What is cellulite?
The Hypodermis consists of small ‘Recesses ‘or ‘lobules’ which are separated by bands of fibrous tissue called septa. In men these tend to run in line with the skin but in women these bands are perpendicular to the skin. Cellulite results from both a build-up of fat in the adipose tissue (the hypodermic fat cells) and water retention around the dermis and hypodermis. If adipocytes increase their volume, as happens with weight gain, and if water accumulates in these recesses, then the walls are compressed, damaging the microcirculation and their natural form of the cell.
Because these walls are attached to the dermis in the anchor points, they pull the skin surface, whilst fat cells push towards the dermis. In other words when the adipocytes get bigger or the oedema increases ‘the envelopes’ containing them change shape and pull on the anchor points of the skin.
The result is a skin surface that takes on a bumpy orange peel appearance. Over time the condition worsens, fat and water become wholly enclosed in a prison of always hardened septa, which is comprised of fibrous connective tissue.
How can targeted cold help
The cold creates an imbalance inside the adipocyte leading to the fat content changing its chemical structure, causing the cell to increase its metabolism and to expel small droplets of fat. The process is known as blebbing. At this point the adipocyte cell membrane is still intact, but as the cellular stress increases the blebbing increases to such a degree the cell membrane will rupture. The fat cells is excreted from the adipocytes alongside the broken fat cells, and then are eliminated through the lymphatic system.
Specifically related to cellulite the cold is absorbed by the absorbed by the fibrous connective branches, which causes the solubilisation of the collagen with consequent debridement of the tight non elastic weft that strangles the lobules. The solubilisation of collagen, in addition to producing the loss of the pitted appearance of the skin, also makes it possible to reactivate the fibroblasts which are stimulated to produce new, more elastic collagen.
The cold technology causes immediate collagen fibre, shrinking in the dermis with a consequent tightening.
The final effect is the improvement of sin laxity and the visible result in the disappearance of the orange peel effect.
1. Hochsinger C. Über eine akute kongelative Zllgewebsverhärtung in der Submentalregion bei indern [in German]. Mschr Kinderheilk 1902;1: 323–7.
2. Jalian HR, Avram MM. Cryolipolysis: a historical perspective and current clinical practice. Semin Cutan Med Surg 2013;32:31–4.
3. Manstein D, Laubach H, Watanabe K, Farinelli W, et al. Selective cryolysis: a novel method of non-invasive fat removal. Lasers Surg Med 2008;40:595–604.
4. Zelickson B, Egbert BM, Preciado J, Allison J, et al. Cryolipolysis for noninvasive fat cell destruction: initial results from a pig model. Dermatol Surg 2009;35:1462–70.
5. Dover J, Burns J, Coleman S, Fitzpatrick R, et al. A prospective clinical study of noninvasive cryolipolysis for subcutaneous fat layer reduction—interim report of available subject data. Presented at: Annual Meeting of the American Society for Laser Medicine and Surgery; April 28, 2009; National Harbor, MD.
6. Klein KB, Zelickson B, Riopelle JG, Okamoto E, et al. Non-invasive cryolipolysis for subcutaneous fat reduction does not affect serum lipid levels or liver function tests. Lasers Surg Med 2009;41:785–90.
7. Coleman SR, Sachdeva K, Egbert BM, Preciado J, et al. Clinical efﬁcacy of noninvasive cryolipolysis and its effects on peripheral nerves. Aesthetic Plast Surg 2009;33:482–8.
8. Mayoral F, Kaminer M, Kilmer S, et al. Effect of multiple cryolipolysis treatments on the abdomen. Presented at: Annual Meeting of the American Society for Laser Medicine and Surgery; April 28, 2012; Kissimmee, FL.
9. Shek SY, Chan NP, Chan HH. Non-invasive cryolipolysis for body contouring in Chinese—a ﬁrst commercial experience. Lasers Surg Med 2012;44:125–30.
10. Stevens WG, Pietrzak LK, Spring MA. Broad overview of a clinical and commercial experience with CoolSculpting. Aesthet Surg J 2013;33: 835–46.
11. Stevens WG, Bachelor EP. Cryolipolysis surface applicator for noninvasive fat reduction in the outer thigh. Presented at: Annual Meeting of the American Society for Laser Medicine and Surgery ;April28,2014; Phoenix, AZ.
12. Carruthers J, Carruthers A. The effect of full-face broadband light treatments alone and in combination with bilateral crow’s feet Botulinum toxin type A chemodenervation. Dermatol Surg 2004;30: 355–66.
13. Fabi SG, Massaki A, Eimpunth S, Pogoda J, et al. Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle reduction of the décolletage. J Am Acad Dermatol 2013;69: 965–71.
14. Edwards AF, Massaki AB, Fabi S, Goldman M. Clinical efﬁcacy and safety evaluation of a monopolar radiofrequency device with a new vibration handpiece for the treatment of facial skin laxity: a 10 month experience with 64 patients. Dermatol Surg 2013;39:104–10.
15. Dobke MK, Hitchcock T, Misell L, Sasaki GH. Tissue restructuring by energy-based surgical tools. Clin Plast Surg 2012;39:399–408.
16. QuanT,WangF,ShaoY,RittiéL,etal.Enhancing structural support of the dermal micro environment activates ﬁbro blasts, endo the lialcells,and keratinocytes in aged human skin in vivo. J Invest Dermatol 2013;133: 658–67.
17. Garibyan L, Sipprell WH III, Jalian HR, Sakamoto FH, et al. Three dimensional volumetric quantiﬁcation off at loss following cryolipolysis. Lasers Surg Med 2014;46:75–80.
18. Sasaki GH. Quantiﬁcation of human abdominal tissue tightening and contraction after component treatments with 1064-nm/1320-nm laserassisted lipolysis: clinical implications. Aesthet Surg J 2010;30:239–45