Cryolipolisis is a non-invasive and non-surgical procedure that aims to extract fat cells from certain parts of the body. This technology has been making waves in the cosmetic and aesthetic world due to its non-invasive features with little to close to no downtime.
To further enlighten our readers on the topic, we’ve gotten in touch with Dr. Tingsong Lim, a seasoned expert in the medical aesthetic field and the Medical Director of Clique Clinic to share his insights. Dr. Lim sits on many global advisory boards for aesthetic medical treatments, and he has represented Asia in many international consensus meetings for aesthetic treatments.
What’s the story behind Cryolipolisis and how does it work?
Dr. Tingsong Lim: Cryolipolysis such as CoolSculpting is a technology invented and proposed by a few scientists (some of whom I know in person), one of them being Rox Anderson from Harvard Medical School. Scientists who were conducting research on fat reduction, initially they were looking at heat as a form of treatment to remove fat cells. This is because fat cells are very sensitive to temperature change.
Hence, they were looking at heat to see the effects of it on fats. However, the problem with using heat-based treatment is that fat cells (depending on certain body types), have a very efficient cooling system. When you have the heat in, the cooling system starts running and fights the heat. To bring the heat to a certain level that could actually cause the fat cells to go into the self-destruction process, it might be compromising in terms of safety. One may burn the skin before the fat cells are eliminated. In this context, there are a lot of variables to take into consideration.
Scientists started to look at the cold element when an interesting phenomenon took place. At Harvard’s Paediatric Department, popsicles were being used to treat babies with teething issues. When babies are teething, there tends to be inflammation and pain. As a result, babies would cry. To help the babies, popsicles were used because they were sweet and cold. However, experts at that time also noticed that when cold popsicles were used, it caused some inflammation in the fat cells called Popsicle panniculitis. This inflammation happens in the fat cells, and it also kills the fat cells. As a result, dimples are formed. This phenomenon eventually led to publications and pointed out a significant question: What if we look into using cold rather than heat-based treatment?
True enough, when a certain temperature drop is created about 10 degrees Celsius, it can cause fat cells to go into self-destruction mode, and in the medical term, we call it apoptosis. When the fat cells are frozen, they crystallise and then send a signal to the body to indicate that
the cell is defective. Once the signal is sent, a process will be started where the Deoxyribonucleic acid (DNA) will be switched off in the cells and the cells will die on their own.
When fat cells are killed forcefully (which is often the case in Liposuction), it can lead to overwhelming inflammation and sometimes it creates scar tissues. This can lead to conditions such as calcification or fat necrosis where the cells die unnaturally.
Whereas, in apoptosis, it can be said that the cells face natural death. When it comes to natural death, the body goes through a certain process to get rid of the dead cells. When it’s an unnatural death, the dead cells have nowhere to exit and this can cause overwhelming inflammation. As a result of the unnatural death of fat cells, there are a lot of side effects such as uneven skin, lumps, and hard tissues. As we grow, the fat cells grow alongside us. The growth of fat cells is also influenced by hormones. For example, people who grew up with a bigger physique tend to have a different body shape as compared to those who grew up slimmer.
In some cases, individuals who were previously overweight may still retain their body shape despite losing weight later in life. Other factors to take into account would be genetics as certain body types are determined by family genetics. Liposuction was used previously where the fat will be forcefully sucked and as a result of this trauma, the fat cells will die. Liposuction helps reshape the body. However, surgical methods come with a lot of risks and injection lipolysis causes a lot of complications. When cryolipolysis came about, it changed how we treat fats and how we sculpt the body. This was seen as a game changer when it first came out around 10 years ago.
When a certain temperature drop is created about 10 degrees celsius, it can cause fat cells to go into self-destruction mode, and in the medical term, we call it apoptosis.”
How many sessions is the procedure, and what are they like?
Dr. Lim: It’s all about planning. Cryolipolysis is just a tool that helps with body sculpting. The first step is to look at the body and identify the areas in which you want to address. In the areas of the body which are thicker, double dosing is usually required. Not all areas require double dosing, it also depends on the body shape as well. To sum it up, we need to look at the area that the patient wants to address, take note of the area size and plan out the designs using the appropriate tools to decide the areas where the patient wants to get rid of the fat. A general rule of thumb when it comes to one treatment of Cryolipolysis, is to take away about 20 percent of the fat depending on the person.
