Treatment Of Lipedema Using Cryolipolysis Associated With Microcurrents
Authors: C Ruiz-Silva, , D Moleiro, , CR Ruiz-Silva, 
Published: October 2024

Through a literature review, we present the technique of cryolipolysis with a mobile gauntlet as a treatment for lipedema. Since lipedema is a chronic disease with a high incidence that affects body aesthetics and self-esteem, it needs treatment in order to avoid emotional illnesses. Lipedema is a disease that occurs in adipose tissues through primary lipotrophy characterized by abnormal fat deposition, mainly in the buttocks and legs bilaterally. The mobile gauntlet technique associated with beta adrenergic stimuli promotes the biogenesis of mitochondrial crests, acting on beige adipose tissue as a treatment for obesity and comorbidities due to its thermogenic and neurogenic effect. The described technique is applied using the plates on a movable gauntlet in 4 cycles of 5 minutes in each 30 x 30 cm area associated with the use of microcurrents. Objective:The objective of this study was to review the literature on the cryolipolysis technique using a mobile handle and its association with microcurrents in lipedema in order to reduce adipose tissue and tone the dermis, reducing pain and the volume of lipedema, with the presentation of clinical cases. Materials and Methods: In this study, we performed a comprehensive review of all scientific articles available and indexed in PubMed and Web of Science over the last 20 years on this technology and its effects on lipedema. We discussed the scientific evidence available from clinical studies and analyzed the effects and possible mechanisms of action on lipedema by associating microcurrents. The treatments were performed using the mobile plate cryolipolysis handle technique, with intervals for reperfusion. We used 4 series of 5 minutes of freezing and in the intervals 3 minutes for return of circulation, that is, reperfusion without injury. We demonstrated the result after 3 sessions. Results: The association of cold with stimulation of the sympathetic nervous system through electrotherapy promotes activation of the PERK and MICUS systems. The action of freezing and simulating physical activity through microcurrent (release of hormones similar to physical activity) after lipolytic stimuli (electrolipolysis) encounters an environment with many lipid droplets that influence the organization of the ridges; Mitochondria perform β-oxidation of fatty acids, but when stimulated by cold, drastic changes in morphology occur due to activation of PERK; (Gallardo-Montejano, 2021). The mobile handle promotes the selective reduction of adipose cells and is effective in the treatment of cellulite and lipedema through the remodeling of dermal collagen (cryodermatringe). Histological analysis confirmed a selective and gradual reduction of adipose tissue by programmed death (apoptosis) triggered by reperfusion. The safety of the method is highlighted by the absence of significant increases in liver enzymes or serum lipids. Molecular studies did not demonstrate changes in peroxisome proliferator-activated receptor (PPAR) transcripts. No changes were evident in the transcripts, which highlights the safety of the technology used (Ferraro, 2012). In our case study, the patients were satisfied with the results, as shown in the photos. Conclusion: The literature review presented histological and biochemical aspects of lipedema. Although it is a disease considered primary lipodystrophy, with a high incidence, more studies on treatments are still needed to improve the quality of life and self-esteem of those with the disease. Among the treatments presented in the literature, the cryolipolysis technique with a mobile handle is presented as a treatment that reduces adipose tissue, as well as reduces the process of edema and inflammation with the association of microcurrent. The plates promote reperfusion in adipocytes, generate reactive oxygen species (oxidation) and activate apoptosis. Adipocytes are reactive to thermal shocks. The mobile handle promotes the selective reduction of adipose cells and is effective in the treatment of dermal collagen remodeling. Concomitant with this effect, there is the activation of PERK, which phosphorylates N-acetylglucosamine transferase (OGT), phosphorylating TOM70 at Ser94, increasing the import of the MIC19 protein into the mitochondria and promoting the formation of ridges and the formation of beige adipose tissue, rich in UCP1, which reinforces our hypothesis that in lipedema we need to inhibit transcription factors, PPRA gamma, and adipocyte typology starting with the mitochondria and their organelles responsible for inhibiting apoptosis (NAIPS).