Pablo Naranjo reveals his combination approach to fat reduction using Zimmer devices.
Cryolipolysis™ received European Union CE Mark approval in 2009 for non-invasive fat reduction and has since become very popular, with an increasing number of treatments performed every year worldwide. One main reason for this development is the high demand by patients for non-surgical alternatives to liposuction. Cryolipolysis™ is now considered to be a very successful method of reducing selected localised fat deposits.
With Cryolipolysis™ systems, heat is extracted from fat cells over an extended period (average of 60 minutes) without damaging the surrounding tissue or skin1. It is not, as is often reported in the media or in the industry’s marketing material, a matter of ‘freezing’ the fat; the aim is to cool down fat cells (via thermal conduction) under around +4°C. This targeted extraction of heat undergoes localized adipose cell death followed by a local inflammatory response.
According to Dr. Ingargiola’s clinical study2, the treatment achieves an average of 20% localized superficial fat tissue layer reduction after several months3, and the triglycerides are evacuated naturally through lymphatic system and then processed by the liver. Cryolipolysis™ is considered an effective method that causes minimal pain and no serious long-lasting side-effects4. When this technology is applied on selected patients and combined appropriately with other treatments, we can obtain a higher level patient satisfaction5. Local fat deposits on arms, hips, abdomen, buttocks or thighs can be treated.
In our Clinic in Spain (Elite Laser, Madrid) we have had the opportunity over the past few years to apply several Cryolipolysis™ devices and test their effectiveness and functionality. We are currently working very successfully with the ZLipo System from Zimmer MedizinSysteme (Neu-Ulm, Germany). Thanks to the flexible instrument settings and different applicators we are able to adapt the treatment perfectly to the individual needs of the patient. For example, it is possible to set the desired temperature of the cooling plates as low as -10°C (in 1 degree Celsius increments). This allows us, for example, to treat thicker abdominal fat very successfully (e.g. at -10°C), but treating patients with a higher sensitivity to cold or thinner fat layers is also possible without problems (e.g. at -5°C).
The intensity of the vacuum can be adjusted to the area (10 different stages), and is able to restrict circulation temporally for adequate maintenance of lower temperatures during the treatment. Another interesting instrument setup in the ZLipo System, which is not common in other Cryolipolysis™ devices, is the possibility of operating with continuous or pulsed vacuum. With three different vacuum frequencies it is possible to achieve a ‘massage’ effect. The vacuum level varies and helps, especially at the end of treatment, to stimulate the metabolism and lymphatic drainage.
In order to ensure an homogeneous mechanical effect — to enable the ‘crystallised triglycerids’ to percute the membrane of the fat cells — we combine Cryolipolysis™ with the Zimmer MedizinSysteme’s Z WavePro shockwave device6.
Dr. Hunt’s studies have shown the advantages of this combination of technologies mean we can expect to achieve a better and significantly faster reduction of fat. Another significant advantage of shock wave treatment is an improvement in the appearance of the skin. Of course, in any kind of fat reduction treatment, skin tightening treatments are always suitable. The combination of Cryolipolyisis™ and shock waves give us three advantages over conventional Cryolipolysis™: faster fat loss, more effective fat reduction and skin tightening.
In addition, shock wave treatment is also applied in our clinic in combination with other therapies such as radiofrequency, ultrasound and injections. All treatment protocols for those purposes can also be found in the software of the shock wave device.
Cryolipolysis™ is a ‘Gold Standard’ technique for fat reduction. Prerequisites for successful treatments are careful patient selection and individually adjustable parameters of the Cryolipolysis™ system. The successful combination of this therapy with shock waves treatment leads to faster and more effective fat loss and improved skin appearance.
- Avram MM, Harry RS. Cryolipolysis for subcutaneous fat layer reduction. Lasers in Surgery and Medicine 2009; 41 (10): 703–8
- Ingargiola MJ, Motakef S, Chung MT, Vasconez HC, Sasaki GH. Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms. Plastic and Reconstructive Surgery 2015; 135 (6): 1581–90
- Derrick CD, Shridharani SM, Broyles JM. The Safety and Efficacy of Cryolipolysis: A Systematic Review of Available Literature. Aesthetic Surgery Journal 2015; 35: 830–6
- Coleman SR, Sachdeva K, Egbert BM, Preciado J, et al. Clinical efficacy of noninvasive cryolipolysis and its effects on peripheral nerves (PDF). Aesthetic Plastic Surgery 2009; 33 (4): 482–8
- Krueger N, Mai SV, Luebberding S, Sadick NS. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Clin Cosmet Investig Dermatol 2014; 7: 201–5
- Hunt JA. Cryolipolysis and radial pulse therapy. Prime 2013; 3 (5)