Non-surgical, non-invasive cosmetic treatments, including non-surgical fat reduction and body contouring are highly appealing to a lot of people. Fear of pain or discomfort, along with the length of recovery and downtime are major obstacles for most people. That is why there is a whole industry dedicated to non-invasive treatments, promising to deliver all the benefits of traditional procedures, but none of the invasiveness or downsides.

There are thousands of dramatic before and after pictures floating around the internet promising incredible results from these quick, cheap, painless treatments. But is the treatment really the best option for fat removal?

Cryolipolysis

Cryolipolysis also known as Coolsculpting is a real, scientifically proven fat reduction treatment. This technique uses a special machine to lower the temperature of the fat and tissue of a specific area to 4 degrees celsius. At this temperature, tissue does not freeze and is otherwise not harmed. (Disclaimer: there are many knock-off or cheap cryolipolysis machines out there that are not safe and can actually cause freeze injuries). At 4 degrees celsius, fat cells (adipocytes) are made to undergo apoptosis (programmed cell death) while the remaining cells are left unharmed. In short, cryolipolysis freezes and kills fat cells without injuring surrounding cells.

The depth of the cooling is the key to the limitation of this procedure. Obviously you can’t cool the entire body to 4 degrees celsius or you would die of hypothermia. With this procedure, only the targeted area’s cells are affected. And within that area, only 20% of the cells are killed. Because of this the results are very minimal, and are usually only very noticeable on a very lean individual with very little external fat. A person with a lot of external fat undergoing this treatment will also have their superficial fat cells killed off, but proportionally, it is an insignificant amount and the result will be nearly invisible.

Some patients will continue to come back for many treatments to remove more fat little by little. In theory that could work, but to have the same dramatic effect as liposuction that would mean hundreds of thousands of dollars spent on hundreds of hours of treatments. Each applicator treatment costs approximately $5,000-$7,000 for a small area (inner thigh, chin, flank). The marketing of this treatment by cosmetic clinics is often the largest contributor to the issue by being quite misleading and unrealistic. Bigger, more business-oriented cosmetic clinics will spend a lot of money on marketing these products in order to book as many patients as possible. Worse yet, they will take on anyone willing to pay, even if they are not candidates for the treatment.

According to Plastic and Reconstructive Surgeon Dr. Martin Jugenburg, “Offering this technique ended up attracting patients looking for large volume non-surgical fat reduction/fat loss. Our cryolipolysis consultations became rejection sessions for those patients who we knew wouldn’t be happy with their results. Unlike other clinics that would take anyone who was willing to pay, we were turning people away all the time. There is no amount of money that can make me take on a patient who is bound to be disappointed by their treatment.”

Having seen the very limited improvements it created, he returned to fine-tuning his surgical liposuction technique to be able to offer treatments to lean patients for much cheaper than what these non-surgical treatments offer.

Risks and Complications

While cryolipolysis is a non-surgical relatively safe procedure, like any treatment, it does have potential risks and complications. The most common complication after cryolipolysis is temporary neurogenic pain in the treated area, which tends to resolve after a few weeks. The most serious complication would be a freeze burn, from an improperly applied applicator, malfunctioning device, or a knock-off device that has not been safety approved. Another potential complication is PAH (Paradoxical Adipose Hyperplasia). This is a situation where' instead of reducing fat, the treatment causes fat increase! Most recently, this complication made headlines around the world when supermodel Linda Evangelista claimed cryolipolysis left her deformed because of PAH. When PAH happens, patients are referred to a plastic surgeon for liposuction of the area to improve the contour

Ideal Candidates

The ideal patient selection for this treatment is someone who is at their ideal weight and has a small area of stubborn fat that they can’t get rid of. They should have realistic expectations and understand that the fat reduction will be minimal. Patients who wish to remove a lot of fat, or who have a lot of excess skin, are not ideal candidates for this procedure, and would not see any significant improvements. Unfortunately, too many clinics still take on these patients even though they know that spending thousands of dollars on these treatments will not improve their conditions.

Dr. Jugenburg says, “Unfortunately, I have seen many patients who are clearly not candidates, but were charged tens of thousands of dollars to continue undergoing treatments that could never work for them. If something seems too good to be true, it is. And non-invasive cosmetic procedures are no exception. I find that really great liposuction performed by an expert surgeon offers the best results for the lowest price.”

If you are still considering choosing cryolipolysis, remember that the amount of fat reduction is very minimal and may not be noticeable in most people. It is ideal for lean patients looking for a specific spot reduction in fat, rather than generalised fat reduction. Keeping your desired body goal in mind, it may be beneficial to have a consultation with a plastic surgeon to review your goals and see what your best options are. In order to achieve visible changes multiple treatments may be required, each with its own cost. These costs add up and end up being equal to surgical treatment, while producing a less significant fat reduction. Liposuction by a plastic surgeon is more effective per dollar spent, more immediate, and able to treat a much larger area, more fat, and result in a significantly more visible transformation.