Cryodermadstringo, Skin Tightening From Cryolipolysis, Observed in CoolSculpting® PatientsJuly 8, 2014,
Patients Undergoing Fat Reduction Procedure May Experience Skin Tightening
Marina del Rey, CA – June 30, 2014 – In a letter to the editor, published in Aesthetic Surgery Journal, Grant Stevens, MD, FACS, Marina Plastic Surgery Associates, an expert in cryolipolysis used with the body contouring CoolSculpting® System from Zeltiq Aesthetics, reports patient skin tightening following the procedure. Cleared by the FDA, CoolSculpting is a noninvasive method for selective fat reduction on the body. This nonsurgical procedure uses controlled cooling to reduce subcutaneous fat without inducing damage to surrounding tissue.
“This letter to the editor presents the first report on cryodermadstringo, skin tightening from cryolipolysis, and is intended to raise awareness of a phenomenon observed in practice but not yet published in the scientific literature,” Dr. Stevens said. “Cryolipolysis is an established, safe and effective procedure for nonsurgical fat reduction. Moreover, it can achieve clinically significant skin tightening results. A clinical research study is currently under way to explore cryolipolysis-induced skin tightening hypotheses, to obtain quantitative objective measurements of skin tightening and to establish the mechanism of action.”
While cryolipolysis is well established as a nonsurgical method for fat reduction, it has not been documented as a skin tightening procedure until now. To illustrate the skin tightening phenomenon often observed in cryolipolysis patients at this practice, two patients are presented. In addition to the expected reduction in fat layer thickness, the patients attained visible skin tightening in the treatment areas. Cryolipolysis treatments were delivered to targeted areas for fat reduction per standard treatment cycles for 60 minutes duration. A vacuum applicator pulled the targeted tissue into an applicator cup with parallel, temperature controlled cooling plates. In addition to the anticipated fat reduction following treatment, skin tightening in the cryolipolysis treatment area was observed.
“While there were only two patients mentioned, the improvement in skin appearance following cryolipolysis was anecdotally reported in many patients. We estimate that a quarter of our cryolipolysis patients show cryodermadstringo, or skin tightening,” Dr. Stevens said.
Cryolipolysis produced significant volume reduction and skin tightening after four months in one female patient. For the second female patient, the large fat volume loss did not result in skin laxity; instead, four months after treatment, the tightened skin adhered well to her new body contours. Pronounced skin folds, evident in pretreatment photos, were no longer visible post treatment.
“The resultant skin tightening has been observed in patients with skin laxity, regardless of age, and does not appear to be treatment site specific. At this point, it is unknown how predictable the skin tightening results are and how other factors, such as patient age, skin condition, number of cryolipolysis cycles and duration after treatment, may affect the resultant skin tightening,” Dr. Stevens said.
A planned study will objectively quantify both fat reduction and skin tightening following cryolipolysis in a larger patient population. Dr. Stevens says this is necessary because the mechanism by which cryolipolysis induces skin tightening is not known. The improved appearance in the skin may not actually be skin tightening but perhaps dermal thickening, resulting in an improved appearance to thin, crepey skin. The change in skin firmness may be the result of stimulated collagen production, new elastin formation, fibrosis or tissue compaction. Histology analysis from previous studies has shown that the epidermis, dermis and underlying muscle tissue were not affected in the cryolipolysis treatment sites. In addition, histologic analysis demonstrated that with the selective removal of adipocytes, the thickness of interlobular septa increased at 90 days post treatment. Additional histology analysis from clinical studies is needed to further investigate the changes to the skin and fat layers following cryolipolysis.
Dr. Stevens is the founder and medical director of Marina Plastic Surgery in Marina del Rey, California. He is also the Chairman of the USC-Marina Aesthetic Surgery Fellowship and the Director of the USC Division of Aesthetic Surgery. He is a Clinical Professor of Surgery at the USC Keck School of Medicine, Division of Plastic Surgery. He is a board certified Diplomate of the American Board of Plastic Surgery, a Fellow of the American College of Surgeons and the International College of Surgeons. Dr. Stevens is on the Board of Directors of the American Society of Aesthetic Plastic Surgery and the International Society of Aesthetic Plastic Surgery where he serves as one of the International Traveling Professors.