Effects of cryolipolysis by vacuum system and by cooling plates: a comparative study

BACKGROUND: Cryolipolysis reduces the thickness of adipose tissue, but are different ways of applying this technology. OBJECTIVES: To compare the histological and immunohistochemical differences between the application of suction cryolipolysis versus plate cryolipolysis in adipose tissue. METHODS: The sample included two participants with localized fat. One participant received a session of cryolipolysis by vacuum system (−11°C, −30 KPA, two cycles of 30 minutes, and three minutes of manual reperfusion); the other participant received cryolipolysis by cooling plates (−5°C, two cycles of 30 minutes, and three minutes of manual reperfusion). After 60 days, participants underwent abdominoplasty surgeries, and tissue fragments were removed and submitted to biopsy. RESULTS: The treated sides showed a significant reduction of localized fat and activation of the adipocyte apoptosis, evidenced by the presence of CASP3. Moreover, this reduction was associated with an increase in COX‐2. The total quantity of collagen was greater on the treated sides, without significant differences between application methods. However, type I collagen was predominant in the vacuum system. The presence of FGF2 indicated activation of pathways of fibroblast proliferation, with a neocollagenesis rate approximately 50% higher in the vacuum system. Analysis showed a greater DRP1 expression in the vacuum system, indicating an increase in metabolic rate due to higher inflammation. The differentiation of adipocytes was significantly present in the side treated with the vacuum system, with a PPAR‐ γ expression 100% higher. CONCLUSION: The vacuum system seems to be superior to cooling plates in the reduction of localized fat, neocollagenesis, and fibroblast proliferation.