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CoolSculpting ®

CoolSculpting® is a cryolysis, or fat freezing device, and concept trademarked by Zeltiq Ltd.

The clinical science, which led to the development of their cryolipolysis technique and the CoolSculpting device, was first in 2008. Dieter Manstein MD, PhD and R. Rox Anderson and their team demonstrated that under conditions, fat cells between the skin and muscle layers, (i.e. fat), is more vulnerable to the effects of cold than other . They also showed that cooling of these fat cells can cause them to reduce in number, without else in the area.

This process was to as `selective cryolysis`. Where `cryo` refers to cold and `lysis` refers to the disruption of a cell wall which leads to its disintegration.

Zeltiq began this treatment as cryolipolysis or cryolipo. It is now part of the of treatments from Aesthetics, the makers of and Juvederm®.

The device uses a variety of applicator heads for tissue-cooling, down to −7°C, and is by an monitoring system.

By the to the area, the tissue is drawn into the shape under vacuum and held in place between two cooling panels. Then, energy, in the form of heat, is from the area and the fatty tissue is cooled.

Sensors in the applicator heads the skin temperature during the procedure to ensure a controlled and consistent . can be adjusted treatment thanks to this feedback from the sensors
The CoolSculpting device comes with a of applicators for targeting different areas of and some clinics may have more at their disposal than others.

• CoolMini™ is ideal for small areas of fat, double chin
• CoolCurve+™ is ideal for curves, such as the flank area (love or muffin tops).
• CoolCore™ is most used for the abdomen.
• Petite™ Applicator is designed to treat upper arms.
• CoolAdvantage™ Applicator is a newer with interchangeable and is ideal for the abdomen, flanks and inner thighs and claims to treat in nearly half the time of previous models.
• CoolFit™ Applicator features a flat applicator design ideal for longer, vertical areas of fat, such as the inner thighs.
• PRO™ Applicator features a unique conformable flat applicator design ideal for non-pinchable fat, such as outer thighs.

• CoolMax™ is ideal for large volume .

using the CoolSculpting device, is a fat . It is the cooling of the subcutaneous fat cells, which induces lipolysis, the down of the fat cells by crystallising them, damaging any of the tissue or the skin. Following the procedure, the fat breaks down over a period of two to four months, resulting in fat loss that appears entirely .

During treatment, a gel pad is applied to skin and the applicator head is positioned and applied. This draws in the tissue in the area being targeted using vacuum, and the controlled cooling can then be applied.

European CE Mark approved in 2009.

U.S. FDA (Food & Drug Administration) approval in September 2010 for the of fat for the flank area (or love handles), May 2012 for the reduction of fat for the area (belly fat), April 2014 to treat the thigh area, September 2015 for treating fat (double chins), April 2016 for the treatment of fat bulges of bra fat, back fat and the buttocks (also known as banana roll) and January 2017 for of the upper arms.

Trained professionals, including doctors and nurses, as well as .

Cryolipolysis is used to reduce fat in areas of the body where there is `pinchable` deposits of fatty tissue, such as on the abdomen, back, thighs, hips, legs, arms and chin.

Ideal candidates have small, stubborn areas of fat and are generally fit and healthy. Common areas to treat include love handles, bra bulges, saddle bags, bingo wings, or muffins tops that are not easily reduced through diet and . As well as post pregnancy tummies where small accumulations of fatty tissue have .

It is not as a weight loss solution, and it is not for large areas of fat, where liposuction may be more appropriate. It is suitable for all skin types and can be used to treat both men and women.

Results from cryolipolysis will begin to show approximately 3 weeks after treatment, with more results apparent after 2 months. The metabolism of the damaged fat cells will continue for up to 4 or 6 months after treatment, so expect to see your final results after around half a year.

The fat cells do not regrow or return, therefore the treatment is considered permanent. Maintaining a diet and lifestyle is important to avoid weight gain in the fat cells.

Cryolipolysis is generally well tolerated. You will feel an intense cold sensation as the begins but this usually within 5 to 10 minutes as the area being targeted is numbed. As the draws in the tissue within the area being treated you will also feel a sensation akin to or mild pinching. Other possible include tingling, stinging, aching or OmniSculpt – Toning/Sculpting cramping as the gets underway.

Most people are happy to be doing other things during treatment, such as read, use mobile devices or even have a rest and nap as the treatment is well .

Many return to their normal straight away afterwards with little downtime . Expect to temporary side including redness, bruising, swelling, tingling, blanching to the skin, tenderness, itching and to the area. You may find your skin is sensitive to the touch. If you have treatment to reduce a double chin, then you may experience a sensation of in the back of the throat. All these sensations and side effects should resolve within a few days, or up to a week after your session.

Although rare, cases of pain and adipose hyperplasia (PAH), where of more fatty tissue appears in the treated area, have been reported post CoolSculpting procedures. PAH is a more common in men than women, and can be successfully with .

Other rare, but potential side effects include, first or second degree burns (frostbite), due to placement of the applicator, hyperpigmentation of the skin in the area (dark patches), or during and hernia.

As long as you are generally and don`t have any skin diseases or infections in the area treated, there are few reasons why you should not this treatment.

Pregnant and breast feeding women are not candidates.

You should also not have the procedure if you have a known to cold, impaired tissue sensitivities, or suffer from cryoglobulinemia (a type of vasculitis), cold disease (a rare blood disease), or paroxysmal cold (also known as syndrome). Please check with your GP if you are unsure about any health concerns you may have.

Due to the risks associated with adipose hyperplasia, and the anatomical in fat between men and women, some men may not be suitable for treatment. Current clinical advice by American Dermatologist, Dr. Terrence Keaney et al in 2016 notes that "careful patient selection avoiding men with visceral abdominal adipose and firm, non-distensible, fibrous fat may be important to minimise the risk of paradoxical adipose hyperplasia".

 The time taken for a treatment will depend upon the size and number of areas being targeted. Multiple areas can be at one visit, on the indication, and the applicators available to the clinic. Newer models of the devices also offer shorter treatment times. A normal session for one area should take between 30 and 60 minutes.

The number of sessions will depend on the area being treated, but most require between 1 and 3 .

The cost of treatment on the size and number of areas being treated. Most people have more than one area of their body treated and a plan can be drawn up for this. Expect to pay between £1,500 and £3,500 for most typical treatment plans.

 (Before, left, After, right) 5 weeks after CoolSculpting treatment
Photos courtesy of Dr. Tracy at The Cosmetic Skin Clinic, Buckinghamshire.

(All before and after photographs are real patients, your results may differ).

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