Cryolipolysis: The Science Behind Fat Freezing

Cryolipolysis is the technical, scientific term for fat cell death triggered through cold. It’s also the technical term for the CoolSculpting procedure! When you break down the word, “cryo” means cold and “lipolysis” is “to break apart fat”.

The mechanism of action behind the CoolSculpting technology originates from 2 well-known academic dermatologists – Dieter Manstein and Rox Anderson from Massachusetts General Hospital and Harvard Medical School. These forward-thinking scientists developed the idea of a fat freezing technique after noting two case studies of fat loss due to cold. Let’s dive deep into it.

The Science Behind CoolSculpting

Popsicle panniculitis – In 1970, The New England Journal of Medicine published a study on what was thereafter termed Popsicle panniculitis. In the study, an infant had inflammation of the subcutaneous fat (the squishy, sponge-like fat… more on that later) after a popsicle rested on her cheek for about 5 minutes. This was the first instance noted of fat having a relationship with cold.

Equestrian cold panniculitis – In 1980, Jama Dermatology published the 2nd case of patients with inflammation due to cold exposure (this time, also in combination with equestrian activities – or riding on horseback in the wintertime). Here, 4 healthy women who rode horses for 2+ consecutive hours a day through the winter had some quite interesting side effects! At first, they had several, small spots of red & itchy skin on the outer thigh (ahem, saddlebags) on one or both of their legs. During one week, side effects progressed to include swelling, bruising and tenderness (referred to as “red-to-violaceous, tender plaques and nodules”). When looked at under a microscope in the study, you could see obvious inflammation of veins at the dermal-subcutaneous fat junction – or where the skin meets the fat layer. P.S. – they also discussed how the tight-fitting, un-insulated riding pants could have slowed blood flow through the skin, helping reduce the temperature in the tissue and heightening the effects of the cold.

So bring it home, already… What this showed is that the cold-fat relationship was not limited to infancy/childhood! And that we can wear yoga tights as pants in the winter. “Allegedly” … (*Of course that’s not backed by science. It’s a joke).

Cryolipolysis Made Its Debut

After putting 2 and 2 together and understanding that fat is certainly impacted by cold, our forward-thinking inventors of the CoolSculpting technology published their own study. In 2008, the first proof of the concept of cryolipolysis was introduced in Lasers in Surgery and Medicine, a scientific journal. This was an effort to establish a new (potential) non-invasive treatment aimed at site-specific fat cell death.

Basically, these geniuses realized that if they could figure out how to sculpt away pockets of fat using cold (which is also a natural anesthetic), they’d be sitting on a big ole’ pot of gold. They tested their theory on Black Yucatan pigs by putting them under general anesthesia and using specific spots to test different temperatures (varying between 20 and -7 degrees Celsius for about 10 minutes). What happened? Obvious loss of several millimeters of fat (gradually) over the course of about 3.5 months!

They also noted a thickening of the fibrous septae (the stuff that connects your skin to the rest of your fascia). Under closer look, there was no evidence of injury to skin, no scaring, serum lipids weren’t impacted – and ultimately, it was shown that you’re pretty much only impacting the adipose, or fat, tissue. They closed their study by basically saying – yep, cold kills fat and we need to look further into this.

And With That, CoolSculpting Technology Was Born

From these studies, using crylipolysis, the CoolSculpting technology was developed and is now the same system that is currently being marketed today.

You know how Bandaid is the name brand for a bandage? CoolSculpting is the gold-standard name brand for cryolipolysis. In fact, Allergan (the owners of CoolSculpting) hold the exclusive, worldwide patent for cryolipolysis technology until 2029! So you might as well save your money and avoid those at-home CoolSculpting gimmicks you’ve seen on the Internet.

Then in 2009…

Another study helped put some extra knowledge about the histological (or under-the-microscope) response of the fat cells after a CoolSculpting treatment. This study basically puts a story-board together of the inflammatory response of the fat directly below the skin during the apoptotic cascade (aka the fat’s funeral procession).

