Effects of Cryolipolysis on the Conversion of White Adipose Tissue: Pilot Study.

INTRODUCTION: Cryolipolysis (CLL) is a widely employed noninvasive procedure for body fat reduction. It operates by inducing cooling, leading to the crystallization of cytoplasmic lipids, loss of cellular integrity, and apoptosis/necrosis of adipocytes, accompanied by local inflammation. Ongoing discussions revolve around CLL's potential to transform white adipocytes into brown adipocytes, potentially yielding more significant effects compared to alternative procedures. OBJECTIVE: Thus, this randomized, blinded clinical study aimed to investigate the effects of CLL on adipose tissue and elucidate the mechanisms involved in its application and capacity for adipocyte conversion. METHODOLOGY: Tissue samples from six patients were assessed at intervals of 45, 60, and 90 days following the application of the CLL protocol during abdominoplasty surgeries. RESULTS: The samples underwent immunohistochemical analyses targeting various markers, revealing higher expression of PPAR-gamma, PPAR-alpha, and UCP-1 markers in CLL-treated samples. CONCLUSION: Therefore, the present study suggests that CLL has the ability to intervene in adipocyte conversion.

The Effects of Body Cold Exposure (Cryolipolysis) on Fat Mass and Plasma Cholesterol.

INTRODUCTION: This study investigates the impact of cryolipolysis on reducing localized fat and altering plasma lipid profiles in 30 overweight and obese women. Conducted at the Health Technology Laboratory of the Evangelical University of Goiás, this clinical research adhered to stringent ethical guidelines. METHODS: Participants underwent three cryolipolysis sessions, with comprehensive assessments of body composition and plasma lipids performed pre- and post-intervention. RESULTS: Significant findings include a reduction in abdominal fat mass by an average of 4.1 kg and a decrease in BMI by 0.7 points (p < 0.05). Notably, total cholesterol levels decreased by an average of 15.7 mg/dL, and LDL cholesterol saw a reduction of 10.2 mg/dL (p < 0.01), with no significant changes in HDL cholesterol or triglyceride levels. These results suggest that cryolipolysis, in conjunction with standardized dietary control, offers a non-invasive alternative to surgical fat reduction, potentially mitigating cardiovascular risks associated with obesity. CONCLUSIONS: The study confirms the efficacy of cryolipolysis in targeted fat reduction and underscores its role in improving key cardiovascular risk factors. These findings warrant further exploration into the long-term benefits of cryolipolysis in metabolic health management and not only for aesthetic treatments.

Innovation of the protocol for the application of cryolipolysis: Effects and mechanisms of action.

BACKGROUND: In recent years, aesthetic procedures aiming at body remodeling and have grown exponentially. Cryolipolysis (CLL) has stood out as a noninvasive resource that acts directly on the subcutaneous adipose tissue promoting a significant reduction of adipose tissue through of cooling that could lead to the crystallization cytoplasmic lipids, loss of cellular integrity, apoptosis/necrosis of adipocytes, and local inflammation, producing selective loss of adipose tissue. Thus, the objective of the present study was to evaluate the effects of a specific technique of CLL application on the inflammatory reactions of the target tissue in different post-application times. METHODS: This is a randomized, blind clinical study that evaluated the tissue sample of six patients after 45, 60, and 90 days of an innovative protocol for the application of CLL, with samples collected through abdominoplasty surgeries. The samples were evaluated by immunohistochemical analyses of several markers. RESULTS: A significantly greater increase in fibroblasts was observed at 45 days and greater phagocytic action at 60 days. Regarding the apoptosis process, the expression of caspase 3 and cleaved caspase 3 markers varied at different times, with cleaved caspase 3 being higher at 45 and 90 days after CLL application. CONCLUSION: The protocol of the CLL presented in this study was able to induce inflammatory responses in addition to confirming the selective apoptotic action at the different times studied.

Cryolipolysis on More than One Body Area Increases Lipid Peroxidation without Changing Lipid Profile and Inflammatory Markers.

