Other noninvasive body-contouring methods that have been described with varying degrees of success include infrared light, lasers, radiofrequency, massage, and even high-frequency ultrasound techniques, yet their long-term viability and consistency in results have not been proven. Cryolipolysis is a recent technology used for controlled, natural, and selective fat reduction utilizing localized cooling to extract heat from adipocytes. Although there are no established, formal indications of when to use this technology, it is used in a variety of clinical situations, from the patient who desires scarless reduction of adipose tissue to those who are unfit to tolerate the anesthesia required for more invasive forms of liposuction. Cryolipolysis
Although the exact mechanism is still being studied, Cryolipolysis works at a cellular level by an overarching theme of inflammation followed by phagocytosis and apoptosis. The basic principles of cryobiology date back to the 1960s when research in rapid freezing and concurrent ischemia were being studied. Adipose tissue, as compared to other tissues, is more sensitive to cold temperatures. Studies performed in porcine and in vitro models, with histological and pathological studies, confirm this cell response. Adipose cells undergo an inflammatory response after exposure to cold temperatures (-1 to -7°C) within the first 72 hours, peaking at 14 days after treatment. Between 14 and 30 days, phagocytosis of adipose cells begins. By 60 to 90 days, the inflammatory process declines and the adipose cell volume decreases with concurrent interlobular septal thickening. This roughly 90-day cycle results in selective subcutaneous fat layer reduction. Cryolipolysis
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