Cryolipolysis (IceBerg)

Selective cryolipolysis appears, at short-term follow-up, to reliably decrease subcutaneous tissue deposits. Reported complications are uncommon and appear to resolve without intervention.
The most common adverse effect is diminished sensation lasting greater than 4 weeks, followed by persistent pain lasting longer than 14 days.
Other reported complications (0.14% or less) were: paradoxical adipose hyperplasia (PAH), visible contour irregularities, pain sufficient enough to abort the procedure, vasovagal reaction, and post-treatment anxiety, bloating, nausea, and pruritis.
Inflammatory response begins on day 3 and peaks around day 14 to remove damaged adipocytes. The resolution of inflammation and lipid metabolism is thought to be completed by 3 months after treatment.
Both animal and human studies confirm that adipocyte damage does not lead to abnormal lipid levels or liver function.
Many researchers note that cryolipolysis is ideal for fit persons with focal lipodystrophy, not individuals with elevated BMI.

Cryolipolysis, when used for reduction of subcutaneous flank fat, is not associated with changes in blood lipid level or liver test at any point over the 12-week follow-up period.

Histological analysis 2–3 months after cryolipolysis shows a significant reduction in the distance between the adipose tissue septa, and no changes in the lipid profile. Just one session leads to a reduction in the thickness of body fat by up to 20%, and the effects are visible after 3–4 months. Cryolipolysis is known for its good efficacy and safety profile; the side effects reported so far are insignificant.

In a systematic review by Kennedy et al., cryolipolysis has been found to be superior to low-level laser therapy, radio frequency, and high intensity focused ultrasound, in achieving fat reduction on abdomen area.
Cryolipolysis also consistently achieves the highest patient satisfaction rate, from 80-100% satisfaction. This is recommended as the first line treatment for non-invasive fat reduction.
The good safety profile is one of the advantages of cryolipolysis, if compared to invasive methods. The side effects which reported in literature were mild and temporary, such as erythema, hematoma, sensibility alteration, and pain. These side effects usually resolve within 14 days after the treatment.
Hypersensitivity and hyposensitivity to stimulus were found in some clinical trials but did not result in permanent disabilities and improved within 1 month. Coleman et al. reported that alteration in skin sensibility would be resolved within 3-6 weeks and biopsy of peripheral nerves at 3 months post treatment revealed no damage or permanent effect in peripheral nerves. Furthermore, pain during treatment was reported as tolerable in 96% of cases.
No pigmentary changes were reported post-treatment in all skin types.
Those studies revealed that cryolipolysis in an Asian population with darker skin type has the same efficacy and safety profiles as Caucasian population.

Average reduction in caliper measurement ranged from 14.67 percent to 28.5 percent. Average reduction by ultrasound ranged from 10.3 percent to 25.5 percent. No significant impact on lipid levels or liver function tests after cryolipolysis treatments was noted in any study. Only mild, short-term side effects, such as erythema, swelling, and pain, were noted. Paradoxical adipose hyperplasia was described in one patient.

According to the existing evidences in animal and human studies, some of the noninvasive techniques such as cryolipolysis, RF, LLLT and HIFU have shown statistically significant effects on body contouring, removing unwanted fat and cellulite. However, the reported effects of such devices were mild to moderate and the mentioned methods have little or no effect on body weight reduction and total percentage of body fat. On average, circumference reduction after noninvasive methods was 2 – 4 cm.

Cryolipolysis Supporting Research