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Murphrey M, Garibyan L. Cryolipolysis: The future of cryolipolysis. J Cosmet Dermatol 2023; 22 Suppl 3:37-47. [PMID: 37988715 DOI: 10.1111/jocd.15985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 08/21/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Cryolipolysis has revolutionized the field of cosmetic dermatology as a nonsurgical procedure, utilizing controlled cooling to selectively destroy fat cells. AIMS AND METHODS This review article will focus on the future prospects of cryolipolysis, considering advancements in current technology as well as innovations that hold promise for the future. We will explore emerging trends in cryolipolysis, considering novel applicator designs, combination therapies, an innovative injectable treatment approach, and the evolving role of this technology in the field of cosmetic dermatology. CONCLUSION The future holds promise for advances in cryolipolysis using both the noninvasive topical cooling approach and the novel injectable ice-slurry technology.
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Affiliation(s)
- Morgan Murphrey
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
| | - Lilit Garibyan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
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Moradi Tuchayi S, Khachatryan Y, Wang Y, Rox Anderson R, Wang JS, Wein MN, Garibyan L. Selective reduction of visceral adipose tissue with injectable ice slurry. Sci Rep 2023; 13:16350. [PMID: 37770553 PMCID: PMC10539385 DOI: 10.1038/s41598-023-43220-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/21/2023] [Indexed: 09/30/2023] Open
Abstract
Reduction in visceral adipose tissue (VAT) mass reduces body weight and metabolic disease risk in obese patients. However surgical removal of VAT is highly invasive and thus not clinically feasible. We developed an injectable ice slurry for selective reduction of adipose tissue through cryolipolysis. The aim of this study was to investigate safety, feasibility and mechanism of ice slurry-induced cryolipolysis of VAT. Perigonadal VAT in diet-induced obese mice and rats was subjected to slurry or sham treatment. Body weight and blood chemistry were monitored for 56 days post-treatment. Histological analysis and molecular studies were performed to elucidate mechanisms of fat reduction. Treatment of VAT was well tolerated in all animals. Slurry induced adipocyte cell death via selective cryolipolysis; significant weight loss was noted at day 21 post-treatment. RNA sequencing from treated VAT samples showed increased expression of genes involved in inflammation, immune response, collagen biosynthesis and wound healing, and decreased expression of adipokines. This study demonstrates that slurry treatment is safe and effective in inducing cryolipolysis of VAT and subsequent weight loss in mice. Ice slurry is promising as a minimally-invasive treatment to reduce visceral adipose tissue.
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Affiliation(s)
- Sara Moradi Tuchayi
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street-Thier 2, Boston, MA, 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, USA
| | - Yeva Khachatryan
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street-Thier 2, Boston, MA, 02114, USA
| | - Ying Wang
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street-Thier 2, Boston, MA, 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, USA
| | - R Rox Anderson
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street-Thier 2, Boston, MA, 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, USA
| | - Jialiang S Wang
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Marc N Wein
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Lilit Garibyan
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street-Thier 2, Boston, MA, 02114, USA.
- Department of Dermatology, Harvard Medical School, Boston, USA.
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Shuhaiber J, Moradi Tuchayi S, Bijari FJ, Guehl NJ, Wang Y, Farinelli WA, Arkun K, El Fakhri G, Anderson RR, Garibyan L. Injectable ice slurry for reducing pericardial adipose tissue. Lasers Surg Med 2023; 55:674-679. [PMID: 37464943 DOI: 10.1002/lsm.23709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/29/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Excess pericardial adipose tissue (PAT) is associated with a higher risk of cardiovascular diseases. Currently, available methods for reducing PAT volume include weight loss through diet and exercise, weight loss with medications, and bariatric surgery. However, these methods are all limited by low patient compliance to maintain the results. We have developed an injectable ice slurry that could selectively target and reduce subcutaneous adipose tissue volume. The aim of this study was to investigate the feasibility and safety of using injectable slurry to selectively reduce PAT volume in a preclinical large animal model. METHODS PAT in Yucatan swine was injected with slurry or room temperature control solution. All animals were imaged with baseline chest computed tomography (CT) before slurry injection and at 2 months after injection to quantify PAT volume. Specimens from injected and noninjected PAT were harvested for histology. RESULTS Slurry treatment of PAT was well tolerated in all animals. Slurry-induced selective cryolipolysis in treated PAT. CT imaging showed decrease in PAT volume in treated area at 8 weeks posttreatment compared to baseline, that was significantly different from control solution treated group (median [range]: -29.66 [-35.07 to -27.92]% vs. -1.50 [-11.69 to 8.69]% in control animals respectively, p < 0.05). CONCLUSIONS This study demonstrated that slurry injection into PAT is feasible in a large animal model. Slurry injection was safe and effective in inducing selective cryolipolysis in PAT and reducing PAT volume. Slurry reduction of PAT could potentially serve as a novel treatment for cardiovascular diseases.
