Variability in responses to Cryolipolysis
It is reported that 100% of cryolipolysis subjects had good outcomes following treatment with the Zeltiq device in its first major study. Further reports by serious and dependable physicians have reported similar results in all their treated patients. So why am I unable to achieve striking outcomes in all my patients on the West Coast of the USA? Not to say that I am unhappy with the overall results, for I still believe that this is currently the best device for non-invasive localized fat reduction. But as often happens, a mature look at long term outcomes can be quite revealing.
I estimate that about 70% of my patients have good results, which means that 3 out of 10 patients are unimpressed. I am surrounded by dermatology residents and fellows who call it as they see it, and they give me that quizzical look when I recount the original study outcomes, wherein every patient could see obvious improvement. We are careful to take standard digital images and we compare them diligently. True, we don’t employ the three dimensional Vector system, and neither do I perform ultrasound or MRIs on patients, but frankly if they can’t feel or see the difference, what’s the point? It’s not enough for us to be satisfied that 100% of patients have measureable improvement by U/S or MRI. Innovativel devices can be killed by hype.
So why are some investigators seeing results in all their patients, and others not. This was one of the issues discussed informally by Christine Dierickx, Henry Chan, Rox Anderson, Arielle Kauvar, and Chris Zachary in Paris recently at Les Journées Parisiennes du Laser 2010 conference, a premier meeting of French laser specialists. Henry Chan has also experienced some patients with little improvement in Hong Kong. Arielle Kauvar has noticed improvement in all her patients. We need to determine from Zeltiq users worldwide whether there are outcome differentials, and if so whether these are related to age and gender, or anatomic, geographic, ethnic, technique or other differences between our patient populations. These might then provide clues as to the cause of this disparity in outcomes.
While musing over lunch, no doubt thinking ‘we are what we eat’, Rox Anderson suggested that the Californian diet was probably lower in saturated and trans fats, and that their fat might ‘freeze’ differently, whereas the East Coasters who enjoy more Philly cheese steak sandwiches might have longer fatty acid chain adipose tissue, with a more responsive outcome. While humorous, this thought has merit, and would be easy to study, even retrospectively.
Also discussed was the question of painful responses. Two patients with prolonged and severe pain post-Zeltiq were previously reported in this Blog. At the time they seemed to be absolute outliers. However, it is clear that there have been a very small number of similar but less extreme painful responses, lasting several weeks. The cause of this painful response is not understood, but could be related to the acute panniculitis itself, or possibly a vascular event, an acute neuritis, or some other noxious stimulus to the fat, the underlying fascia, or possibly the underlying muscle. Rox reminded us that the glomus cell is involved in the control of vascular shunting in a cold environment, and that these shunts can be associated with significant pain. Given that the Zeltiq suction device effectively shuts off the vascular supply to the affected skin and subcutaneous tissue for 60 minutes, one could predict hypoxic tissue responses, despite the protective nature of the cooling.
The normal sequelae of numbness, a modest burning sensation, and other paresthesias are commonplace for several weeks or months. All patients should be informed about these. Further, these side effects might be used therapeutically in order to control chronic cutaneous pain syndromes, such as post herpetic neuralgia.
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I am glad I have come across your site. I have been looking up info on cryolipolysis treatments. Most of what I have if on zeltiq. I beleave that is a barnd name, or company name. I must say all the sites i have seen over the last 3 days all say 20% fat reduction, and they make it seem like that is in all the people that have tried it. Pluss there is not alot of details on how many treats ments you need, or how large of area is cover in a treat ment. They also do say anything about side effects.
Was how ever thinking could this treatment be use along with ultrasonic or radiofrequency with this (not on the same day) maybe a couple of weeks to a month later. ??? to get the max out of your fat loss
Also how long would you need to wait in between cryolipolysis to get another one on the same area?
I have noticed that everyone talks about percentage fat loss but what about inches? Like any other person i want to drop a dress size or some unwanted inches in the area treated. What are the stats on that?
Change in circumference is not a good measure of response … often overestimated in the studies. Do your clothes hang better? Is your belt a little looser?