In the present study, the effects of cryolipolysis on one and multiple body areas, assessing body composition, lipid profile and peroxidation and inflammatory markers were investigated. Twenty-four women aged between 20 and 59 years were randomly assigned to three groups: (1) control, (2) cryolipolysis on the abdomen and (3) cryolipolysis on the abdomen + flanks. Anthropometric measurements, bioimpedance and ultrasound were performed, as well serum lipid profile, lipid peroxidation markers (malondialdehyde and myeloperoxidase) and inflammatory markers (C-reactive protein and Interleukin-1ß) were determined. In addition, food consumption and physical activity level were evaluated. Data were obtained at 0, 10 and 30 days (t0, t10 and t30) after cryolipolysis. Cryolipolysis did not change anthropometric measurements, body composition or lipid profile. Interestingly, the abdomen + flanks group had significantly increased plasma myeloperoxidase activity at t0, t10 and t30, and increased malondialdehyde levels at t0 and t10 when compared to the other groups. Furthermore, there were no differences between macronutrient intake and total energy value, physical activity level, malondialdehyde and interleukin-1ß at t30. Cryolipolysis did not change body composition, lipid profile or inflammatory markers investigated. On the other hand, when used on the abdomen and flanks, it produced an increase in lipid peroxidation markers, malondialdehyde and myeloperoxidase.

Cryolipolysis for local fat reduction in adults from Brazil: A single-arm intervention study.

BACKGROUND: Localized fat is a matter of great concern among individuals from today's society. Cryolipolysis is a noninvasive technique that have shown great results in reducing localized fat. AIMS: To analyze the efficacy of cryoplipolysis on visible local fat reduction in submental region, arms, or male breast (pseudogynecomastia) in Brazilian subjects, and to assess possible factors associated with treatment success. METHODS: Single-arm, nonrandomized trial, with volunteers from both genders with visible excess fat in the arms or submental region or men presenting pseudogynecomastia. Eligible subjects were submitted to physical, photographic, and ultrasound analysis before and three months after intervention. A single cryolipolysis session was performed using specific methods for each region, followed by a local massage for two minutes. Data were described as measures of central tendency and dispersion and measures of frequency. Reduction in measurements and factors associated with treatment success was analyzed using appropriate statistical tests. RESULTS: Thirty-six subjects underwent one session of cryolipolysis in each area (22 subjects treated the arms, 20 the submental region and 9 the breast). In general, a mean reduction of 19.1% was observed. Significant differences were observed for almost all body parts analyzed. Body mass index was the only variable showing a significant relationship with intervention results. CONCLUSIONS: Cryolipolysis is a useful noninvasive tool in reduction of visible localized fat in arms and submental region and of pseudogynecomastia. Obese subjects are not benefited by the treatment.

Effects of cryolipolysis on lower abdomen fat thickness of healthy women and patient satisfaction: a randomized controlled trial.

OBJECTIVE: To analyze the effects of cryolipolysis on the fat thickness of the lower abdomen of healthy women and patient's satisfaction. METHODS: Design and setting: a randomized controlled trial, with concealed allocation and blinded assessor. PARTICIPANTS: 34 healthy women between 18 and 48 years, skinfold in the lower abdomen ≥3cm, BMI between 18.5 and 27kg/m2, low level of physical activity, and no contraindication to cryolipolysis were allocated to intervention group (IG, n=17) or control group (CG, n=17). INTERVENTIONS: The IG received one session of cryolipolysis with -10°C of temperature for 50min. The CG was not submitted to any kind of intervention. Both groups did the evaluation protocols at baseline, 30, 60 and 90 days after the intervention. MAIN OUTCOME MEASURES: fat thickness was measured by ultrasonography (US), skinfold (SF) and abdominal circumference (AC1 and AC2). RESULTS: No significant differences between the IG and CG were demonstrated at any evaluation at any time of follow up for the variables US (30 days: 0.05cm (95%CI: -0.12; 0.22), 60 days: 0.05cm (95%CI: -0.11; 0.20) and 90 days: 0.04cm (95%CI: -0.7; 0.25)), SF (30 days: -0.09cm (95%CI: -0.25; 0.08), 60 days: -0.14cm (95%CI: -0.36; 0.09) and 90 days: -0.001cm (95%CI: -0.237; 0.234)), AC1 (30 days: 0.42cm (95%CI: -1.1; 1.9), 60 days: -0.1cm (95%CI: -1.74; 1.54) and 90 days: -0.007cm (-1.9; 1.9)) and AC2 (30 days: 0.183cm (95%CI: -0.84; 1.20), 60 days: -0.13cm (95%CI: -1.61; 1.35) and 90 days: -0.31cm (95%CI: -1.61; 1.00)). CONCLUSIONS: The current study showed that a single application of the utilized protocol of cryolipolysis does not produce any significant effect on fat thickness of the lower abdomen of healthy women. CLINICAL TRIAL REGISTRATION NUMBER: NCT03160976 (https://clinicaltrials.gov/ct2/show/NCT03160976). Contribution of the Paper: the study is one of the first studies in the literature with methodological rigor to report an unfavorable result for localized abdominal fat treatment with a single session of cryolipolysis.

Comparative thermographic analysis at pre- and postcryolipolysis treatment: Clinical case report.

