Patient Information Leaflet
Cryolipolysis (Fat Freezing)
If you are considering having Cryolipolysis treatment, we recommend that you read the following information. This will help you to be fully prepared, know what questions to ask and what you should expect from your practitioner or therapist. Prior to treatment, you should have a face-to-face consultation with your treating practitioner or therapist and be offered a cooling off period before returning for treatment. This will allow you time to consider your decision carefully based on the information you have been provided with.
Cryolipolysis, also known as fat freezing or cryogenic lipolysis, was first developed in 2008 and is a relatively new technology for non-surgical fat reduction. It is a non-invasive procedure where targeted fat cells beneath the skin are subjected to sub-zero temperatures (generally between -4 and -10oC) which causes lipolysis (the breakdown of the fat cells) without causing damage to the skin or surrounding tissues when the precise suction, temperature and exposure are controlled.
The average person has approximately 30 billion fat cells in the body, weighing about 13.5kg. When we diet, the fat content in individual fat cells (adipocytes) is reduced, leading to weight loss and reduction in size of fat compartments, however the fat cells remain in the body. If calorific intake increases without increasing exercise, these fat cells will store fat and increase in size, leading to weight gain and an increase in fat content.
Although cryolipolysis physically destroys fat cells, it is still possible for fat compartments to increase in size to the levels before treatment or greater as the remaining fat cells can swell considerably. Although fat cells cannot multiply, unlike most other cells within the body, once they have increased to approximately 170% of their normal size, new fat cells are produced from pre-adipocytes, leading to a higher number of fat cells. It is important that a good diet and exercise, or further treatments, are adopted to maintain fat reduction post treatment.
There is little recovery time or side effects from cryolipolysis, making it a popular treatment. Results are not instant, as it takes between 2 – 4 months for the fat cells to be removed by the body. Cryolipolysis can effectively destroy between 20 – 40% of fat cells in a treatment area. It can also be combined with other treatments, such as ultrasound cavitation and intralipotherapy, to achieve optimum results.
Make sure you understand why cryolipolysis may be suitable for you and alternative options.
Cryolipolysis works best when applied to superficial fat pockets and can be described as sculpting and refinement for those wishing to target stubborn areas of concern. It is not suitable for general weight loss and is most effective in targeting specific mild to moderate bulges of fat in otherwise healthy individuals.
- Love handles/flanks
- Muffin tops
- Back fat
- Arms/Bingo wings
- Double chin
Ensure cryolipolysis is an effective treatment for the area you want fat reduction.
The cryolipolysis procedure involves the use of an applicator that delivers a gentle vacuum pressure that draws up tissue between cooling plates which create sub-zero temperatures. This low temperature causes thermal damage to fat cells, causing them to crystalise, expand and burst, without causing damage to the skin or subcutaneous tissue. The treated fat cells are removed through natural metabolic processes within the body over time allowing a gradual reduction in fat from targeted areas to create a slimmer, more defined appearance. The procedure generally takes about 30 – 60 minutes to perform and more than one treatment may be required. It can be combined with other treatments to achieve better results. The interval between repeat cryolipolysis treatments is generally a minimum of 6 weeks, although different body areas may be treated within this time. There are many different cryolipolysis devices on the market, which vary according to the number of handpieces attached, range of size and shape of handpieces, suction, temperature, treatment time and cost.
Cryolipolysis treatments are usually painless, but you will experience a slightly unpleasant feeling of your skin and fat being sucked into an applicator handpiece once it has been applied. You will also feel an extreme cold sensation that can be a little uncomfortable at first but then often becomes more of a numbness sensation. However, if you do experience more discomfort than you would expect or any distress during the procedure, you must inform your practitioner or therapist immediately as this may indicate that the vacuum has not been applied correctly or the settings are incorrect.
Immediately after treatment, the skin may be a little reddened, will feel extremely cold and likely be quite numb, although the sensation and temperature normally returns to normal within a few minutes.
The procedure is non-invasive and considered safe, with few associated risks, providing a thorough medical history has been taken and considered prior to treatment commencing. It is imperative that an anti-freeze pad or gel is applied prior to treatment to prevent skin damage by direct contact with the freezing plates of the cryolipolysis handpiece. Your practitioner or therapist should use the appropriate handpiece and apply the correct settings based on the area to be treated, amount of fat and medical considerations to minimise potential adverse effects.
Side-effects may be more likely due to the following factors:
- Patient factors: Location and amount of fat present, lifestyle factors, diet, age, certain medical conditions, certain medications.