I’m a fit mother of 3 with a bit of a pooch. No stretch marks and skin is in reasonably good condition. I had the treatment done 20 days ago. 2 sessions of the medium applicator on my lower abdomen, 1 on the left, 1 on the right with an overlap in the middle. Belly was slightly hard, slightly swollen, numb and in dull pain with tingling for a couple of days. I could not bare it being touched, but now it is totally fine. The skin feels “thinner” and my belly is protruding less, which is great. I was warned that my skin would not tighten along with the reduction in fat and sadly I think this is the case with me. It’s not an awful sagging mess, but I wish it would be a be firmer. I have been massaging the area every evening since the unpleasant sensations have subsided in the hopes that this will help with my skin’s condition. Is there any research available in relation to the effects of regular massage post treatment?
Great description! Everything you describe is as it should be. But I have not seen sagging or looseness of the skin yet … I believe there is some stretchback associated with a fibrotic reaction within the fat, but my colleagues generally would not agree with me
I had the procedure 4 days ago in my lower and upper abdomen, and I am in excruciating pain. I can’t seat straight, I can’t bend over, I have not slept in 3 days. The pain im feeling is worse than the pain I felt after a C section. I still am keeping my fingers crossed, this will work. But I am also very worried, because my life its not normal right now. I don’t even walk normal, sometimes I feel Im going to pass out since the pain get worse.
Interesting! Have you considered the alternative explanation for the non-responders that the fat was reincorporated into other undamaged fats cells (in the same general area) rather than being metabolized?
As a layperson, it would seem logical (to me at least) that in this way caloric intake and metabolism could significantly influence the results as for any procedure causes lipolysis, as they don’t remove fat from the body.
This is not to say that I never consider this for shifting my belly fat, just that for the costs I’d exercise more and eat less, just to be on the safe side as it were.
DONT DO IT. I had mine done at harvey nichols in london. it cost £3,200 – 2 months salary and I was deemed to be a ‘perfect shape’ for this to be effective. 9 weeks later absolutely no difference other than a numb hard permanent (it seems) swelling around abdo. and the pain for the first 6 weeks was excrutiating and worrying with no backup or support. JUST DONT GIVE THEM YOUR HARD EARNED MONEY.
I am 2 days post treatment. I am very fit. I am 45 yo with 17-18% body fat. I have had about 11 abdominal surgeries (4 were MAJOR surgeries that were needed after complications from a hysterectomy and complicated diverticulitis). I have to say that initially I was surprise at the level of intensity of the suction. I wasn’t sure I could handle it for an hour but it subsided and I was really ok. Just a bit uncomfortable- like you can’t tale a deep breathe. No pain except some when it was removed and the doctor massage the area. I have worked out both days after the procedure which included lifting weights and running. My abdomen is sore bit not painful at all. I had a great workout yesterday. I will post again in a few weeks.
Sounds about right … hope it works out for you!
I paid 2100 to have 3 treatments with no success at all. I work out everyday and I was seeing another Dr independently from the one who did the Zeltiq to make sure my measurements were being watched with an outside independent professional. The Zeltiq Dr took pics but no weight or measurements. When I went back they asked if I could have possibly gained weight!!! Well, that was shocking since I weight myself everday. However it prooved that they agreed their was no change except looking bigger now. I have contacted Zeltiq but of course I have never recvd any response that would tell me why I may have been the odd one who had no results. I only saw advertizements and all positive confirmation from everything I looked up and with Dr Oz okay I figured it was the right decision . Has anyone had any success in getting their money back and finding out why it may not work on some body types? Im aprox 5ft 6inches and between 152-156 for the past aprox 8yrs. I work out everyday with weights and cardio. Looking forward to responses. ..Would love info..God Bless
There’s no such thing as a sure bet in life … I always tell patients that while 7/10 get a good or very good result, this means that 3/10 don’t see much improvement. Sorry to say that you might be in this latter group. How long since your treatment? You need to wait three months for a final assessment …
Hello, well i just finished reading all the comments. Very interesting.
Im 31, male. I want to have the the coolsculpt procedure performed on my lower abdomen.
