Pharmacological treatment of complications after the use of Cryolipolysis: case series.
Authors: Ruiz-Silva, C Ruiz-Silva, C , Leite, MPF Leite, MPF , Moleiro, D Moleiro, D , Ruiz-Silva, CR Ruiz-Silva, CR , Montagner-Moura, JE Montagner-Moura, JE , Ruiz-Silva, KR Ruiz-Silva, KR 
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 water-rich tissues, such as the
skin. Cryolipolysis stands out as a non-invasive
method for body contouring without damaging
subcutaneous tissue, becoming a popular treatment
to non-invasively address localized fat
accumulation and tone the dermis. However, a
large number of complications have occurred and
beauticians and aestheticians have no reports in the
literature on how to treat these complications with
medication. The most reported complication in
Pubmed is paradoxical adipose hyperplasia (PAH),
but in clinical practice, several complications
occur, such as frostbite, frostbite, panniculitis, PAH
and hyperchromia after inflammation.
Objective:This study aims to describe the authors'
experience in 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, describing the
lesions and the drugs with the greatest effectiveness
in the treatment.
Materials and methods:Exploratory research was
carried out, 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, but when an intercurrence
occurs, we must be able to treat and avoid
complications.
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, high-quality antifreeze
membrane and mandatory use of the “liner”
(plastic) as occurs throughout the world, protection
of sympathetic innervation through microcurrent
and finishing with drugs that promote the inhibition
of factors that lead to cell multiplication such as
PPAR gamma and CD 68. In case of injury, the
professional must be able to prescribe drugs that
prevent the progression of the complication.