- Practitioner factors: Training, years of experience, number of procedures performed.
- Premises factors: Suitability of the environment.
Cryolipolysis has very few complications, however no treatment is without risk and these should be discussed during your consultation.
We recommend that treatments are performed in a suitable clinical environment.
Possible adverse effects include:
- Pain/Tenderness: You may experience some minor tenderness, discomfort, aching or stinging post-treatment. In rare occasions, this may last for several weeks. If you do have more pain than expected, it is important to contact your treating practitioner or therapist.
- Redness: Following treatment, it is normal for the skin to appear quite red. This normally settles within a couple of hours but can occasionally persist for longer.
- Swelling: Any treatment which causes controlled trauma to the skin or tissues can lead to swelling. Following cryolipolysis, this is usually minor and generally settles within a few days.
- Bruising: Due to the suction applied, this can sometimes lead to trauma and bruising of the skin. The risk of bruising is increased if the handpiece is not placed correctly, if the settings are incorrect or if there is not sufficient fat for the applicator head. If bruising occurs, you should contact your treating practitioner or therapist for a review.
- Skin sensitivity: Rarely, cryolipolysis can cause damage to a sensory nerve in the area treated resulting in hypersensitivity which may manifest as a burning, stinging, electric shock, or excessive physical sensitivity (hyperaesthesia) of the area. If this occurs, it is likely to take several weeks or months to resolve and if it persists for more than 12 months, may become permanent.
- Dimpling/Irregularities: Due to the nature of a cryolipolysis treatment, not all fat cells are exposed to the same degree of freezing and may not respond equally to the procedure, which can result in irregularities once the results become apparent. Further intervention may be required to achieve a smoother, more cosmetically acceptable result either using cryolipolysis or another treatment modality.
- Paradoxical Adipose Hyperplasia (PAH): This is an extremely rare adverse effect of cryolipolysis with a reported incidence of 0.0051% and is caused by the freezing process creating a reactionary process in the fatty tissue that thickens and expands the fat cells rather than destroying them. It typically presents about 6 months post-treatment, is more common in males, and is identified as the increase in fat corresponds exactly with the area treated. If this occurs, it is important to arrange a review with your treating practitioner or therapist. It is not recommended that further cryolipolysis is used to treat this adverse effect as this may cause further complication, but other treatments may be possible.
- Skin Damage/Necrosis: Although cryolipolysis is considered safe, it is possible to cause damage to the overlying skin akin to frostbite. This can lead to skin damage, ulceration, and scarring. You must seek a review with your treating practitioner or therapist if this occurs as good wound management may prevent scarring.
If you develop any unexpected side-effects after treatment, it is important to contact your practitioner or therapist for a review as soon as possible, as they may be able to offer some corrective treatment. Although your practitioner or therapist may contact you by telephone or video call initially or you may send your own photographs, this is no substitute for a face-to-face review to provide an accurate diagnosis.
Your practitioner or therapist should provide you with an out of hour’s emergency number.
Prior to your treatment you should have a consultation with your practitioner or therapist to explain the procedure, advise on expected results, address your expectations, and discuss alternative treatment options. For cryolipolysis to be a suitable treatment, there needs to be enough fatty tissue that can be sucked into the applicator head and your practitioner or therapist should assess this during your consultation. You will need to complete a medical questionnaire to ensure that you are suitable for treatment and should be offered a cooling off period to enable you to make an informed decision with full disclosure of the possible risks and side effects specific to you. You should also be informed of the cost of the treatment. Before your cryolipolysis procedure, you will be required to sign a consent form, this may be on paper or electronic, and be given the opportunity to ask any further questions. Measurements will often be taken prior to treatment which may include your weight, Body Mass Index, thickness of fat usually recorded using calipers, biometric profile and photographs. As well as forming part of your medical record, these measurements are useful for monitoring improvement over time. Photographs should not be used for any other purpose without your explicit permission.
Do not feel pressurised or coerced into having treatment at the same time as your consultation.
Before the treatment is carried out, you should be made comfortable and warm, as you can feel cold during the procedure. The practitioner or therapist may mark out the treatment area with a pen or pencil. If there is any false tan or body creams over the treatment area, this should be removed prior to treatment. An anti-freeze pad or gel should be correctly applied to the skin before the applicator handpiece is placed over the area. The practitioner or therapist should record the details of the pad or gel used. This is used as a barrier to protect the skin from damage due to the freezing process and will initially feel cold and slippery. Depending on the area being treated, one or two handpieces may be used. Once the cryolipolysis device is started, you will experience a pulling sensation as your skin is sucked into the handpiece followed by a cold sensation. A normal treatment will often last between 30 to 60 minutes depending on the type of machine that is used, and the area being treated. Once the treatment has been completed, the vacuum is switched off, the applicator removed, and the area cleaned to remove any gel.