About 3 months ago I had my appendix taken out because there was a Carcinoid tumor inside. They performed the surgery laparoscopically.
Would it be safe for me to have the Coolsculpt procedure ?
Any feedback would be greatly appreciated
Thankyou
Alberto
Question:
can Cryolipolysis be used for a double chin: neck area. My wife had lipo on her neck which made it uneven in appearance. Could this procedure even out the unevenness of lipo.
thanks,
Mike
No. Your best bet would be to repeat neck liposuction or to wait for Kythera’s ATX101 which is a series of intra fat injections of deoxycholate. Dramatic responses in early studies with MRI images which are very reliable. Kythera is doing the right thing here, slow, steady, reproducible science. Don’t expect this any time soon though, unless you want to volunteer for the phase III studies.
It’s been 5 days since I had the zeltiq procedure in an office in Marina del Rey in California (1 large applicator, lower abdomen). As others have stated, the first 10 minutes of the procedure was incredibly uncomfortable, and gave me cold sweats and the feeling of passing out. I stuck through it and the rest of the hour was tolerable.
I want to share that the last few days has been the strangest experience: swollen belly is one and the closest thing I can compare the feeling to is like how your mouth feels after going to the dentist…except in he belly area, yet unlike going to the dentist, this feeling has yet to let up…in fact i feel it’s gotten worse. Numb, tingly, swollen and uncomfortable.
I know at this point all I can do is wait. I was to have a second treatment (upper abs) next week but I’ve cancelled/postponed it until this feeling goes away or at least starts showing signs of improvement as far as pain/discomfort… I was told all negative side effects should resolve in two weeks time. I’ll keep you all updated. For the record, I am still hopeful the procedure did its magic, but it should also be documented that the days following he procedure is not a good time.
I agree ,,, it’s a slightly wierd sensation, and you describe it well. The numbness can last for about 3-4 weeks. It has never been persistant to my knowledge.
HI..I work for a derm in Florida and am involved in treating patients with Zeltiq…..we do have some patients that experience pain post treatment….we do NOT recommend ibuprofen due to the fact, from what I understand, cryolypolosis is partly effective due to the inflammation caused by the procedure…..is there any truth in this? Could the use of Ibuprofen effect the results of the treatment?
…. I was never told that Zeltiq does not work for some patients. If I was told that 3 out of 10 people are not satisfied, I would have never gambled my $3,000 on those type of odds.
Well, in fairness, the success rate of 7 out of 10 represents the outcomes in my clinic over a 2 year period. The original multicenter trials indicated 100% patients were demonstrated by ultrasound to have some fat reduction, with an average of 25% fat loss. So your treating physician was correct in this regard.
2 months down the line and the pain has finally gone but areas remain numb. I have seen absolutely no reduction in fat despite trying to diet also, in fact I’ve gained & the whole area treated feels very strange. £3,200.00. I would have parted with that money happily if there had been a result. As it is I’m appalled that my hard earned money has been absolutely wasted. TWO MONTHS HARD EARNED SALARY YOU SHOULD BE ASHAMED OF YOURSELVES HARVEY NICHOLS.
Hello Jan,
…… Finally, this device hasn’t even undergone a placebo-controlled study to evaluate it’s utility. ….
You should consider taking the time to actually read the peer reviewed scientific publications on the Zeltiq device. Where do you get your information from? … The multi center trials were unilateral treatments, ie only one side was treated … you can’t do better than that for comparison of efficacy. There is no doubt that this works. Of course there are other ways of reducing fat non-invasively these days, including ultrasound and probably radiofrequency. But please don’t bother writing any more misinformation … people will see it for what it is.
