Cryolipolysis

A guide to understanding cryolipolysis

What is cryolipolysis

Cryolipolysis, also known as cryoadipolysis, originated in the United States when researchers from Harvard University and Massachusetts General Hospital observed that adipocytes (fat cells) are particularly sensitive to cold and undergo self-destruction—through a process known as apoptosis—when exposed to very low temperatures.

Based on this laboratory finding, researchers developed a device designed to harness this selective fat-destroying effect for aesthetic purposes. The result is a technology that incorporates a controlled cooling system capable of freezing adipocytes and inducing their selective destruction, without damaging the skin or surrounding tissues, thanks to the use of a protective insulating membrane that acts as a safety mechanism.

What the procedure involves

Cryolipolysis equipment includes different applicators designed to adapt to various body areas, such as the subgluteal fold (banana roll), abdomen, flanks, inner thighs, submental area, arms or saddlebags.

The session requires no specific preparation and does not involve anaesthesia or sedation. No needles, cannulas, electrical currents or energy sources are used. The procedure is carried out with the patient lying comfortably on a treatment couch and begins with the placement of a protective anti-freeze membrane to prevent skin damage.

Next, the appropriate applicator is positioned, and the specialist sets the target temperature for the session, which typically ranges between 0°C and –10°C, depending on the treatment area. The applicator applies vacuum suction to the tissue and delivers controlled cooling, which freezes the subcutaneous fat. During the session—which lasts between 35 and 75 minutes, depending on the area treated—the patient does not need to do anything.

Although the treatment is not painful, some patients report a sensation of tightness or mild discomfort during the first 10 minutes due to the vacuum suction. This sensation usually subsides quickly, as the cold itself produces a natural anaesthetic effect.

Effects of cryolipolysis

Once fat cells crystallise as a result of cooling, apoptosis (programmed cell death) occurs. Macrophages then eliminate these damaged adipocytes through natural physiological pathways, primarily via the lymphatic system, as well as through urine and sweat. This process takes place gradually over the two to three months following treatment, which is when definitive results become visible.

At that point, a comprehensive assessment is carried out to evaluate outcomes. Fat layer thickness reduction can be objectively measured using ultrasound and is also clearly visible to the naked eye. If necessary, a second session may be scheduled. The number of sessions varies depending on the volume of fat to be treated: while many patients achieve satisfactory results with a single session, two to three sessions are most commonly required.

After the cryolipolysis session

Cryolipolysis is a highly safe treatment that does not require prior preparation or recovery time. There is no need for sick leave, and patients can resume their normal daily activities immediately after the session. One of its main advantages over other localised fat treatments is that the results are permanent, as the destroyed adipocytes do not regenerate. The procedure is suitable for both men and women, with particularly noticeable results in areas such as the abdomen, flanks, back and saddlebags

“In general, the best results are achieved by combining several therapeutic options and acting early.”

Contraindications

Cryolipolysis shares the usual contraindications associated with body aesthetic treatments that use technology. These include pregnancy and breastfeeding, fever or active infections, open wounds or active skin lesions in the treatment area, recurrent skin conditions, coagulation disorders, cancer, immunosuppression and significant scarring. In addition, it is contraindicated in patients with cold-related conditions, such as cold urticaria, hypersensitivity to low temperatures, Raynaud’s disease (a rare vascular disorder affecting the fingers and toes that worsens with cold exposure) and cryoglobulinaemia (abnormal production of cold-induced immunoglobulins that can lead to tissue necrosis).

Recovery after cryolipolysis

Cryolipolysis is a quick and safe procedure. After the session, patients typically notice redness in the area where the applicator and protective membrane were applied. Occasionally, a small bruise may appear due to the suction. It is common to experience a sensation of numbness or increased sensitivity in the treated area as a result of the low temperatures used. This gradually resolves over 7–10 days following treatment.

In very rare cases, superficial skin lesions may occur, usually due to incorrect placement of the protective membrane. This risk is easily avoided by careful positioning and ensuring sufficient time is taken to place the membrane correctly before starting the session.

A very uncommon side effect known as Paradoxical Adipose Hyperplasia (PAH) has been described. As the name suggests, this condition involves an increase rather than a reduction in fat volume in the treated area due to adipocyte proliferation.

PAH is extremely rare. A recent multicentre review reports an incidence of approximately one case per 4,000 procedures. It is more common in men, does not pose a health risk and can be effectively treated with liposuction.

In addition to its very low incidence, available data indicate that PAH is significantly less frequent with modern cryolipolysis devices. Although Grupo Pedro Jaén has not recorded any cases throughout all the years this treatment has been performed, it is important to note that this adverse effect does not compromise patient health and, crucially, our Body Aesthetics specialists are fully trained to manage and resolve it should it occur.

More information

Below are some key considerations regarding cryolipolysis, as well as the authorship and references supporting the information provided on this page: