Minimally invasive methods of submental fat correction: a modern approach and personal experience

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OBJECTIVE

To show the author’s experience of improving the submental area shape by removing subcutaneous fat with cryolipolysis. Excessive deposition of submental subcutaneous fat is one of the most common aesthetic problems, and today for the correction patients prefer non-invasive procedures to surgical interventions.

MATERIAL AND METHODS

The review presents the results of preclinical and clinical studies used cryolipolysis in this area, summarizes data on patient satisfaction and objective effects of the procedure. The results are described from the perspective of three-dimensional analysis. In addition, the effectiveness of the combined action of cryolipolysis with other methods, such as micro focused ultrasound, monopolar radio wave lifting, ultrasonic lifting, etc., are shown. Personal experience of using cryolipolysis in combination with micro focused ultrasound at the SMAS level, RF-lifting, indirect lipolytics and fillers is also shown.

CONCLUSIONS

According to the literature analysis results, cryolipolysis is an effective method for correcting excessive deposition of submental subcutaneous fat from the point of view of subjective and objective assessment. But also other methods can potentiate the effect of cryolipolysis and increase the procedure effectiveness. In particular, many domestic studies have been conducted on this issue. The method is characterized by a favorable safety profile with minimal side effects, the most common of which are bruising, erythema, swelling, tingling and numbness, which disappear within a few weeks. All this together demonstrates the fact that cryolipolysis has great potential for development and wider application in clinical practice.

Keywords:

minimally invasive methods

submental fat correction

cryolipolysis

Authors:

Chebotareva Yu.Yu.

Clinic «ESTELAB»

Received:

07.12.2020

Accepted:

02.02.2021

List of references:

Raveendran SS, Anthony DJ, Ion L. An anatomic basis for volumetric evaluation of the neck. Aesthet Surg J. 2012;32(6):685-691.
Garibyan L, Sipprell WH 3rd, Jalian HR, Sakamoto FH, Avram M, Anderson RR. Three-dimensional volumetric quantification of fat loss following cryolipolysis. Lasers Surg Med. 2014;46(2):75-80.
Shek SY, Chan NPY, Chan HH. Non-invasive cryolipolysis for body contouring in Chinese — a first commercial experience. Lasers Surg Med. 2012; 44(2):125-130.
Schlessinger J, Weiss SR, Jewell M, Narurkar V, Weinkle S, Gold MH, Bazerkanian E. Perceptions and practices in submental fat treatment: a survey of physicians and patients. Skinmed. 2013;11(1):27-31.
Consumer Survey on Cosmetic Dermatologic Procedures [press release]. 2015.
Huettner F, Vasconez LO, de la Torre JI. Neck rejuvenation — anatomy and clinical correlation. Facial Plast Surg. 2012;28(1):40-51.
Allergan. Unpublished data. CoolSculpting. The study of patients. INT01252018. March 2018. (In Russ.).
Cosmetic Surgery National Data Bank Statistics. 2020.
Fakhouri TM, El Tal AK, Abrou AE, Mehregan DA, Barone F. Laser-assisted lipolysis: a review. Dermatol Surg. 2012;38(2):155-169.
Georgesen C, Lipner SR. The development, evidence, and current use of ATX-101 for the treatment of submental fat. J Cosmet Dermatol. 2017;16(2): 174-179.
Keramidas E, Rodopoulou S. Radiofrequency-assisted Liposuction for Neck and Lower Face Adipodermal Remodeling and Contouring. Plast Reconstr Surg Glob Open. 2016;4(8):e850.
Manstein D, Laubach H, Watanabe K, Farinelli W, Zurakowski D, Anderson RR. Selective cryolysis: a novel method of non-invasive fat removal. Lasers Surg Med. 2008;40(9):595-604.
McBean JC, Katz BE. Laser Lipolysis: An Update. J Clin Aesthet Dermatol. 2011;4(7):25-34.
Alizadeh Z, Halabchi F, Mazaheri R, Abolhasani M, Tabesh M. Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat. Int J Endocrinol Metab. 2016;14(4).
Shah GM, Greenberg JN, Tanzi EL, Monheit GD. Noninvasive approach to treatment of submental fullness. Semin Cutan Med Surg. 2017;36(4):164-169.
Thomas MK, D’Silva JA, Borole AJ. Injection Lipolysis: A Systematic Review of Literature and Our Experience with a Combination of Phosphatidylcholine and Deoxycholate over a Period of 14 Years in 1269 Patients of Indian and South East Asian Origin. J Cutan Aesthet Surg. 2018;11(4):222-228.
Humphrey S, Sykes J, Kantor J, Bertucci V, Walker P, Lee DR, Lizzul PF, Gross TM, Beddingfield FC 3rd. ATX-101 for reduction of submental fat: A phase III randomized controlled trial. J Am Acad Dermatol. 2016;75(4): 788-797.e7.
Jones DH, Carruthers J, Joseph JH, Callender VD, Walker P, Lee DR, Subramanian M, Lizzul PF, Gross TM, Beddingfield FC 3rd. REFINE-1, a Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase 3 Trial With ATX-101, an Injectable Drug for Submental Fat Reduction. Dermatol Surg. 2016;42(1):38-49.
Rzany B, Griffiths T, Walker P, Lippert S, McDiarmid J, Havlickova B. Reduction of unwanted submental fat with ATX-101 (deoxycholic acid), an adipocytolytic injectable treatment: results from a phase III, randomized, placebo-controlled study. Br J Dermatol. 2014;170(2):445-453.
Ingargiola MJ, Motakef S, Chung MT, Vasconez HC, Sasaki GH. Cryolipolysis for Fat Reduction and Body Contouring: Safety and Efficacy of Current Treatment Paradigms. Plast Reconstr Surg. 2015;135(6):1581-1590.
Lidagoster MI, Cinelli PB, Leveé EM, Sian CS. Comparison of autologous fat transfer in fresh, refrigerated, and frozen specimens: an animal model. Ann Plast Surg. 2000;44(5):512-515.
Wolter TP, von Heimburg D, Stoffels I, Groeger A, Pallua N. Cryopreservation of mature human adipocytes: in vitro measurement of viability. Ann Plast Surg. 2005;55(4):408-413.
Zelickson B, Egbert BM, Preciado J, Allison J, Springer K, Rhoades RW, Manstein D. Cryolipolysis for noninvasive fat cell destruction: initial results from a pig model. Dermatol Surg. 2009;35(10):1462-1470.
Kilmer SL, Burns AJ, Zelickson BD. Safety and efficacy of cryolipolysis for non-invasive reduction of submental fat. Lasers Surg Med. 2016;48(1):3-13.
Silva HL, Hernandez EC, Vazquez MG, Delgado SL, Blanco AP. Noninvasive submental fat reduction using colder cryolipolysis. J Cosmet Dermatol. 2017;16(4)460-465.
Rodopoulou S, Gavala MI, Keramidas E. Three-dimensional Cryolipolysis for Submental and Lateral Neck Fat Reduction. Plast Reconstr Surg Glob Open. 2020;8(4).
Li MK, Mazur C, DaSilva D, Canfield D, McDaniel DH. Use of 3-Dimensional Imaging in Submental Fat Reduction After Cryolipolysis. Dermatol Surg. 2018;44(6):889-892.
Bernstein EF, Bloom JD. Safety and Efficacy of Bilateral Submental Cryolipolysis With Quantified 3-Dimensional Imaging of Fat Reduction and Skin Tightening. JAMA Facial Plast Surg. 2017;19(5):350-357.
Jain M, Savage NE, Spiteri K, Snell BJ. A 3-Dimensional Quantitative Analysis of Volume Loss Following Submental Cryolipolysis. Aesthet Surg J. 2020;40(2):123-132.
Vanaman M, Fabi SG, Cox SE. Neck Rejuvenation Using a Combination Approach: Our Experience and a Review of the Literature. Dermatol Surg. 2016;42(Suppl 2):94-100.
Kruglik EV, Sadretdinova ESh, Kokhnyuk DV. Efficiency of cryolipolysis in the submental area in complex correction of face soft tissues: subjective and objective assessment. Plastic Surgery and Aesthetic Medicine. 2020;2:57-61.
Kruglik EV, Likhtinova AN, Saromytskaya AN, Chebotareva YuYu, Yusova ZhYu. The use of cryolipolysis for body contouring in monotherapy and in combination with other methods of aesthetic correction. Clinical Dermatology and Venereology. 2020;19(5):771-780.
Chebotareva YuYu, Gubanova EI. A new approach to chin correction using the CoolMini CoolSculpting By ZELTIQ applicator. Hardware Cosmetology. 2018;1-2:206-212.
Chebotareva YuYu, Gubanova EI. Correction of submental area fat deposits by cryolipolysis. Personal experience and author’s classification adapted for quick assessment and preliminary determination of the number of procedures. Hardware Cosmetology. 2019;3-4:206-212.
Yusova ZhYu. CoolMini applicator in the combined protocol of submental area face aesthetic correction. Plastic Surgery and Aesthetic Medicine. 2020; 1:94-99.
Stevens WG. Does Cryolipolysis Lead to Skin Tightening? A First Report of Cryodermadstringo. Aesthetic Surgery Journal. 2014;34(6):32-34.
Carruthers J, Stevens WG, Carruthers A, Humphrey S. Cryolipolysis and Skin Tightening. Dermatol Surg. 2014;40:184-189.
Lozano JNJ. Skin dermal changes after cryolipolysis: a molecular and histological investigation. ASLMS; 2020.
User manual: Cryolipolysis system CoolSculpting with accessories. (In Russ.).
Instructions for use of MesoSculpt C71. (In Russ.).
Administration UFaD. 510(k) clearance K133212. 2014 [May 22, 2017]. https://www.accessdata.fda.gov/cdrh_docs/pdf 13/K133212.pdf
Ho D, Jagdeo J. A Systematic Review of Paradoxical Adipose Hyperplasia (PAH) Post-Cryolipolysis. J Drugs Dermatol. 2017;16(1):62-67.

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