Cryolipolysis to reduce cellulite through cold.

The cellulite refers to a skin alteration that primarily appears in women postpubertal, with a prevalence of 70 to 80% and can occur on the pelvis, lower limbs, and abdomen. Cellulite is characterized by irregular, bumpy skin often described as “orange peel,” visible as small dimples and protrusions on the skin’s surface. Depending on its stage, it may be visible only when the skin is pinched or constantly present. There are different types of cellulite, mainly adipose, aqueous, and fibrous, each with a specific mechanism.

The adipose cellulite is linked to lipid overload It involves an increase in adipocyte volume, the hypodermal cells that compress adjacent tissues and impair blood and lymphatic circulation. The aqueous cellulite, on the other hand, is due to circulatory issues and water retention. It is linked to impaired venous and lymphatic return, causing tissue swelling by fluid infiltration. The fibrous cellulite is a deep-seated, firm, sometimes painful form that can take on a purplish tint. It results from the hardening of collagen fibers surrounding adipocytes in the hypodermis. This hardening is linked to a glycation process in which sugars bind to the fibers, altering their structure and flexibility.

Cryolipolysis is a noninvasive technique that involves exposing fat cells to intense cold to destroy them. A device is used during a cryolipolysis session to apply targeted cooling to the desired areas. Skin and fat cell temperatures drop to between -5 and -10°C. Fat cells are more sensitive to cold than other skin cells because they consist of lipids with a higher freezing point. At this temperature, lipids form ice crystals. This crystallization damages adipocyte cell membranes and disrupts their integrity. Apoptosis, a mechanism of cell death, begins and releases fats from the cells into the body, where they are eliminated by the lymphatic system over the following weeks. Results do not appear immediately. It takes one to three months for the cells to break down and evacuate naturally.

Although its main use is reducing localized fat deposits, some studies suggest it may have an indirect beneficial effect on the appearance of cellulite adipose. When these cells are destroyed by cold, the amount of fat in the treated area decreases, which may reduce the appearance of dimpling.

A study published in Dermatologic Surgery aimed to assess cryolipolysis efficacy for reducing fat deposits and its effects on skin texture, laxity, and cellulite. After 16 weeks, 11 subjects who underwent cryolipolysis reported a notable improvement in skin firmness and elasticity, as well as reduced thigh dimpling, rated on a scale of 0 to 3 (3 indicating significant improvement). On average, cellulite improvement was rated at 1.5, suggesting a moderate effect. However, some participants observed a greater improvement, ranging from moderate to significant (score of 2 to 3).

These findings should be interpreted with caution, as the small sample size and few studies do not confirm the direct effectiveness of cryolipolysis in reducing cellulite.

This technique is suitable for treating body areas such as the abdomen, inner thighs, back, love handles, and infragluteal folds. It is contraindicated during pregnancy and breastfeeding. It is also unsuitable for individuals prone to cold-related conditions such as cold urticaria or hernias.

Scientists report that cells that die cannot reproduce. However, if a person regains weight, since remaining cells can still expand, new unsightly areas may appear. Cryolipolysis yields satisfactory results on adipose cellulite. It is less effective on aqueous cellulite caused by poor circulation or fluid retention. It does not affect fibrous cellulite, which is painful and long-standing.

Side effects may appear after treatment, such as redness or slight swelling at the treated site. Some people report discomfort. Sometimes they experience pain or tingling, including burns, peripheral sensory neuropathies, hyperpigmentation or inguinal hernias at the treated site. These issues subside after 15 days. The dermatologist examines the skin before cryolipolysis to prevent them.

• VERGNANINI A. L. & al. Cellulite: a review. Journal of the European Academy of Dermatology and Venereology (2002).

• HUMPHREY S. & al. Cryolipolysis and Skin Tightening. Dermatologic Surgery (2014).

• NAOURI M. Efficacité de la cryolipolyse Cristal™. Étude rétrospective sur 1 an chez des patients ayant payé leur traitement. Annales de Dermatologie et de Vénéréologie (2015).

• MISHRA V. & al. Cellulite: a review with a focus on subcision. Clinical, Cosmetic and Investigational Dermatology (2017).

• KAMINER M. S. & al. Insights Into the Pathophysiology of Cellulite: A Review. Dermatologic Surgery (2020).