Hello Dr. Zachary. I posted a comment on May 2, 2011 in regards to my concern that Zeltiq may not work for me because I have been vegan for 13 years. I had my first Zeltiq treatment done on March 17, 2011 and my second treatment on the same areas (belly and flanks)performed on May 18, 2011. I went to Dr …. for both Zeltiq treatments. I spent a total of $3,000. I have seen NO results at all. I called the doctor’s office about a month ago to report that I have had no results. I spoke to a girl named Courtney at the doctor’s office. She said to give it 6 months and she scheduled me for a follow up with Dr. …. for Sept. 15, 2011 to assess my results. She said that at the follow-up, Dr. …. and I will take a look at my before and after photos. My appointment is approaching and I have lost hope that I will see any changes in these last few weeks. I know I’m not just being overly particular or (crazy!) Before my first treatment, I tried on a pair of jeans which my belly and muffin tops hung over. I even took these jeans to Dr. ….’s office so they could take before and after photos of me wearing them. Currently, just as before my Zeltiq treatments, I can still easily zip these jeans. However, the same about of belly fat and muffin top is present. I am disgusted because I really thought that 2 treatments of Zeltiq costing $3,000 would dramatically reduce these trouble areas. I have always been physically active and relatively thin. I workout about 5 days a week – running, lifting weights, and doing ab workouts – 5 days a week for an hour or more per workout. I am a single mom with two sons and $3,000 was a lot for me to waste on treatments which have given me no results. If I’ve had results, it must be extremely minimal because I certainly do not notice ANY difference. I am hoping Dr. …. will be honest and admit that he too sees no results (or very, very little results)from my Zeltiq treatments. I’m also hoping he will give me my money back or offer to do the two treatments again free of charge. Dr. Zachary, can you tell me how would you rectify this situation if you were faced with it?
Well frankly, you need to have reasonable expectations … not everyone will have a good or very good response. I always tell patients that about 7 out of 10 do well or very well, and 3 out of 10 will not. It would appear that you did not have a good result. It’s all about patient selection and how you respond to the cryolipolysis. Every patient is different. I am sure you were told about the potential benefits and drawbacks during your consultation. The cost is the cost and I can’t say anything about this except that this would be a reasonable reimbursement considering the cost of the device and consumables. Sorry to be so blunt, but it is what it is.
2 weeks on now and slight improvement but still very painful and taking far too much analgesia to function properly at work. Not able to go to physician – he’d be on telephone to zeltiq. Very disappointing.
To those who are reading this blog, I want to express the fact that the great majority of those who are treated with the Zeltiq Cryosculpting device get a good or very good result. The small minority of subjects who develop this severe pain issue is indeed a small minority. Having said this, those that have these symptoms are more likely to post their issues on a blog than if they have had a great result. Not trying to minimize these reactions, but most patients do very well.
I had this done 2 weeks ago. The pain since day 4 after has been god awful. And basically untreatable, until I finally read and demanded Lidocaine patches.
Someone on this site who also had the pain mentioned sneezing. I must say, I now realize that might be what happened to me. I also sneezed mid way through the procedure. It suddenly hurt much worse. I kept hitting the “call button” but no one ever came. Finally it got numb again and I made it through.
Now I realize that when I sneezed the middle section of my stomach got sucked back in for the second time and got treated TWICE.
I’m pretty worried and upset that this dr.s call button didn’t work and no one came in when I knew something felt wrong. But I think the company needs to alert people that the position changes when you sneeze. I’m upset that no one knows this.
It’s 9 days since i had 4 areas treated in one go. At the time it wasn’t too painful but has become increasingly painful since then. Very sharp,needle pains, cramps and intense pain in all 4 areas. Whole area remains swollen, skin burning but numb? Have spoken to place in london where treatment took place and I am just told will get better. I’ve taken shedloads of ibruprofen and paracetamol daily with little effect and cant sleep for pain. Seriously thinking some long term damage done here. Cant go to work – rolling on bed in agony. Terrified but nowhere to go for help. This has cost me 2 months wages and I’m usually as tough as they come. Dont know where to turn. If only i could put clock back.
From my experience, I can tell you that this WILL improve and resolve totally within a couple of weeks. Very unlikely that this has caused any damage to your skin. It’s important to keep in contact with your physician, and if they can’t help, contact Zeltiq, the manufactuers, as they will have special expertise in this. On a more positive note, those who have more discomfort tend to get a better long term result, in my opinion.
No one is directly answering the pain problem. I had the surgery 5 days ago on my abdomen area. I have been experiencing sharp needle like pains in my area I usually can tolerate pain but it really hurts. I tried tylenol- doesnt work.