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Affiliation(s)
- Jeffrey Shuhaiber
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sara Moradi Tuchayi
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Felicitas J Bijari
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicolas J Guehl
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ying Wang
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - William A Farinelli
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Knarik Arkun
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, Massachusetts, USA
| | - Georges El Fakhri
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard R Anderson
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lilit Garibyan
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Mineroff J, Nguyen JK, Jagdeo J. Potential treatment modalities for suprapubic adiposity and pubic contouring. Arch Dermatol Res 2023; 315:1615-1619. [PMID: 36757442 DOI: 10.1007/s00403-023-02555-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/22/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
Abstract
Excess suprapubic adiposity can have negative consequences for patients, including concerns related to physical comfort, sexual function, hygiene, and esthetics. Historically, treatment options for pubic contouring have been limited to surgical methods. The purpose of this article is to review the literature investigating the use of minimally invasive fat reduction treatments for suprapubic adiposity including cryolipolysis, injection lipolysis, radiofrequency, and ultrasound. A thorough search of the PubMed database was conducted to search for studies evaluating the use of cryolipolysis, injection lipolysis, radiofrequency, and ultrasound for suprapubic adiposity. The literature search did not yield any publications that evaluated the use of cryolipolysis, injection lipolysis, radiofrequency, or ultrasound for treatment of suprapubic adiposity. Minimally invasive treatments for fat reduction, including cryolipolysis, injection lipolysis, radiofrequency, and ultrasound, have clinically demonstrated safety and efficacy in various anatomic locations. However, clinical studies evaluating these procedures for suprapubic adiposity are noticeably absent. These options may confer benefits such as decreased recovery time, risk, and cost to patients. Future clinical studies evaluating these potential treatment modalities for suprapubic fat reduction are warranted.
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Affiliation(s)
- Jessica Mineroff
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA
| | - Julie K Nguyen
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, 8th Floor, Brooklyn, NY, 11203, USA.
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA.
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Orestes MI, Tuchayi SM, Wang Y, Farinelli W, Arkun K, Anderson RR, Thomas R, Garibyan L. Safety and feasibility of selective tongue fat reduction with injected ice‐slurry. Laryngoscope Investig Otolaryngol 2022; 7:1675-1680. [PMID: 36258870 PMCID: PMC9575057 DOI: 10.1002/lio2.902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives There is growing evidence that excess adipose tissue within the head and neck contributes to obstructive sleep apnea (OSA), particularly in obese patients. This subset of the population is often difficult to treat with surgical therapies. We theorized that a novel, transcervical method of injectable cryoablation using ice‐slurry can achieve low temperatures without causing neurovascular damage or airway distress in a swine model. Methods Four Yorkshire pigs were injected with ice‐slurry comprised of normal saline and 10% glycerol cooled to −6°C via a transcervical, ultrasound guided approach. Direct laryngoscopy was used to confirm accurate placement of the slurry. Thermocouple placement at the needle‐tip was used to measure temperatures at injection site. Swine were monitored for clinical signs of tongue necrosis and airway edema for 2 months, and then euthanized. Twelve biopsy samples from the base of the tongue were collected for histology. These were assessed for presence of tissue damage, inflammation and collagen formation by a blinded board‐certified pathologist. Results Tongue tissue temperature below 10°C was achieved for 13.5 ± 1.1 min. Minimum tissue temperature was −4 ± 0.6°C. There was no clinical or pathological evidence of tongue damage to include damage to the lingual nerve or artery. There was some histologic evidence of new collagen formation in areas of the tongue. Conclusions Transcervical ultrasound‐guided ice‐slurry injection is feasible, well‐tolerated at temperatures previously shown to be capable of selectively targeting adipose tissue in the base of the tongue in a preclinical swine model, without causing neurovascular damage or airway distress when properly injected.
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Affiliation(s)
- Michael Ian Orestes
- Department of Surgery Uniformed Services University of the Health Sciences Bethesda Maryland USA
| | - Sara Moradi Tuchayi
- Wellman Center for Photomedicine, Department of Dermatology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA
| | - Ying Wang
- Wellman Center for Photomedicine, Department of Dermatology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA
| | - William Farinelli
- Wellman Center for Photomedicine, Department of Dermatology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA
| | - Knarik Arkun
- Department of Pathology and Laboratory Medicine Tufts Medical Center Boston Massachusetts USA
| | - R. Rox Anderson
- Wellman Center for Photomedicine, Department of Dermatology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA
| | - Richard Thomas
- Department of Surgery Uniformed Services University of the Health Sciences Bethesda Maryland USA
| | - Lilit Garibyan
- Wellman Center for Photomedicine, Department of Dermatology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA
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