When the device is removed, the treatment area may feel solid or slightly frozen and have taken on the shape of the treatment applicator. Massage may be applied but this will return to its normal appearance within a few minutes. The skin will initially feel very cold and be pink or red. There may be some aching, spasm, tenderness or altered sensation for the first few days, but normal activities can be resumed immediately. Cryolipolysis has been clinically proven to remove up to 40% of fat cells after one treatment. Compared to other fat reduction treatments, cryolipolysis has little downtime, no need for anaesthesia, no incisions, and no difficult aftercare such as exercise or having to wear compression garments.
Most people will achieve a noticeable and satisfying improvement over time, however like many body treatments, some people do respond better than others.
As cryolipolysis is non-invasive, most people are suitable for this treatment, particularly those who do not want or are precluded from an invasive procedure. However, you may not be suitable if any of the following applies:
- If you are pregnant, breast-feeding, actively trying to conceive, or undergoing IVF.
- If you have eczema, dermatitis, sunburn, or previous radiation therapy in the treatment area.
- If you have certain medical conditions, such as liver or kidney problems, poorly controlled diabetes, blood clotting disorders, cancer (undergoing radiotherapy or chemotherapy), diseases affecting the lymphatic system, or immunosuppression (either medical or drug-related).
- If you suffer from Raynaud’s phenomena, peripheral vascular disease, diabetic neuropathy, cold urticaria, cold agglutin disease, cryoglobulinemia or paroxysmal cold haemoglobinuria.
- If you are suffering from any skin infection or inflammation in the treatment area.
- If you are unwell, including coughs and colds, on the day of treatment.
- If you have a pacemaker or metal implant near the site where you are having treatment.
- If you have a large amount of weight to lose.
- Body dysmorphia or certain mental illnesses.
- If you are under the age of 18 years.
It is important to be honest about your medical history, previous procedures, skin care products used and any medication taken so that you can have a safe and effective treatment.
- Avoid alcohol consumption for 3 days prior to treatment, as the liver must deal with metabolism of the released fat. You should also consider that alcohol contains empty calories and consumption is not conducive to weight loss treatments.
- You should aim to drink a litre of water before treatment and to maintain good hydration and fluid intake over the next few days to aid elimination of fat.
- Reduce your intake of other toxins, including caffeine and smoking.
- Reduce your intake of refined carbohydrates with a low fibre content.
- Implement healthy diet and lifestyle changes to enhance fat loss. Your practitioner or therapist should be able to provide you with relevant advice specific to your needs.
- Discuss any medical or aesthetic treatments that you are planning with your practitioner or therapist before treatment so these can be taken into consideration.
- If you are unwell on the day of your appointment, contact the practitioner or therapist to reschedule.
- Avoid sunbeds and tanning for 1 week before and after treatment.
- Ensure your practitioner or therapist is informed if there are any changes to your medical history or medication taken before receiving any treatment.
- Do not plan to have treatment within 2 weeks of an important social event or holiday as this may not allow enough time for side-effects to settle or to have a review appointment.
After treatment, most people can resume their normal daily activities although immediately after cryolipolysis, there may be some redness, tenderness and swelling at the treatment site.
Although there is little evidence, many practitioners advise the following:
- Drink at least 2 litres of water per day to aid with the elimination of fat.
- Make dietary and lifestyle modifications to help achieve your desired results.
- Reduce alcohol consumption for 8-12 weeks.
- Avoid saunas, swimming pools and sunbeds until the initial swelling and redness has settled.
- Contact your practitioner or therapist if you experience any unwanted side-effects.
Ensure you know the following information:
- Practitioner’s/therapist’s full name
- Practitioner’s/therapist’s profession/qualifications
- Practitioner’s/therapist’s contact details (address, telephone number, and email)
- An emergency contact number in case a complication occurs.
If you are not happy with your treatment outcome, you should attempt to resolve this with your treating practitioner or therapist in the first instance. If you need to see a different person, you are entitled to receive a copy of your treatment record outlining the treatment area, device used, and settings, to have your concerns addressed safely. However, remedial treatment may not always be possible. Sometimes it may be necessary to allow time for the side-effects to wear off. Practitioners and therapists are legally required to have indemnity insurance in place for all the treatments they perform which you can confirm at your initial consultation.