We also have to pay close attention to the consistency of fat as there is a superficial layer and a deep layer of fat. Cryolipolysis only targets the superficial fat pad, whereas the deep fat pad requires another modality to treat it. The templates are what we call the apparatus to measure and the applicators are the one that is put on during the Cryolipolysis treatment. Each applicator is designed in a certain shape to accommodate the different parts and angles of the body. The templates and applicators have also evolved since Cryolipolysis made its debut. The latest Cryolipolysis technology also has built-in artificial intelligence to enhance accuracy and consistency in the calculation of fat percentage to remove. This helps improve safety and makes the whole experience efficient.
Does Cryolipolysis work for everyone?
Dr. Lim: Firstly, it’s important to look at the end goal. For some body types, Cryolipolysis is effective in certain ways and may need to be accompanied by other forms of treatment. For example, if a person has deep fat pads, they can consider adding on sculpture. In another scenario, if a person is struggling with loose skin, the results can’t be seen evidently unless their skin is tightened.
Based on circumstances, we carry out a combination of treatments to ensure the results are visible. That being said, everybody is a potential candidate as cryolipolysis helps to take away or reduce fat. People with diabetes, hypertension, and other metabolic syndrome generally may benefit from Cryolipolysis because it will help to take away some fat cells. The more fat cells one has, the more lipotoxicity there is in the body. It should also be highlighted that if a diabetic person’s sugar level is not good, they should definitely control their sugar level first before going for treatments. This helps with the healing process.
Overall, there are no contraindications and everybody has the choice to do it except in very rare cases where an individual’s red blood cells crumble or succumb to the treatment when they get too cold. This is a very rare disease and it happens in a very small population in Europe. In fact, there are no real contraindications except for rare diseases. It’s also best recommended that before treatments if someone has any kind of disease or problems, they ought to check with a healthcare provider.
Can Cryolipolysis be categorised as a weight-loss treatment?
Dr. Lim: Cryolipolysis is never a weight loss treatment. It’s important to understand that slimming, body sculpting, muscle building, and body/skin tightening are all different types of treatments. These are the four categories when it comes to body aesthetics. These four categories are better known as SSTF which stands for Slim, Sculpt, Tone, and Firm. Cryolipolysis is not a weight loss programme. However, for people who are going into weight loss, it can help with issues such as love handles and boost overall confidence.
When the planning is done poorly and cryolipolysis is done incorrectly, indentations can happen. This is when the fat cells are removed incorrectly from an area of the body.
Are there any potential side effects or complications of Cryolipolysis?
Dr. Lim: There can be complications and side effects if Cryolipolysis is done incorrectly. When the planning is done poorly and Cryolipolysis is done incorrectly, indentations can happen. This is when the fat cells are removed incorrectly from an area of the body. In the past, with the initial stages of Cryolipolysis (the very first type), the skin is sucked in and it stretches the skin leading to trauma. When the collective tissue is broken (due to the trauma from stretching), the body will heal it and this then turns into scarring.
Initially, it looks as if the fat goes away, however, after that, the fat seemingly comes back bigger. This phenomenon is called paradoxical adipose hyperplasia. This was the initial term that was given for this phenomenon and it has continued to be used. However, it’s a misnomer. The adipose (body fat) didn’t get bigger, but the scar tissues inside give the impression that the fat cells have grown more. It’s not fat cells, it’s scarring.
With the new and evolved technology, we haven’t seen this phenomenon happen anymore. However, there are copycats out there who are still using the old versions of the technology. As a result of this, issues can arise. It’s important for people to look into the type of Cryolipolysis technology that is being used in the facility that they’re surveying alongside taking note of the facility’s track record and success rates.
What’s the recovery period for people who underwent Cryolipolysis?
Dr. Lim: The downtime used to be around four to 12 weeks with the older technology. Now, we have seen almost zero downtime. In fact, a lot of people can return to their daily work without many issues. It has evolved so much that nowadays it’s very comfortable and easy to do. Some people may experience mild bruising, swelling, or ache, but it is fast recovering.
How long do people have to wait before the results of Cryolipolysis can be seen?
Dr. Lim: Generally from what I’ve seen, people who exercise and are active tend to see results within a month. It can also take up to three months. However, it all depends on the activities carried out by the individual. Overall, it can take around one to two months for the results to be seen.
How much does the treatment cost?
Dr. Lim: It can cost anywhere between RM1,800 to RM2,500 per cycle. Overall, an individual needs around six to eight cycles. So, cumulatively, we’re looking at around RM8,000 onwards.
How long does its effects last?
Dr. Lim: Cryolipolysis is a permanent fat reduction treatment. However, if someone suddenly gains a lot of weight, this can impact fat cell growth and may cause an increase in overall body fat numbers.
