#cryolipolysis vs. #liposuction - non-invasive vs. surgical treatment for fat reduction.

Cryolipolysis is the result of continued innovation and development in the area of noninvasive body contouring in aesthetic plastic surgery.The demand for body contouring procedures is rising because of the advent of bariatric surgery. Body contouring procedures allow surgeons to treat isolated areas of excess fat that lead to asymmetric appearance and adiposity in unwanted locations. Currently, liposuction is the most frequently employed and effective technique for body contouring but, due to its invasive nature, comes with inherent risks including bleeding and infection with an associated longer recovery time. Furthermore, one of the most common complications of liposuction is contour irregularities. Cryolipolysis is a recent technology used for controlled, natural, and selective fat reduction utilizing localized cooling to extract heat from adipocytes. Although there are no established, formal indications of when to use this technology, it is used in a variety of clinical situations, from the patient who desires scarless reduction of adipose tissue to those who are unfit to tolerate the anesthesia required for more invasive forms of liposuction.

Although the exact mechanism is still being studied, cryolipolysis works at a cellular level by an overarching theme of inflammation followed by phagocytosis and apoptosis. Adipose tissue, as compared to other tissues, is more sensitive to cold temperatures. Adipose cells undergo an inflammatory response after exposure to cold temperatures (-1 to -7°C) within the first 72 hours, peaking at 14 days after treatment. Between 14 and 30 days, phagocytosis of adipose cells begins. By 60 to 90 days, the inflammatory process declines and the adipose cell volume decreases. This roughly 90-day cycle results in selective subcutaneous fat layer reduction.

Although one of the greatest advantages to cryolipolysis is its safety in the population, there have been documented unwanted side effects that occur. Symptoms include erythema, edema, decreased sensation, and pain in the treatment area, but none have been reported as permanent. Finally, although found to be effective, cryolipolysis is not a suitable replacement for high-volume liposuction because traditional liposuction can remove more adipose tissue whereas cryolipolysis is not intended for high volume removal of adipose tissue in a single sitting.

Clinical studies have shown cryolipolysis to be efficacious in reducing fat in the lower and upper abdomen, inner and outer thighs, flank area, and back. In terms of longevity, case studies report fat reduction sustained for 2 to 5 years posttreatment. Finally, studies show more than 80% satisfaction rate among patients, with more than 80% of patients willing to recommend treatment to a friend. Overall, cryolipolysis offers patients a safe, effective, controlled, and noninvasive method to deal with unwanted fat in various parts of the body.

Font: Medscape.