Many people pursuing an ideal physique are willing to splurge on body slimming or sculpting procedures. “Cryolipolysis” (also known as "fat freezing”) has become popular in recent years, touting selling points such as “nonsurgical”, “non-invasive” and “no recovery time” to attract consumers. However, the Consumer Council’s study revealed that cryolipolysis procedure can only be used for spot reduction but is not effective for weight loss. Consumers should also be mindful that such procedures are not suitable for everyone. For example, obese or significantly overweight people, individuals with saggy skin and poor skin tone, certain diseases, wounds, eczema, psoriasis, dermatitis and other skin problems should not consider fat freezing procedures.
The Council visited 7 beauty parlours and clinics providing fat freezing body slimming services and enquired about the details on relevant procedures. It was found that the costs, suggested number of treatment sessions, and recommended treatment area varied amongst service providers, with some beauty parlours /clinics replying that they will assess the efficacy by visual inspection or comparison of photos taken before and after the procedure, while some even claimed that consumers “could feel the effect personally” instead of adopting scientific measurement to access the efficacy.
The Council stresses that fat freezing and other body sculpting procedures cannot replace healthy lifestyle and appropriate weight management measures. Consumers are reminded not to easily believe in advertised results and promotional claims, while hoping to rely solely on beauty treatments to achieve an ideal body shape. Instead, a healthy physique should be achieved through persistent healthy habits, such as a balanced diet and an adequate amount of cardio exercise.
For Localised Fat Reduction but Not Weight Loss
Not for Overweight People or Areas with Insufficient Subcutaneous Fat
Cryolipolysis is a “fat freezing” procedure which selectively destroys subcutaneous fat cells using a controlled low-temperature treatment, aimed at resulting in apoptosis of the fat tissue in the target area which is then eliminated by the body through metabolism. As cryolipolysis is only a treatment meant for spot or localised fat reduction but not overall weight loss, it is not suitable for obese or significantly overweight individuals. Referring to information from the United States Food and Drug Administration (USFDA), FDA-cleared devices are intended for cold-assisted lipolysis of the submental and submandibular areas in individuals with a Body Mass Index (BMI) up to 46.2, and also for the treatment of fat in areas such as the upper arm, back, below the hips, thighs, abdomen, and flanks in individuals with a BMI up to 30.
On the other hand, another study pointed out that the targeted treatment site should have a sufficient amount of fat. Otherwise, it might affect the positioning of the applicator during operation. Cryolipolysis is not suitable for treating areas which are primarily muscle (such as the calves), or areas or individuals with severely saggy skin. The relevant procedure is also only intended for treatment of subcutaneous fat but not for reduction of visceral fat.
Charges and Times of Treatment Varied Amongst Beauty Parlours
Be Careful of Loose Assessment Methods and Claimed Efficacies
The mystery survey was conducted by the Council staff. 7 beauty parlours and clinics providing cryolipolysis treatments were visited and enquired for detailed information on relevant treatments targeting a particular area of fat in the upper arms of the staff. Costs could range from $4,900 to about $48,000, a variance of almost 8.8 times, while the treatment sessions required also varied significantly, ranging from 2 to 6 sessions, and with inter-sessional intervals from 1 week to 2 months, meaning that the whole treatment would require at least 1 month to 6 months to complete.
In general, the first treatment session would target superficial fat tissues, whereas areas with more fat might require more sessions to achieve a more visible effect, while between sessions a resting period (such as a few weeks) is also needed. Referring to the information from the American Academy of Dermatology Association (AAD), as it may take 4 to 6 months’ time for the affected area’s fat cells to be gradually eliminated from the body, treated fat bulges cannot be eliminated immediately. Another study pointed out that the elimination of fat might be affected by various factors, such as the vascular distribution and metabolic activity. As such, the final result may vary between individuals.
Having paid for the treatment, consumers would normally expect to have a notable result. Some of the surveyed beauty parlours stated that after the procedure, the targeted treatment sites will show a reduction in fat cells ranging from 18% to up to 27%, though the actual reduction rate might differ amongst different body parts while the effect might also vary from person to person. Examination of the beauty parlours’ websites revealed certain claims such as “27% reduction in fat with just 1 treatment session” and “up to 27% fat reduction in the treated site”. However, the websites also stated in smaller print that it was a “reduction in fat cells”, meaning that the treatment could only reduce the fat cells in the treatment site rather than the overall body fat. Furthermore, the websites generally did not explain how the percentage reduction in fat cells was measured.
When the Council staff asked about the assessment of the treatment efficacy, some beauty parlours only stated that photos taken before and after the treatment will be compared, or even through visual inspection, whereas a few of them claimed that consumers “could feel the effect personally”, reflecting a rough assessment that lacked quantitative measurement.
Amongst the complaint cases received by the Council relating to the “cryolipolysis” procedure, some complainants expressed that despite having received multiple treatment sessions, certain parts still showed unsatisfactory or even no results. The Council reminds relevant service providers that they should suggest a clear measurement method to assess efficacy, such as using a caliper, as well as the time required to achieve a more notable result. This could give consumers a more comprehensive and concrete understanding of the efficacy of the relevant procedure, so as to avoid consumer disputes arising from the results not meeting expectations.
Cryolipolysis May Cause Side Effects
Qualified Professionals and Devices Should Not be Overlooked
After receiving the fat freezing procedure, the treatment area will feel intense cold, stiffness, and swelling, etc., which will generally subside in a few hours, whereas other sensations including erythema, bruising, numbness and pain might persist for a few days to a few weeks. Although the risk of developing side effects is relatively low for cryolipolysis, the AAD revealed that the underlying risks of surface irregularities and asymmetry after treatments. A minority might even develop rare side effects such as paradoxical adipocyte hyperplasia (visibly enlarged tissue volume). In recent years, there have been cases of severe frostbite, paradoxical adipose hyperplasia, morphea and other conditions which affect the appearance of the skin. Inexperienced operators, misplacement of the device applicator, insufficient protective gel pads, or equipment of poor quality might be the reasons involved.
The American Society of Plastic Surgeons also reminded patients with medical conditions associated with low temperatures, including cryoglobulinemia, cold urticaria, and paroxysmal cold hemoglobinuria, not to receive cryolipolysis procedures.
Besides, a number of overseas studies have suggested that the procedure should be performed by trained physicians or medical professionals. However, the 7 surveyed beauty parlours/clinic expressed that the relevant procedures will be performed by their “therapists”, nurses or “physician assistants”, with some service providers claiming that the customer need not see a doctor during the entire process. Only 1 clinic declared that an assessment will be conducted by a doctor before the procedure, and that the consumer could choose a nurse or doctor to perform the procedure, yet the charge might vary.
The Council urges beauty parlours and clinics providing relevant services to fully disclose all potential risks and limitations related to the procedure, while ensuring the treatment is performed by professionally trained operators, so as to safeguard consumers.
The Council reminds consumers to consult with a doctor before considering receiving the treatment procedure, and to review their personal medical record, physical condition and medicines, discuss expectations for fat reduction, as well as to understand the potential risks of the procedure and the attainable results. Before deciding whether or not to receive relevant treatments, consumers should also make detailed enquiries with the beauty parlours/clinics about the qualifications of the operators who will perform the procedure, in addition to the information of the device to be used, such as whether it is listed under the Medical Device Administrative Control System of the Department of Health, or has acquired clearance by overseas health authorities (such as the FDA).
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