When you first read about it, the appeal of fat freezing, also known as cryolipolysis, may seem irresistible: shorter downtime, less discomfort and a lower price tag than liposuction.
So, why don’t we offer this option to our New York liposuction patients?
First, it can be helpful to understand a bit about the economics. When a medical device manufacturer develops technology for a new aesthetic procedure, the equipment often comes with a hefty price tag. A cosmetic surgery practice that opts to acquire the equipment must then recoup the outlay. No matter how effective (or not) the new procedure proves to be over time, the practice needs to market it in order to cover the cost of the technology. Priding ourselves on complete honesty, we don’t want to be in this position with our patients.
The idea behind CoolSculpting, the branded procedure employing cryolipolysis equipment made by Zeltiq Aesthetics, a subsidiary of Allergan, seems to make sense. The applicator chills fat cells deep under the skin, the cells die and are processed out of the body over the course of a few weeks or months. But the RealSelf “worth it” rating hovers around 70%. In our view, that’s just not good enough.
What are the leading reasons some people are dissatisfied with the results of cryolipolysis?
Cost vs. Benefit
Even doctors who are fans of CoolSculpting acknowledge that treatment only removes 20-30% of fat in the target area, compared to up to 90% for liposuction. That means 2-3 sessions for many people, and at an average of around $2000 per treatment, it’s easy to spend more than anticipated.
It takes weeks or months to see results with cryolipolysis since it takes time for the body to cleanse itself of dead fat cells. On the other hand, fat is immediately banished with liposuction, and though there is inevitable swelling, most of our New York liposuction patients notice a difference right away.
Although most CoolSculpting patients seem to suffer just mild discomfort during and after treatment, some experience unexpected intense pain several days after treatment. This delayed-onset pain, says one RealSelf plastic surgeon, “can last 10 days or so.” Because CoolSculpting is billed as a non-invasive liposuction alternative, people tend not to expect this side effect.
An Unexpected Outcome
A new complication of cryolipolysis has surfaced fairly recently. It’s called paradoxical adipose hyperplasia (PAH), and is thoroughly discussed in this article in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons.
The article characterizes PAH as “an enlarged, firm, well-demarcated mass of subcutaneous tissue, or, as one RealSelf reviewer put it, “a large, protruding gross lump of firm fat!” Though the occurrence of PAH is relatively rare, the authors of the journal article note that it’s a “very upsetting” complication and presents a “significant burden” to those unlucky enough to experience it. Treatment is usually liposuction.
One woman in Kansas who developed PAH has now filed a lawsuit against her cosmetic surgery clinic for not warning her about this possible side effect. We can’t comment on whether the lawsuit has merit, of course, but it’s worth noting that the article in Plastic and Reconstructive Surgery mentions that the incidence of PAH seems to be underreported, and it “may occur more frequently than in the manufacturer’s reported data.”
To Sum it All Up
We are always on the lookout for promising new treatments to offer our patients, especially less invasive options. But given that when patients walk through our door, they’re entrusting us with not only their wallet but their health, our standards for taking on new technology are very high.
We know that many people with small, localized fat deposits have been pleased with the results of cryolipolysis. But we have also noticed reviewers who comment “disappointed” and even “waste of money.”
When we perform liposuction in New York, we don’t worry that patients will have less than favorable reactions. The procedure is tried-and-true, downtime is usually just a few days, discomfort is quite tolerable and the fat cells are gone immediately and forever. And, given our thirty years of experience with liposuction for women and men, including revision liposuction for those dissatisfied with their first cosmetic surgeon, we know we can deliver the expected results.
Why not come in for a consultation and find out why we remain so enthusiastic about liposuction?