So the million dollar question that no one can answer on here is what can we do or take for these sharp pains. I can’t sleep or function at work they are so painful.
I received the treatment on my lower and upper abdomen one week ago. The first five minutes was extremely intense . I went into a cold sweat and felt faint. The nurse had left the room and I think if she had stayed I may have asked her to stop treatment …..it was that intense . ( normally I consider myself a “tough cookie” ) after the first five minutes I was able to catch my breath and calm myself down . The remaining 55 minutes are not painful , just awkward .
When leaving my stomach felt bloated and warm to the touch ….skin red and tender. Unfortunately , the pain has grown worse each day that has passed. It’s a sharp tingling , pins and needle feeling and my skin is very warm to the touch . At different times of the day my stomach goes from looking “flatter than when I first left after having the treatment to looking very swollen again.
I have been able to go about doing my daily routine , of taking care of my home , family , working part-time . I have not felt well enough to exercise , which I usually do about 4-5 days a week . I have to be honest I did not tell family or friends I did this……so I have no one to complain to ( LOL ! ) but , my family has noticed that I have been a little cranky.
I am so hoping I get a positive result for the amount of discomfort I am feeling . I feel that the medical staff should to be a little more forthcoming on what the recovery period may be like .
I’m suppose to have my Love handles done ………..jury’s still out ?
Elizabeth, it is likely that you are going to have a good result. You certainly had a good, though uncomfortable, reaction to your first Zeltiq treatment. In my experience, the great majority of patients who experienced severe pain noticed this after abdominal treatments, and I can’t remember anyone discussing this after love handle treatment. If diet and exercise can’t provide you with the body shape you want, then cryolipolysis seems very reasonable.
Hi. I tried the treatment today and I am feeling like a huge failure. Because of the intense pain that continued to get worse I stopped the treatment after 8 minutes. My dr kept telling me the pain would let up but I was in a cold sweat with
Tremendous nauseau and at the verge of passing out. I wanted so very much to have the treatment but could not stand the pain.
I had to remain in the drs office for 10 minutes because I was faint. I had a headache and nausea for 20 minutes after. Has anyone had this type of response?
Hi, I was almost overwhelmed by the initial pain too–just had this done today. The whole procedure was much more painful than I had expected, and I did a good amount of research. I’m OK now, but there is something kind of barbaric about the whole thing. If I have a good result, of course, I’ll consider the pain a reasonable trade-off, but just barely.
I had Zeltiq 4 days ago, large applicator on my lower abdomen,
a one hour treatment. Initially the procedure was quite painful, but just as everyone else has reported within 10 minutes it became more bearable. I previously had 2 ceasarian sections &
5 laparoscopic surgies through my belly button, so during the procedure my belly button was extremely irritated. After the procedure, not only was the treated area extremely cold, but my entire body was very cold for 3-4 hours, while the outside temperature was 82 degrees, my hands were very cold & I had to wear a sweater.
I have a few small bruises, a small hickie area and tenderness below the navel. All these were forewarned to me as possible.
My skin is very sensitive and itchy.
Immediately following the procedure and currently, I have swelling, not extreme but I can’t suck in my belly (as is my normal), the muscle are working but the swollen belly stays the same. I have been eating sensibly & drinking lots of water, I am looking forward to great results.
Hi. My name is Sherry and I had Zeltiq done on my lower abdomen 6 days ago. The procedure went fine, in that all the sensations I experienced were noted before the procedure.
I was not prepared however, for the discomfort I have been feeling since then. My skin is very sensitive to the touch, crampy, with these sharp nerve-like pains going through the abdomen at irregular intervals. The pain woke me up from my sleep last night.
Frankly, it has caused me worry and I wish I had been better advised to expecting this type of discomfort.
After reading other comments left by others, on this site, I think the pain is more common in after-procedure than the company is letting on.
