyle are stable and fit the protocol.
With cryoadipolipolysis, some patients do get temporary numbness in the treated area. This is self limiting and usually responds within a week, with some outlays going on for six weeks.
One of my patients came to see me who had been requesting Vaser on her outer thighs and hips for months. However, her skin tone wasn’t as tight as I would have preferred for Vaser—she could have got some dimpling, so decided that it was not the right treatment for her. I offered cryoadipolipolysis instead. At eight weeks, she had significant reduction of thigh circumference—six centimetres.
So we can get great results. When you’re used to sucking the fat out of patients to get a reduction and you see a treatment that actually does a job better than with a cannula, you feel you’re on to a winner.
Patients can have two treatments on the same day, in different areas. So if they have two one-hour procedures, they can be in the clinic for 2.5–3 hours—compared to a liposuction procedure, which can be an ongoing saga.
The treatment is not necessarily practitioner-dependent but to get the “wow” effect, you do need the experience to understand what is possible, what level to treat, where to place the applicator cups and how to apply them.
Fat freezing is safe, effective, has proven results and there is no downtime. It actually bridges the gap between surgical and non-surgical fat-removal treatments, so we don’t lose as many patients that don’t want surgery.
Dr Ravi Jain is the medical director of the Riverbanks Cosmetic Clinics and director of Cocoon Medical UK Ltd, distributors of Cooltech