In 2010, the US Food and Drug Administration (FDA) approved cryolipolysis, a method developed a few years earlier by scientists at Massachusetts General Hospital and Harvard University in Boston. Also endorsed by the European Medicines Agency, it is an alternative to liposuction for the removal of localized fat, but without surgery, needles, or anesthesia and, consequently, without postoperative and recovery time. Fantastic. Millions of people annually undergo the procedure both in advanced aesthetic clinics and in modest beauty salons that use cheap equipment but without guarantees. A problem, because the technique is not innocuous and requires validation from the doctor.
Cryolipolysis is a non-invasive treatment that aims to eliminate fat by applying extremely cold plates (up to 11 degrees below zero) on fat cells. The cold produces apoptosis, "a kind of programmed death of the cell, it is induced to commit suicide," explains Dr. Susan Judas, from the Tufet clinic. The effects are not immediately visible. The body gradually eliminates the fat destroyed by the cold, the effects begin to be visible after three or four weeks and the process lasts about three months.
CoolSculpting (from Allergan Aesthetics, an AbbVie subsidiary) is the only FDA-cleared and EU-stamped cryolipolysis medical device. With it, 17 million treatments have been carried out worldwide, according to the company. The latest version of the machine costs more than 100,000 euros and the consumables are just as expensive.
However, the online offer of Chinese-made equipment that is advertised as “professional” at very cheap prices – a few thousand euros – is extensive. Even domestic equipment is advertised, such as "a freezing machine for fat loss at -5 degrees" for 63.95 euros. “The best thing that can happen to you with that is to waste time and money,” says Dr. Judas. "With a quality machine you can't offer sessions for 100 euros," she continues.
Indeed, beauty clinics value each session (if it works, a second intervention is not necessary) at a minimum of 350 euros depending on the area to be treated. But hairdressers and beauty centers have found a gold mine in the ease of acquiring a machine and the supposed security, which is not such, of the treatment.
In the absence of possibilities to practice liposuction, go ahead with false cryolipolysis. Cheap devices for getting cold through the skin without damaging its structures are useless at best. At worst, they can be dangerous. But for 25 euros, the price per session offered by a beauty salon in Murcia, zero guarantees can be expected.
According to EU documentation, cryolipolysis can cause mild side effects, most of which are transient, such as erythema, bruising, and swelling. But "important and long-lasting effects such as paradoxical adipose hyperplasia (PAH) are also reported." Allergan estimates this risk at 0.033% of treatments, one in 3,000, although there are higher risk estimates than those announced by the manufacturer.
Clínica Toscana was a pioneer in the use of CoolSculpting in Barcelona. "It works so much that, if you don't do it well and you go too far, you can take away more," says its medical director, Carlos Jarne, and points out that many doctors undergo this treatment at his center. But, he points out, "it is not suitable for everyone, it has side effects and a medical assessment is essential."
In eight years he has encountered a case of PAH, which consists of an effect opposite to the one sought: the adipose tissue grows in volume, hardens and forms a lump. It was solved, as in most cases, with the treatment that was intended to be avoided: liposuction. Scalpel. He wanted to biopsy the patient (not the client) to investigate the cause of the malfunction, but he refused. “I just wanted a solution and that's it,” Dr. Jarne recalls. Last year the Spanish Society of Aesthetic Medicine processed 500 complaints for intrusion, "which produces a generalized feeling of impunity and an erroneous perception of aesthetic medicine."
