CoolSculpting

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CoolSculpting is the brand name for a type of cryolipolysis procedure. Cryolipolysis is a non-invasive method of fat removal which uses extreme cold to freeze subcutaneous adipose tissue in certain localized areas of the body to reduce areas of fat. [1] [2] [3] It is Food and Drug Administration (FDA)-approved for treatment of the submental area, under the jawline, the upper arms, lumbar rolls, brassiere rolls, flank area, abdomen, thighs, and under the buttocks. [1] CoolSculpting is among the most widely used forms of cryolipolysis. [1] Often the terms "cryolipolysis" and "CoolSculpting" are used synonymously or interchangeably. [4] [2]

Effectiveness data provided by the manufacturer of CoolSculpting indicates that following 1 to 3 treatments on 7 different areas and follow-up of 3 to 6 months after final treatment, before-and-after photos were classified correctly 84 to 91% of the time by independent physician raters, fat layer thickness measured by ultrasound was reduced by 1.9 to 3.9 mm (0.075–0.15 inches), and subject satisfaction was 62 to 93%. [5] A 2015 systematic review of 19 studies and case reports of cryolipolysis found mean reductions in caliper-measured skinfold thickness of 14.7 to 28.5%, reductions in ultrasound-measured skinfold thickness of 10.3 to 25.5%, and high rates of patient satisfaction. [6] A 2023 review of 18 studies of cryolipolysis found average reduction in fat thickness of 2.0 to 5.1 mm or 16.6 to 32.3% on ultrasound and of 2.3 to 7 mm or 14.9 to 21.5% with caliper. [2] The review concluded that cryolipolysis is safe and modestly effective for reducing focal adiposity, but that the quality of available data was low. [2]

Complications of cryolipolysis include erythema (30%), numbness (19%), swelling (15%), bruising (11%), paresthesia (11%), and pain (8%). [2] [6] These side effects are rated as mild to negligible in severity and generally resolve after a few weeks. [2] [6] No cases of persistent ulcerations, scarring, paresthesias, hematomas, blistering, bleeding, hyperpigmentation, or hypopigmentation were identified in the 2015 systematic review of 19 studies and case reports. [6] A subsequent 2023 review found the incidences of persistent skin discoloration, wound formation, and infection to be very low. [2] More serious adverse reactions like severe/persistent pain, dysesthesia, skin hyperpigmentation, motor neuropathy, and Paradoxical adipose hyperplasia (PAH) may occur less commonly. [7] [8] PAH is a rare reaction characterized by fatty enlargement of the treatment area months after application. [8] A 2023 review found 4 cases in the reviewed studies, or an incidence of about 0.12% across 3,445 treatment cycles in 976 patients. [2] However, the incidence of PAH may be underestimated, with some centers finding rates of 0.67 to 1.0%. [8] [9] PAH can be treated with surgical liposuction and/or abdominoplasty. [8]

CoolSculpting was developed and marketed by Zeltiq Aesthetics and was introduced for use in the United States in 2010. [10] It was originally approved for use on the flanks and abdomen, but it was cleared for use on the thighs in April 2014 [10] and other areas subsequently. [1] Litigation has occurred due to adverse effects of cryolipolysis. [11]

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References

  1. 1 2 3 4 Kania B, Goldberg DJ (November 2023). "Cryolipolysis: A promising nonsurgical technique for localized fat reduction". J Cosmet Dermatol. 22 (Suppl 3): 1–7. doi: 10.1111/jocd.16039 . PMID   37988716.
  2. 1 2 3 4 5 6 7 8 Hetzel J, Awad N, Bhupalam V, Nestor M (November 2023). "Cryolipolysis in the United States-Review of the clinical data". J Cosmet Dermatol. 22 (Suppl 3): 8–14. doi: 10.1111/jocd.16029 . PMID   37988714.
  3. ↑ "Cryolipolysis is the process of freezing fat". www.uclahealth.org. Retrieved 2024-04-12.
  4. ↑ Derrick CD, Shridharani SM, Broyles JM (September 2015). "The Safety and Efficacy of Cryolipolysis: A Systematic Review of Available Literature". Aesthet Surg J. 35 (7): 830–6. doi:10.1093/asj/sjv039. PMID   26038367.
  5. ↑ https://www.coolsculpting.com/pdfs/CSC125713-v2_Important_Safety_Information.pdf
  6. 1 2 3 4 Ingargiola MJ, Motakef S, Chung MT, Vasconez HC, Sasaki GH (June 2015). "Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms". Plast Reconstr Surg. 135 (6): 1581–1590. doi:10.1097/PRS.0000000000001236. PMC   4444424 . PMID   26017594.
  7. ↑ Hedayati B, Juhász M, Chu S, Mesinkovska NA (October 2020). "Adverse Events Associated With Cryolipolysis: A Systematic Review of the Literature". Dermatol Surg. 46 (Suppl 1): S8–S13. doi:10.1097/DSS.0000000000002524. PMID   32976167.
  8. 1 2 3 4 Cox EA, Nichols DS, Riklan JE, Pomputius A, Mehta SD, Mast BA, Furnas H, Canales F, Sorice-Virk S (December 2022). "Characteristics and Treatment of Patients Diagnosed With Paradoxical Adipose Hyperplasia After Cryolipolysis: A Case Series and Scoping Review". Aesthet Surg J. 42 (12): NP763–NP774. doi:10.1093/asj/sjac219. PMID   35961054.
  9. ↑ Stroumza N, Gauthier N, Senet P, Moguelet P, Nail Barthelemy R, Atlan M (March 2018). "Paradoxical Adipose Hypertrophy (PAH) After Cryolipolysis". Aesthet Surg J. 38 (4): 411–417. doi:10.1093/asj/sjx159. PMID   29145587.
  10. 1 2 Krueger N, Mai SV, Luebberding S, Sadick NS (2014). "Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction". Clin Cosmet Investig Dermatol. 7: 201–5. doi: 10.2147/CCID.S44371 . PMC   4079633 . PMID   25061326.
  11. ↑ Hibler BP, Eliades PJ, Kagha KC, Avram MM (December 2021). "Litigation Arising From Minimally Invasive Cosmetic Procedures: A Review of the Literature". Dermatol Surg. 47 (12): 1606–1613. doi:10.1097/DSS.0000000000003202. PMID   34417380.
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