Intercurrences And Complications Of The Use Of Cryolipolysis: Series Of Cases And Treatments.
Authors: C Ruiz-Silva, , MPF Leite, , CR Ruiz-Silva, , MP Hage, , JE Montagner-Moura, 
Published: January 2025

The cryolipolysis technique uses selective and controlled cooling based on the principle that lipid-rich tissues are
more susceptible to cold damage than surrounding water-rich tissues. Cryolipolysis stands out as a non-invasive
method for body contouring without damaging subcutaneous tissue, becoming a popular treatment to noninvasively address localized fat accumulation and tone the dermis. The complications previously reported in the
literature are mostly paradoxical adipose hyperplasia (HAP), but there has been a large increase in unreported
injuries in recent years, with several complications such as frostbite, frostbite, panniculitis, HAP and
hyperchromia post-inflammation.
Objective: This study aims to describe the authors' experience guiding professionals in the management and
treatment of several cases of complications resulting from the application of the Cryolipolysis technique. We
guided more than 10,000 complications in 12 years, and made a brief review of the world literature on the subject.
Materials and Methods: An exploratory study was conducted, presented in a narrative review, to demonstrate
the action of the Cryolipolysis technique used in the treatment of aesthetic dysfunctions. The review explored
scientific articles published and available in the following databases: MEDLINE (Medical Literature Analysis
and Retrieval System Online), PubMed (National Library of Medicine), SCIELO (Scientific Electronic Library
Online), LILACS (Latin American and Caribbean Literature in Health Sciences), and Google Scholar. In
addition, a series of cases of complications from the use of the cryolipolysis technique that occurred in a
multicentric manner and developed with the use of various commercially available equipment were added to this
study.
Results: when using techniques based on scientific studies, respecting time and temperature, in addition to
associations with equipment, drugs and techniques that inhibit cellular precursor factors, we will reduce possible
intercurrences and complications. The most common complications described in this study are neuropathic
lesions in sympathetic innervation, paradoxical adipose hyperplasia, frostbite, frostnip and hemosiderin
hyperpigmentation.
Conclusion: The scientific literature demonstrating the lesions and their possible causes with the cryolipolysis
technique is robust, but it did not prevent serious complications secondary to the use of Cryolipolysis, which has
become common in aesthetics in Brazil and worldwide. Therefore, it deserves full attention for the adoption of
appropriate application techniques to minimize such complications, among them: greater temperature control
with machines that show the skin temperature on the panel, correct time control, without exaggeration, highquality antifreeze membrane and mandatory use of the “liner” (plastic) as occurs throughout the world,
protection of sympathetic innervation through microcurrent and completion of the techniques with inhibition of factors that lead to cell multiplication such as PPAR gamma and CD 68 through shock waves or 40 kHz ultrasound, in addition to not performing vigorous massage on hard frozen tissue.