The study showed that immediately after treatment, the fat cells look totally normal, despite having a fatal injury. Why? Because the injury is subtle, and the cells are technically still alive.

Fast forward 3 days, and you’ll see your first evidence of pending fat cell death – where there’s an invasion of inflammatory cells in the fatty tissue. Then, at 7-days post procedure there’s obvious inflammation and if magnified, you can see the dead fat cells and the nuclei of the inflammatory cells. The inflammation runs rampant and gets more intense over the course of 30 days – and the fat cells change to be an irregular shape. BONUS – the fat starts disappearing after 30 days and continue to disappear as they’re flushed out and removed from the body. By 90 days post-CoolSculpting, most of the dead fat cells are gone. There’s also an obvious change in the density of the connective tissue between the fat and skin – which translates in layman’s terms to thicker, healthier looking skin.

With ultrasound imaging, you could see a 33% decrease in the fat layer thickness at 90 days. In biopsy, you could see the superficial fat layer reduced about 1cm (or 50%!!) at 3 months. Once again, no damage to the skin, nerves, or muscle in this study.

The Safest and Most Proven Technology in Non-Invasive Fat Reduction

CoolSculpting is the world’s #1 non-surgical option for fat reduction because of the enormous amount of research behind the technology itself. It’s the safest and most proven option available on the market, with over 100 peer-reviewed publications to date.

Even the effects of CoolSculpting on nerve function have been tested. Results show short-term changes in the peripheral nerve fibers that resolve shortly after treatment. Basically, patients notice fleeting changes in sensation (or feel a little numb to touch) after being treated with CoolSculpting as a normal side effect. All sensations returned on average at about 3.5 weeks after CoolSculpting treatment according to studies and self-reported experience. Biopsy results show that there were minimal effects of CoolSculpting (aka cryolipolysis) on the epidermal nerve fibers in the skin. Translation? Expect to be numb for about 3.5 weeks, and don’t count on any long-term change in skin or surrounding tissue after your CoolSculpting treatment.

As far as CoolSculpting results in scientific studies, 86% of patients treated achieved reduction in the fat thickness layer (they were all treated in the abdomen and flank / love handles). The technology has come a long way over time and at Element Body Lab, our results are backed by our Body Lab Promise so you know your investment is protected.

Finally, long-term results have been studied proving that the technology works over time, despite fluctuations in weight and size. In 2016, Dr. Bernstein published his findings showing continued visible differences at 6 and 9 years post-treatment! (As an FYI – that’s been as long as CoolSculpting’s been around.)

Why Freezing Fat Works…

The lipids within the adipose cells (or fatty tissue) crystalize at a warmer temperature than ice crystals in water. Think about this… Olive oil hardens in the refrigerator, but water stays in its same liquid state. That’s because fat is hyper-sensitive to cold. This is exactly what allows us to treat non-surgically through the skin layer – impacting fat and sparing the surrounding skin, muscle, nerve, etc.

The subtle injury to the fat alone causes the cells to go through “apoptosis” or natural, programmed cell death which happens in the first few days. The rest of the process basically relies on your wound-healing response, where your inflammatory cells digest between 20-25% of the treated fat cells and you eliminate them, gradually over time through your lymphatic system after cryolipolysis.

Element Body Lab – The Dallas CoolSculpting Experts

The process itself is scientific, but the artistry of picking the right tools and the right treatment plan do impact your results and overall satisfaction with your CoolSculpting experience.

We at Element Body Lab pride ourselves on offering the best customer service, the highest trained providers who understand the extensive knowledge behind the CoolSculpting technology, and to provide Dallas with the absolute best body sculpting experience possible. Give us a call to learn more about the treatment at 214-897-3006 from the Dallas CoolSculpting Experts.

Until then,
Happy freezing

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