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What are the side effects of cryolipolysis?



Aug 11, 2010
Very popular in aesthetic clinics, this procedure has generated doubts in researchers regarding responses to treatment. Know more!

Increasing dissatisfaction with body image has led in the past decade to advances in the search for less invasive cosmetic treatments for localized fat reduction. Among other techniques, cryolipolysis has emerged as a new body contouring method that uses controlled cooling to selectively destroy fat cells; with the objective of serving the public who, even practicing exercises and having a relatively healthy diet, feel the need to burn "that fat" located.

Although the exact mechanisms of cryolipolysis on the subcutaneous tissue remain unknown, the current literature indicates that a crystallization of the adipose tissue accompanied by an ischemic lesion can occur, which generates an inflammatory process. It is known that the greater the degree of inflammation, the more immune defense mechanisms present in the tissue will be required to return to normal. For this reason, this article for iHealth aims to document the main hypotheses about cellular changes that develop in adipose tissue, due to the cryolipolysis technique.

According to the studies, the reduction or fat accumulation in adipose tissue at different body sites is dependent on the ability to produce enzymatic lipolysis in adipocytes (cells that store fats and regulate body temperature),transforming the triglycerides into glycerol and free fatty acids. Lipolysis occurs through neurotransmitters of endogenous catecholamines (eg, epinephrine) that bind regularly to beta adrenergic receptors on the surface of adipocytes and stimulate the lipolytic pathways. However, in areas where adipocytes exhibit a relatively low sensitivity to catecholamines, there is less ability of this lipolytic response, which leads to localized adiposity.

Expanding reports that fat cells may be preferentially sensitive to cold injury, a study subjected pigs to prolonged skin cooling to investigate apoptosis of adipocytes and to observe, until then, possible clinical or histological damage over the skin. According to their investigations, immediately after treatment, there are no noticeable changes in subcutaneous fat. However, within 3 days after treatment, there is evidence of an inflammatory process stimulated by apoptosis of adipocytes, reflected by an influx of inflammatory cells.

Fourteen days after performing the technique, the peak of inflammation occurs. At this stage, the adipocytes are surrounded by histiocytes, neutrophils, lymphocytes and other monomorphonuclear cells. Between 14 and 30 days, macrophages and other phagocytes surround, phagocyte and digest the contents of dead cells as part of the natural response to rid the body of unwanted material. Around 60 to 90 days, the inflammatory response seems to decrease, the volume of the fat cells reduces, and a thickening between the interlobular septa. The dissolution of adipocytes occurs gradually over a period of months, and the consistency of lipid levels in the following exposure to cold suggests a safe metabolism.

Another hypothesis investigated proposes that suction vacuum with heat extraction (induced by the cryolipolysis apparatus) prevents blood flow and induces the crystallization of target adipose tissue (from fat cells) when cryolipolysis is performed. According to some researchers, when cold ischemic injury occurs (absence of blood supply at low temperature),there is the possibility of promoting a cellular lesion in adipose tissue, causing a reduction of Na-K-ATPase activity, decreasing levels of triphosphate adenosine and lactic acid that were elevated, thus releasing mitochondrial free radicals. (There may also be generation of toxic oxygen radicals, which may contribute to the death of fat cells.)

Theoretically, the process of apoptosis of adipocytes and compensation of the released lipid should result in elevation of lipids in the blood serum. However, human studies have reported that there were no significant changes in mean values observed for any level of blood lipids or liver test at any point or over the 12-week follow-up period, making the technique safe.

Thus, although cryolipolysis has increased in popularity, is considered effective and has a low prevalence of adverse events, the transformations that occur in the human body are still not well reported. It is important to carry out new research that focuses on unraveling the cellular and molecular changes resulting from this process so that this technique is used with greater safety and for the side effects to be avoided.


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