Understood. Clearly I don’t represent the company, but will say that Zeltiq/CoolSculpting is trying to understand this phenomenon, and have gone to some lengths to educate the treating physicians that this type of discomfort can occur. All physicians who have this device have been instructed that these symptoms, though quite uncommon, are possible and should be discussed with prospective patients. Thanks for sharing your story with us. I do believe that underreporting of symptoms and side effects with any new device is the norm, but that within a relatively short time, we should have much more information about the incidence and severity of the pain issues associated with this treatment.
I had zeltiq 5 days ago. I had the larger application head on my lower/mid abdomen. It was more painful than I thought. I’m 5’7, 130 pounds but have a belly I can’t get rid of, even at my thinnest, 125 pounds. I have had numbness and tenderness for sure the last 5 days, only real swelling day 2 & 3. But today on day 5 I’ve been getting these nagging shooting pains or “zaps” as someone said. I can tolerate it but it’s uncomfortable. Although zeltiq says you can get right back to exercising, I personally can’t imagine doing any exercise that would use my lower abs, which are many. I will report this to my dr. I am just hoping this stabbing pin needle pain fads fast, my stomach is still extremely numb and tender as well.
I can guarantee that this discomfort will resolve in the not too distant future … And I hope that this treatment achieves what you want. No treatment is without its problems, but for the time being, cryolipolysis remains one of the most predictable non-invasive fast reduction technologies. Generally speaking, subjects can get on with their regular life, including exercise.
I had Zeltiq performed on March 17, 2011 – approximately 6 weeks ago. I did not experience any lasting pain or discomfort, only some numbness which subsided after a few weeks. Unfortunately, I am not seeing any results at all. I had Zeltiq performed on my abdomen and my flanks. I am 5’6″ and weigh 128 lbs. I exercise regularly (at least every other day for an hour). From what I have read on prior comments, I am now wondering if I am not getting results because I a vegan. I have a second round of Zeltiq scheduled for May 18, 2011 and I don’t know if it would be a waste of money. I would appreciate any input. Thanks.
Probably a little early to make a decision about this treatment just yet, but as you can tell from my previous posts on this device, not all patients do well. I would say that 70% do well or very well, which means that 30% do less than well. The vegan diet comment is write interesting … We are what we eat … And some evidence would suggest that dietary fats are stored and and processed according to their fatty chain length.
And different chain length fatty acids probably have varying freeze points which will undoubtedly have different outcomes in terms of cryolipolysis (Zeltiq) outcomes.
Hello, I had Zeltiq done the first time on 12/8/10, and the first few min on the machine were intense, but tolerable. I had numbness and tingling for a week or so, and every once in a while a (zap) of random pain. I went in for my follow up 3/8/11, I have lost over an inch, im very happy with my results, but I went ahead with another application, still the same pain results during w no bruising. I am however having sharper more intense zaps this time after, mostly positioning and clothes placement. I am wondering if it has something to do with the fact that there is less fat? or because of being previously treated? I am eager to see the results after the 2nd time!
I had Zeltiq 1 week ago and I experienced significant pain and nausea for the first 10 minutes of the procedure on my lower abdomen. The night after the procedure, I began experiencing extreme burning and sensitivity of the lower abdominal skin. I have tried Ibuprofen and topical pain relieving creams without relief. I am hoping it resolves soon!
Thank you. Please see my response to similar reactions below. I would be advised that these symptoms will disappear, though they can last for a few weeks. Please notify Zeltiq of these symptoms as the company has been very responsive and proactive with regard to these issues. One good thing to know is that, in my experience, those with more symptoms have generally had excellent results .. this is my opinion, and should not be taken as gospel! CBZ
I had the zeltiq treatment one week ago. Three days after treatment I started getting sharp stabbing pains in the area treated – the fatty “pouch” below my navel. These pains come and go. Paracetamal not relieving this. Sometimes the pain is excruciating – it wakes me up at night. Also the skin in this area is very sensitive – I can hardly bear touching it. Should I worry? I haven’t seen this response in any of my online reading. I have reported it to my doctor who says it will “go away” in a few days – what may have happened to cause this response?