INTRODUCTION: Although the exact cryolipolysis mechanisms on adipose tissue remain unknown, the current literature indicates that it may occur a crystallization followed by an ischemic reaction which generates an inflammatory process. OBJECTIVE: To evaluate thermographically, the tissue's circulatory pattern of a patient submitted to the cryolipolysis technique and the beginning of the inflammatory process, through variations of temperature gradients and the evaluation of the pains degree of the patient in these same moments. METHODS: A descriptive study, of an interventional case report, performed in an 18-year-old patient who had clearly visible fat in the lower abdomen area, with a skin fold greater than 2 centimeters and body mass index ≤ 30 kg/m2 . RESULTS: Comparing the maximum temperatures showed on the last thermography with the pre-application image, an increase of 0.4°C was observed, which is suggestive of abnormality. Regarding the minimum temperatures verified, there was a significative decrease in the temperature with the procedure, which was observed on the last 5 minutes (ΔT = 9.8°C). However, in 48 hour, the minimum temperature began to recover (ΔT = 0.3°C). CONCLUSION: The observed data indicate that there was a significant decrease in the temperature during the cooling phase, whereas in the recovery phase, the inverse was found.

Effects of contrast cryolipolysis on flank region adiposity: Case study.

BACKGROUND: The Contrast Cryolipolysis is a non-invasive technique that aims to reduce localized adiposity with its heating-cooling-heating method, resulting in a 45% fat loss in the treated area, with no damage to the skin. OBJECTIVE: To investigate the effects of contrast cryolipolysis compared to conventional cryolipolysis on localized adiposity. MATERIALS AND METHODS: This is a case study was carried out with two volunteers. The cirtometry, ultrasonography, and the anthropometric characteristics' analyses of volunteers were performed before and after the intervention. The right flank region underwent conventional cryolipolysis, and the left flank underwent contrast cryolipolysis. RESULTS: The procedures performed in both volunteers had positive results. However, the use of Contrast Cryolipolysis promoted greater loss of adipose tissue, reducing perimetry and cirtometry measurements, as well as the adipose tissue thickness, acknowledged via ultrasonography. CONCLUSION: The contrast cryolipolysis promotes greater localized adiposity reduction than the conventional cryolipolysis.

Noninvasive submental fat reduction using colder cryolipolysis.

BACKGROUND: Cryolipolysis has shown to significantly reduce localized subcutaneous fat, including submental fat. Temperatures below -11°C have not been used to treat the submental region. OBJECTIVE: The purpose of this study was to evaluate safety and efficacy of Cryolipolysis for noninvasive reduction of submental fat using lower temperatures and reduced treatment time. METHODS: A small volume applicator was used to treat 15 subjects, using a noninvasive tissue cooling device (CoolSculpting System, ZELTIQ Aesthetics, Pleasanton, CA, USA) during 45 and 30 minutes at -12 and -15°C, respectively, to induce reduction of submental fat. Two treatments with an interval of 10 weeks were performed. Adverse events were monitored to assess safety. Treated area was evaluated using digital photography, and caliper measurements prior treatment, 10 weeks after first treatment and 12 weeks after second treatment. All patients were also evaluated before and after 12-week postlast treatment by Magnetic Resonance Imaging (MRI). RESULTS: The mean (SD) reduction measured by skin fold caliper was 33% (3.2 mm [1.7 mm]), (95% CI, 0.2297-0.4236; P=.05), and by MRI, mean (SD) reduction was 1.78 mm (1.157 mm). Independent blinded panel was able to correctly identify 60% of before and after photographs; 12 of 15 subjects (80%) were satisfied or very satisfied with the treatment. Side effects were mild and resolved completely within 10 weeks, except for one hyperpigmentation, which resolved spontaneously within 6 months after last treatment. CONCLUSION: Cryolipolysis with colder temperature and reduced treatment time continues to be effective and is safe for noninvasive reduction of the submental fat.

Criolipólisis plana: efectos sobre el tejido adiposo en el área subumbilical de 38 pacientes. Observaciones clínicas de su aplicación / Cryolipolysis flat: Effects on adipose tissue in the subumbilical area of 38 patients. Clinical observations of its application

Se estudiaron 38 casos de pacientes controladas durante cuatro meses. Se seleccionó el área subumbilical para evaluar la acción clínica y comunicar las observaciones, sobre la aplicación de la criolipólisis plana en la piel y celular subcutáneo, como así también, los efectos adversos y otros no descritos.

We studied 38 cases of patients followed by four months. Only the subumbilical area was taken to evaluate the clinical action and to communicate the observations on the application of flat cryolipolysis in the subcutaneous skin and cellular, as well as the adverse effects and others not described.

