For those who spend hours in the gym to burn off fat, the idea may sound counterintuitive. But researchers are investigating the possibility that that applying precise, cold temperatures to those troublesome bulges could actually result in modest fat loss.
In an article published last December in the journal Lasers in Surgery and Medicine, Dr. Mathew Avram, director of the Massachusetts General Hospital Dermatology Laser and Cosmetic Center in Boston, conducted a review to help determine whether a device used to cool the skin during dermatological treatments could also effectively reduce fat deposits under the skin.
The idea that applying a precise cold temperature to these fat deposits is an approach that has been explored over the past five years. And according to Avram's review, it holds promise.
The technique "takes advantage of the differential in fat's susceptibility to the cold," Avram said. "Fat freezes at a higher temperature than the rest of the skin does. Thus, at a certain temperature you can freeze the fat, but not harm the skin."
Avram was quick to point out, however, that the results are "not comparable to liposuction, and this is not a weight-loss device." And he said that even though the device used in the technique is approved by the U.S. Food and Drug Administration, this particular use has not yet earned the FDA's okay -- and thus is not ready for public consumption.
But in terms of safety, Avram said, "At this point, these studies seem to be reassuring."
Santa Monica-based cosmetic surgeon Dr. Mark Berman, president of the American Academy of Cosmetic Surgery, agreed that the technique appears to hold promise for fat reduction.
"The good news is that there does not seem to be any problem caused when the body is reabsorbing the [fat]; there are no demonstrable changes in liver function," he said. "I can see this becoming another dermatologic weapon. This is going to be a nice little device."
However, cosmetic surgery experts also said that if widely adopted, the technique will join other minimally invasive fat busting techniques in a growing and competitive field.
"It is likely to create significant interest, as have all these 'alternatives to liposuction,'" said Dr. Michael McGuire, president of the American Society of Plastic Surgeons and associate clinical professor of plastic surgery at UCLA. "But the reality is that they are very limited in their effect."
"It's a novel procedure; studies have demonstrated its efficacy and safety," said Dr. Jessie Cheung, associate director of cosmetic dermatology at the New York University Langone Medical Center. "The question is, are patients willing to pay for the technology and the likely need for multiple treatments to achieve their desired contour?"
Even Berman said that if the technique catches on, the relatively modest results may be oversold by some overzealous practitioners.
"The thing that I worry about is that some guy gets a hold of one of these machines and says to the public, 'here's a minimally invasive way to get rid of all of your fat.' People get the idea that they can freeze their tuchis off," he said.
Still, it appears that for a modest degree of improvement in a trouble spot, the technique may be able to deliver. Avram said that the procedure, if it ever achieves FDA approval and becomes adopted, will most likely be for patients who have a stable weight and are in relatively good shape.
The device works by sucking in a small area of skin and cooling it for about an hour -- a process that Avram said is painless. Following the procedure, the fat does not disappear right away; in fact, it takes between two and four months to dissipate.
"It's a gradual process, which probably means it's a safer process," Avram said.
But if a patient waits enough, analysis of the fat tissues treated with the technique show that it does work. "In one study, it showed a 22 percent fat layer reduction," Avram said.
As for where this fat actually goes, Avram said it's still a bit of a mystery.
"The short answer is, we don't know," he said. "You would have to figure out a way to see how the fat is metabolized. Because it isn't an acute event, because it happens over time, there is reason to believe that this fat is being taken up more gradually. To me, if the fat removal happens over a long period of time, then in theory it should be safer."
If and when cryolipolysis does become an option for fat reduction, it will be not be the first minimally invasive technique that claims to help patients dissolve away the inches. Purported fat busters that harness ultrasound waves, lasers and injections are among the currently available options, and Avram said the field is growing.
"Increasingly, we're seeing devices being developed to remove fat in a non-invasive manner," he said. "But we're really at the beginning phases of this field."
McGuire said that as a rule of thumb, consumers should be cautious on these new techniques until they are approved and the results are in.
"As with all new therapies, a cautious, skeptical approach is wise, and realistic expectations are essential," McGuire said. "Don't rush to be the first person to try a new technique, since the undesirable side effects, and risks may not be identified initially."
As for the specifics of cryolipolysis, Avram said the precise temperature used in the treatment is a trade secret. But he said that those hoping to get rid of a few bumps and bulges should not try to take matters into their own hands.
"I wouldn't recommend that people jump out into a snow bank and expect to lose fat," he said. "If that worked, Alaska would be the thinnest state in the country.
"This is not something you want to try at home."