The market for aesthetic medicine is developing in an incredible way. Today, grooming is an indispensable attribute of a successful person. And we are talking about this in a complex way: both the face and the body should be well-groomed. Despite intense physical activity, proper nutrition and the use of many hardware methods, we still cannot achieve ideal body curves.
That is why hundreds of medical minds around the world are working every day to improve methods and develop new ones in order to finally close the issue with excess local fat deposits. Maria Sergeeva – dermatologist, specialist in anti-age medicine, member of AAAM, IPS, EADV, UADV, IALMS, chief medical consultant of "Ukrainian Aesthetics" company.
Why careful approach to choosing a cryolipolysis machine is important
So, today we will talk about one of the most effective methods of working with adipose tissue – cryolipolysis. This innovative non-invasive technique was first introduced by Manstein et al. in 2007. This technique is performed by applying the applicator to a certain area with a given temperature for a set time, affecting adipocytes while maintaining the integrity of the skin, nerves, blood vessels and muscles.
Cryolipolysis is becoming one of the most popular alternatives to liposuction for zonal fat reduction.
It so happened that in my arsenal since 2013 there were more than 10 cryolipolysis devices, more than 1000 procedures were performed. Acting as an expert for several companies, repeatedly had to work with complications. Thanks to this, I was the first doctor who raised the topic of complications after cryolipolysis at the AMWC 2015, Monaco and IMCAS 2017, Paris congresses, proposing methods for preventing and treating the undesirable consequences of this technology. The international response has been overwhelming. This turned out to be a global problem when using equipment from dubious manufacturers.
The safety of our patients should always come first, so I have been very careful in choosing the ideal device for my patients. The device of choice was CRIOCUUM from TERMOSALUD, which represents our doctors "Ukrainian Aesthetics".
What is the essence of cryolipolysis, and what are the requirements for the apparatus for its implementation
What is TERMOSALUD CRIOCUUM? This is a device for local correction of excess deposits of subcutaneous adipose tissue, which allows you to guarantee the elimination of 45% of the volume of the grip of the maniple in one procedure.
When exposed to very low temperatures (down to -100C) for a long time (on average 45 minutes), crystallization of adipose tissue occurs, while there is no long-term effect on the overlying epidermal and dermal structures. However, this ischemic cold injury can cause cellular damage in adipose tissue via cellular edema. Na-K-ATPase activity decreases, adenosine triphosphate decreases, lactic acid levels increase and mitochondrial free radicals are released.
Another theory of mechanism of action exists that suggests that the initial crystallization and ischemic cold injury that occurs in cryolipolysis later combines with ischemic reperfusion to cause the production of reactive oxygen species, an increase in cytosolic calcium, and activation of the apoptosis pathway.
Ultimately, crystallization and ischemic cold injury of target adipocytes induces apoptosis of these cells and the claimed inflammatory response, which is subsequently accompanied by the removal of damaged cells from the affected area within several weeks. Histological studies show that within 3 months, macrophages are mainly responsible for cleaning the tissue from damaged cells and their decay products.
Clinical studies have shown no significant changes in lipid levels and liver function tests after cryolipolysis.
The result of the procedure is already visually determined after 1-2 months (Fig. 1). To protect the epidermis and dermis from exposure to low temperatures, a special antifreeze membrane is used, so only adipocytes remain under the gun.
Fig. 1. The result of 1 procedure after 2 months. Therapy of 4 zones: upper and lower abdominal, left and right lateral areas of the abdomen
A feature of CRIOCUUM is the control of the necessary therapy parameters. The set temperature is clearly regulated by touch sensors around the entire perimeter of the maniple, which excludes its decrease to critically low numbers, leading to frostbite. The negative pressure with which vacuum capture is performed directly depends on the thickness of the fat fold, which accordingly affects the condition of the vessels and the subsequent result of therapy.
Cryolipolysis protocol and patient selection principles
Ideal patient for CRIOCUUM cryolipolysis – this is a patient with localized excess fat deposits. If the diagnosis – obesity, then cryolipolysis therapy is inappropriate. The clinical result will not have a significant impact on the overall aesthetic picture. It is also worth noting that cryolipolysis does not work with visceral fat, so "beer tummies" will be able to get fat reduction only at the subcutaneous level.
It is extremely important to understand the contraindications to the procedure:
• impaired microcirculation in the area of planned exposure, Raynaud's syndrome;
• coagulopathy;
• postherpetic neuralgia;
• diabetic polyneuropathy;
• cold urticaria and other hypersensitivity reactions to exposure to low temperatures;
• acute dermatoses in the area of the procedure;
• open wounds, scars and hernias in the affected area.
Cryolipolysis Protocol:
1. Photodocumentation and measurements (fat fold thickness and circumference).
2. An antifreeze membrane impregnated with antifreeze gel is applied to the correction zone.
3. Setting therapy parameters: temperature and negative pressure, which varies depending on the thickness of the fat fold.
4. Installation of the maniple and vacuum capture of the fat fold (Fig. 2).
5. Exposure 45-60 min.
6. Remove the manipula and massage the area for 1-2 minutes to restore tissue temperature and increase the effectiveness of the procedure.<
Fig. 2. Vacuum capture of the fat fold was performed. The handpiece is installed on an antifreeze membrane
Low profile of adverse events after the cryolipolysis procedure – this is one of the main advantages of the technique, especially when compared with invasive therapies. But here the manufacturer of the apparatus for this method plays a key role.
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