Thank you for this report. There have been approximately 22 such cases in the world, about 0.04% incidence. Although uncommon, it is now a recognised problem. The good news is that is does always go away. We will be presenting the latest data on complications with cryolipolysis at the upcoming ASLMS meeting.
hi,
ummm, so i just recently saw a story on this technology on ABC’s nightline and it immediately raised a question.
if this technology is basically based on the phenomenon of “popsicle panniculitis” and that’s a condition that can occur in children even after brief exposure to ice or cold, couldn’t just an hour long ice compress (let’s say on the abs) do the same thing as the zeltiq?
it doesn’t have the advantage of squeezing off and isolating the fat to target it so precisely but if you hold an ice pack against your belly long enough, that fat’s gonna get pretty darn cold wouldn’t it? and i don’t see why (if the pack is on long enough) that it wouldn’t result in the same effects…
am i missing something?
All very reasonable … except that kids can suck on iced popsicles for longer than than a brief period … I don’t know if there is any good data about how long a child would have to chill the cheek fat for to induce this type of response.
Further, ice applied to the abdominal skin has two disadvantages … there is no temperature control, meaning that a cold injury could be induced in the skin with subsequent frost bite and/or ulceration. The Zeltiq device controls the temperature carefully at around 5 degrees Centigrade. Second, the Zeltiq device actually shuts off the blood supply to the fat, which enhances chilling very significantly. Some of the discomfort after removing this device is related to blood reperfusion of the fat in the treated area.
If all you needed was external chilling, then there would be a large proportion of people with skinny butts in Minnesota …
I had zeltiq one week ago on my upper abs. The setting was at 65, but was so painful they had to lower it to 60. It was uncomfortable, but a bearable during treatment. I had laser lipo last year at this time, so I am wondering did that make a difference in my sensitivity? I am having a lot of soreness and now gas. Why?
Very interesting thoughts … I can’t tell you if there is a direct relationship between prior “laser lipo” and your painfull experience with the Zeltiq device recently. We are presenting data concerning complications with the Zeltiq CoolSculpting device at the upcoming ASLMS meeting this year. I can tell you that, although uncommon, severe pain can occur (0.05%), and I have heard of GI symptoms as well. I would make sure you let your physician know about your symptoms, so that he/she may report these to the company, which by the way, is taking all such reports seriously.
I am a physician and I have just purchased the Zeltiq and have been using it for only 2 1/2 weeks. I had a treatment myself 6 days ago. I had a lot of pain upon application of the hand piece with cold sweat and nausea. It subsided in 10 minutes and i was able to continue with no problem. About 40 minutes into the procedure I sneezed and had sharp stabbing pain across my abdomen worse on the left side. I almost removed the hand piece but finished the procedure and had the hand piece removed at the full 60 minutes. Immediately after the procedure I had return of the intense doubled over pain and nausea. It subsided in 10 minutes. No bruising after the procedure but I have numbness in the skin. Starting about three days ago I started to have sharp stabbing pains that have been mild until this am. Since this am I have been taking anti-inflammatories and still I am having very disturbing pain. I am considering some codeine if the latest dose doesn’t work. So far I have done about 50 treatments and one patient had the same kind if pain and nausea/cold sweat in the beginning and the end minus the sneeze episode.
I just felt the need to share this and will update as time goes on.
I would pass this information onto Zeltiq. The more information we physicians, and the engineers at Zeltiq, have the better! Thank you for sharing … it’s important for us to know the good news about these products … and the bad …
I am not sure if this is the place to make contact, but I am a filmmaker in Toronto Canada and was wondering if this treatment is here? and i was also thinking of shooting a documentary about wait loss treament and would like to know more about how this interesting machine works.
P. Roger
Roger, Absolutely. I am sure there would be a cadre of dependable physicians up North who would share. Try Alistair and Jean Carruthers in Vancouver. Or call Dave Heagy at Zeltiq and ask who has this device in Toronto.
