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There is an almost universal urge to lose weight, reduce the amount of fat on the body, and improve the appearance of the skin. This is because of not only media representations of ideal bodies, but also because of our increasing knowledge of the harmful effects of being overweight. Nowadays, there are many effective noninvasive procedures that physicians can use to achieve this goal. Some noninvasive procedures can achieve a better definition, smoothness, and shape of the human body. Body contouring is the fastest growing field of dermatology.

Some people are reluctant to have any procedure that involves invasive surgery, such as liposuction, because it has many negative effects, large costs, and requires large amounts of time to heal. Recently, there has been a demand for more effective and safer procedures for reducing fat and skin tightening. There are now several effective noninvasive procedures for body contouring. Noninvasive body contouring procedures are not as dramatic as surgery, and results may not be seen immediately, but they are often requested by patients who want to improve their appearance. Noninvasive treatments use specific physical properties of fat to cause a diffusion of triglycerides from cells of the body and to result in a reduction in size, necrosis, or apoptosis of adipocytes. Cold-induced adipocyte apoptosis has been widely used for years and has been the most extensively researched.

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There are 4 main techniques that are commonly used for achieving noninvasive body contouring: cryolipolysis, radiofrequency, high-intensity focused ultrasound (HIFU), and laser therapy. Although no one noninvasive treatment is currently considered to be the gold standard, scientists continually try to determine which procedures are most effective. We will explain each of these procedures in order to help dermatologists decide which procedures to use to treat their patients.

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Cryolipolysis freezes adipocytes that are more susceptible to freezing than other water-rich cells. This causes them to die more quickly and protect surrounding tissues. If adipocytes are frozen and killed, macrophages that are able to digest the apoptotic cells will cause a decrease in the amount of fat that is stored in the skin for the next 2 to 3 months. Cryolipolysis was approved in 2010 for treating excess fat in the abdomen and thighs; the treatment was approved again in 2015 and 2016.

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Patients use a small, flexible tube that is used to treat the area they are treating, and then vacuum the treated area between 2 cooling panels for 30 to 60 minutes. Many patients are very pleased with the results of cryolipolysis, and they have never experienced any adverse effects of the procedure. Common complications of cryolipolysis include redness and swelling, and it is possible to feel as though someone is touching the area being treated. These complications do not last long; they disappear after several weeks. Some people are concerned that lipid levels and liver enzymes may increase after adipose tissue is removed. However, these levels have been reported to be within normal limits. Those values have been reported to be within normal ranges during and after a procedure like cryolipolysis. Patients should be warned that paradoxical adipose hyperplasia, which is a rare condition that can cause a large, hard, tender mass of fat to form at the treatment site 2 to 3 months after treatment. It is estimated that this happens in 1 in every 20,000 people. It is possible that the incidence of paradoxical adipose hyperplasia, a rare side effect of cryolipolysis, may be underestimated, because one practice reported a risk of 0.47% in 422 patients who received this treatment. This has not been reported in people who have undergone other fat reduction procedures, such as a liver transplant or a fatty liver graft. Cryolipolysis is safe for all skin types to undergo. There are no reports of changes in the color of the skin after treatment. If you are experiencing severe cold-induced illness (eg, cryoglobulinemia, cold urticaria), or if you have very severe varicose veins or atopic dermatitis, you should not undergo this procedure. Some patients who undergo this procedure benefit most from removing small or moderate amounts of adipose tissue and/or fat cells (Figure 2).12,17 Cryolipolysis is safe and can help relieve symptoms of menopause.

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CoolSculpting is a noninvasive procedure that removes fat cells that are causing problems. You may find that certain fat cells on your body are particularly stubborn. This procedure is called cryolipolysis (pronounced cryo-low-op) and is very safe. FDA approved this procedure in 2010 and it is a safe and effective way to permanently remove fat cells.

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Scientists discovered that freezing fat is beneficial when someone is very ill and dies. Fat freezes when the temperature is high, higher than that of the skin. Cryolipolysis cools your fat cells to a point where they freeze, but your skin and other body tissues are not affected.