Efeito da criolipólise na região abdominal / Effects of cryolipolysis in the abdominal region

O tecido adiposo forma uma camada abaixo da pele, na hipoderme, no qual se encontra o predomínio de adipócitos, um tipo de célula que acumula gotículas de lipídios em seu citoplasma. A técnica de criolipólise foi desenvolvida por pesquisadores da Universidade de Harvard, nos Estados Unidos, é um método não invasivo, que utiliza baixas temperaturas para eliminar a gordura localizada, assim não necessitando de anestesia ou qualquer substância injetável, indicado para pessoas que tenham gordura localizada, não sobrepeso. O objetivo desse trabalho foi verificar os resultados da criolipólise na região abdominal. Para realização do procedimento foram selecionadas três voluntarias do sexo feminino, com idades entre 26 e 34 anos, sendo as três com adiposidade localizada na região abdominal inferior e superior. Foi aplicado o procedimento de criolipólise no abdome, com duração de 60 minutos. Através da aplicação do procedimento podem-se observar resultados satisfatórios com a redução de medida. Assim conclui-se que o método de criolipólise foi eficaz na adiposidade localizada na região abdominal. (AU)

The adipose tissue forms a layer beneath the skin in the hypodermis, in which is the predominance of adipocytes, a type of cell that accumulates lipid droplets in its cytoplasm. The technique of cryolipolysis, developed at Harvard University in the United States, is a noninvasive method that uses low temperatures to eliminate localized fat, thus not requiring anesthesia or any injectable substance, indicated for people with localized fat, not for overweight. The aim of this study was to verify the results of cryolipolysis in the abdominal region. Three volunteers were selected to perform the procedure, with ages ranging from 26 to 34 years old, and three with adiposity located in the lower and upper abdominal regions. The cryolipolysis procedure was applied to the abdomen, with duration of 60 minutes. Through the application of the procedure satisfactory results could be observed with the measurement reduction. Thus, it was concluded that the cryolipolysis method was effective in localized adiposity in the abdominal region. (AU)

Infusão controlada de CO2 no tratamento de fibrose pós criolipólise / Controlled infusion of CO2 in fibrosis treatment after cryolipolysis

Introdução: A fibrose está associada à deposição excessiva de fibras da matriz extracelular, onde os fibroblastos são a principal fonte de produção de colágeno. Neste processo pode ocorrer uma disfunção e a produção de colágeno ocorrerá de forma desordenada. A infusão controlada de CO2 no tecido subcutâneo é um procedimento para fins terapêuticos visando a melhora dos sintomas de doenças inflamatórias e isquêmicas. Posteriormente, verificou-se que a infusão de CO2 através de agulhas melhorou não só a circulação sanguínea em tecidos isquêmicos, como aumentou o aporte de oxigênio localmente. O objetivo deste estudo foi avaliar a eficácia da aplicação da infusão controlada de CO2 em lesão fibrótica decorrente da aplicação de criolipólise. Métodos: Foi realizado um estudo descritivo. No relato em questão, a paciente apresentou fibrose na região tratada 15 dias após ter sido submetida à criolipólise. O tratamento proposto foi infusão controlada de CO2 associada à massagem Vibrocell®. Resultados: A partir da 5ª sessão foi observada redução do processo fibrótico. Conclusão: A associação dos procedimentos de infusão controlada de CO2 e Vibrocell® nos parâmetros apresentados neste relato de caso foram satisfatórios no tratamento da fibrose pós criolipólise com dissolução total após a 8ª sessão. (AU)

Introduction: Fibrosis is associated to excessive deposition of extracellular matrix fibers, where fibroblasts are the main source of collagen production. In this process the production of collagen can occur in disordered form. Controlled infusion of CO2 in the subcutaneous tissue is a procedure for therapeutic purposes aimed at improving the symptoms of inflammatory and ischemic diseases. Later, it was verified that CO2 infusion through needles not only improved the blood circulation in ischemic tissues, but also increased the oxygen supply locally. The objective of this study was to evaluate the efficacy of the controlled infusion of CO2 in fibrotic lesions due to cryolipolysis. Methods: A descriptive study was carried out. The patient presented fibrosis in the treated region 15 days after being submitted to cryolipolysis. The treatment was a controlled infusion of CO2 associated with Vibrocell® massage. Results: After the 5th session, the fibrotic process was reduced. Conclusion: The association of controlled infusion of CO2 and Vibrocell® in the parameters presented in this case were satisfactory in the treatment of fibrosis after cryolipolysis with total dissolution after the 8th session. (AU)