I am a dermatologist from Bilbao,Basque Country (Spain). I know Dr Zachary from tha ASLMS meetings and like his comments. I have no financial interests in Zeltiq. Our team performed so far 61 cryolipolysis on abdomen and flanks. Of them, 13 patients were followed up 4 months. Of these 13 all but 2 patients lost 0,5 cm or more in one treatment.6 out of 13 patients lost 0,7-1,1 cm. The “non reponder” 2 patients lost 0,2-0,4 cm fat in the abdomen. But one of these 2 was treated also on the lateral flanks and had more than 0,7 cm lose. So in the same patient, one area can get better result than other area. We are seeing that some are mesurement problems. We use a plicometer, which is not accurate, and also there is a variability from one technician or doctor to the other and from right side to left side measurements. Also it is difficult to measure 3 months later on the exact same points. Until mesurements are not accurate is difficult to make accurate staments on results . In general our patients are satisfied and 10 out of the 61 had taken 2 treatments so far. The pain issue is interesting: We had one patient last month (young male) with intense pain inmediately after retiring the suction device 2 times (right-left). The pain recurred with the second suction even trying with “preventive” ibuprofen. Interesting for me is that pain was relieved with heat and lasted about 2-4 minutes, as if reheating the tissue to normal temperature was the cause. It remembered me how skin hurts for some minutes after doing cryotherapy of warts or others. Vascular quick vasodiltation (quick reperfusion) may be implied. Other 2 patients had pain (less intense) related to suction which was releived diminishing the suction. In this case pain could be muscular since it occurred in a heavy trainer man with little fat and in a woman with littel fat above the umbilicus
Great comments! Thank you for your insight. The onset of pain was rapid in your case, suggesting that this was not necessarily associated with a slow onset panniculitis. The discussion about aetiology of this rare instance of severe pain continues ……
Interesting new information from the Harvard Laser Course – “What’s the truth” last weekend. I understand that of the 30,000 treatments already performed with the Zeltiq device, there have been about 7 more cases of moderate to severe pain, worldwide. The company is very interested in doing the right thing here, which is finding the cause of these temporary but significant symptoms. With an incidence of approximately one in 3000 cases, these symptoms are not likely to be considered unacceptable. Nevertheless, the treating physicians should warn patients of this possibility, and report any untoward issues directly to the company.
I am sorry I only get to a leave a reply now while I sit here at my desk and not while enjoying a leisurely Parisian lunch…nonetheless, a great topic to discuss.
I too have somewhat variable responses. The majority of patients, (diligently documented by 3-D imaging, 2-D imaging as well as tape measure and weight) have a response. But I certainly have had non-responders. I cannot find a common variable for the non-responders. I do think there may be something to the concept of perhaps different fat freezes differently. Although my patients are east coast folks, they are fairly fit, low fat diet, athletic individuals who are most likely taking in less saturated fats.
An interesting article looking at fluctuation and criteria of porcine fat firmness published in animal science looked at fat quality, to examine the fluctuation and criteria of porcine fat firmness. Several physiochemical methods were performed on 237 porcine perirenal fat samples that were obtained randomly from a commercial market. The relationship between perirenal fat and the middle subcutaneous fat layer was investigated to predict fat quality. Each physiochemical property of the perirenal fat showed considerable variation as a 40-fold difference in firmness was observed between the most extreme samples. Differences between these extremes were 19°C in melting point, 0·0043 for refractive index, and 18 g per 100 g fatty acid methyl esters for saturated fatty acids (SFA) concentration. Strong curvilinear relationships were found between Instron and sensory firmness scores (R=0·90–0·96, no.=24). These results indicate that there are wide fluctuations in the porcine fat quality. The paper discusses the variable percentage of saturated fats and the degree to which it responds to melting. This may provide some theory to then examine in human fat…ratio of saturated fats freezing at different temperature.
I have also had a few patients experience significant discomfort after the procedure. All resolved within 2-7 days of procedure and controlled with tylenol. As it seemed to increase in intensity with certain movement/ body positions, seems to suggest microfascial or musclar tears. I have now started to decrease suction from recommended 60 in some smaller patients, or patients who do not have enough laxity to allow for greater suction.
Lori. Great comments and very insightful.
Some of my patients who don’t notice much improvement can still have a noticeable change in their ‘pinch test’. That is comparing the thickness of a roll of fat (let’s call it what it is!) before and after. Not very scientific, but relevant nevertheless. Appreciate the thoughtfulness of your response. Chris