This weekend, physicians and aesthetic experts gathered in New York for the Aesthetic Plastic Surgery: The Next Generation symposium. Dr. Sydney Coleman of New York spoke about Zeltiq, a new method of non-surgical fat reduction.



Zeltiq works by using precisely controlled, targeted cold therapy in a treatment that lasts about one hour per treatment area. The skin to be treated is suctioned between two cooling plates which take the fat to just above freezing. The cold extracts energy from fat causing it to die. Though it is referred to as cryolipolysis, it is not actually "freezing" the fat or the surrounding tissues. Rather, it crystallizes the lipids in fat cells causing the slow collapse of cells as they die. The procedure is biologically selective meaning that it only targets fat cells and only those in the superficial fat layer close to the skin. The body then carries off the dead cells over the course of two to three months so that the result is seen more gradually.

Dr. Coleman did say that this is not liposuction, so while the results are measurable, they are modest. The procedure is ideal for fit patient with a stubborn fat pocket who is unwilling to undergo surgery. There is no associated downtime, just some redness that lasts around 2 hours Some patients report a suction mark similar to a 'hickey' where the device was attached.

The procedure is not FDA approved for fat lipolysis at this time though it does have FDA approval for use in dermatologic surgery. Currently, the use of Zeltiq for fat reduction is off label. The results appear to be long lasting and testing has shown no increase in blood lipids or blood cholesterol. Other procedures which 'melt fat' have concerned some physicians for fear that the body cannot properly process the large quantity of fat introduced into the lymphatic system at once. Zeltiq seems to avoid this concern as it takes several weeks for the fat to be expelled.