Each year, 45 million Americans — many of them women — are consumed with thoughts of muffin tops, love handles and other parts of their bodies, especially as the season for beach and bathing suits looms. Figures from the American Society of Plastic Surgeons show that $11 billion was spent on cosmetic procedures in 2012, accounting for 1.6 million procedures.
For those seeking to battle their perceived problems, a procedure called CoolSculpting is gaining prominence because it doesn’t require pills, exercise, needles or surgery.
“I really like this procedure,” said nationally known, board-certified cosmetic and reconstructive surgeon Kimberley Goh from her office in Myrtle Beach. “It tells the cell it’s time to die. [The cells] go, and they don’t come back.”
The procedure is based on Cryolipolysis (a registered trademark) and was developed by Harvard University scientists Dieter Manstein M.D. and R. Rox Anderson M.D. They discovered that cooling the skin will kill fat cells without harming the skin or tissue surrounding them.
Five years ago, Goh contacted representatives of Zeltiq Aesthetics, which manufactures the apparatus for CoolSculpting. She was satisfied with what she learned and decided to become certified and purchase the needed equipment.
Zeltiq was founded in 2005, and its CoolSculpting procedure has become the most accepted, noninvasive body-contouring method. It has sold its equipment to medical practices in more than 60 countries and reports more than 1 million treatments have been performed worldwide, 427,000 alone in 2013.
Goh is an advocate of CoolSculpting and has been offering the procedure since 2011. She emphasized that it is a body-contouring treatment, not a weight-loss method.
“It’s noninvasive,” she said, explaining that the procedure is U.S. Food and Drug Administration approved.
Audrey Grice, licensed practical nurse for 23 years and licensed esthetician for almost six years, said the four physicians in Wilmington Plastic Surgery decided in 2011 that CoolSculpting would be part of their practice. They and Grice became certified, and she has performed 1,500 treatments.
“It’s for fat that won’t leave,” she said. “Every patient has had good results.”
She has had several treatments herself, some on her upper and lower abdomen and some on her flanks. “It’s wonderful,” she said. “It’s customizing to the person’s body type.”
She emphasized that it is not an appropriate treatment for the obese because it’s not a weight-loss plan. It is appropriate for those who eat well and exercise but have “jiggling fat.”
Goh said she has interested patients contact her office for a free consultation to determine if they qualify, what their goals are and what treatment plan to pursue. Most treatments are last one hour and involve a device being placed on the problem area. Excessive fat is drawn into the device and cooled to 34-degrees Fahrenheit.
“Twenty to 25 percent of the fat cells are gone forever [after one treatment],” Goh said. “The cells go on a hunger strike and die.”
Patients resume their schedules as soon as the treatment is over. They may experience some bruising and reddening, but no scarring results. Skin is not permanently affected, and freezing does not occur because the area is not cooled to the freezing point, 32 degrees Fahrenheit. The procedure has proved to be safe, and the same area can be treated several times until a patient reaches the desired result.
“A candidate has a localized collection of fat,” Goh said. “It doesn’t work well when fat is spread evenly. After the treatment, clothes fit better, but you don’t change size. You have a moderate change.”
The procedure does not tighten skin, produce a loss in weight or require anesthesia or surgery. It does remove fat, reduce bulges and save time.
The procedure works well around the waist, hips, abdomen and thighs. Goh said she won’t do the procedure on the neck, and few people would benefit from having it on the arm because it doesn’t tighten the skin. In her experience, about 50 percent of those who have a consultation do not qualify because they need to lose a large amount of weight, have a medical condition that eliminates them or have another situation that exempts them.
Possible candidates should ask themselves if they can “pinch an inch,” if they exercise and if they are in good general health.
Kimberly Cooper, certified CoolSculpting technician, surgical technician and certified nursing assistant in Goh’s practice, said she’s had the procedure on both flanks and on her upper abdomen.
“I am very happy with it because it’s nonsurgical,” she said, “and there’s no downtime. You can have it done and go back to work. It’s an easy way to get rid of some unwanted areas that diet and exercise don’t always get.”
At Facial Aesthetic Center in Myrtle Beach, a medical spa, licensed esthetician and office manager Catherine Pelton said she took the training and began performing the CoolSculpting procedure in January 2014.
“Patients love it,” Grice said. “They come back for more and more and more. They come for CoolSculpting because it is not uncomfortable. It’s easy and there’s no surgery.
“Results often improve a patient’s self-image. Surgery is a great option, but it’s not always the best option. [CoolSculpting] is another tool in the toolbox to get patients where they want to be.”
FOR MORE INFORMATION
Learn more about CoolSculping at www.coolsculpting.com.
In the first evidence of a natural intervention triggering stem cell-based regeneration of an organ or system, a study in the June 5 issue of the Cell Press journal Cell Stem Cell shows that cycles of prolonged fasting not only protect against immune system damage — a major side effect of chemotherapy — but also induce immune system regeneration, shifting stem cells from a dormant state to a state of self-renewal.
In both mice and a Phase 1 human clinical trial, long periods of not eating significantly lowered white blood cell counts. In mice, fasting cycles then “flipped a regenerative switch”: changing the signaling pathways for hematopoietic stem cells, which are responsible for the generation of blood and immune systems, the research showed.
The study has major implications for healthier aging, in which immune system decline contributes to increased susceptibility to disease as we age. By outlining how prolonged fasting cycles — periods of no food for two to four days at a time over the course of six months — kill older and damaged immune cells and generate new ones, the research also has implications for chemotherapy tolerance and for those with a wide range of immune system deficiencies, including autoimmunity disorders.
“We could not predict that prolonged fasting would have such a remarkable effect in promoting stem cell-based regeneration of the hematopoietic system,” said corresponding author Valter Longo, the Edna M. Jones Professor of Gerontology and the Biological Sciences at the USC Davis School of Gerontology, and director of the USC Longevity Institute.
“When you starve, the system tries to save energy, and one of the things it can do to save energy is to recycle a lot of the immune cells that are not needed, especially those that may be damaged,” Longo said. “What we started noticing in both our human work and animal work is that the white blood cell count goes down with prolonged fasting. Then when you re-feed, the blood cells come back. So we started thinking, well, where does it come from?”
Prolonged fasting forces the body to use stores of glucose, fat and ketones, but also breaks down a significant portion of white blood cells. Longo likens the effect to lightening a plane of excess cargo.
During each cycle of fasting, this depletion of white blood cells induces changes that trigger stem cell-based regeneration of new immune system cells. In particular, prolonged fasting reduced the enzyme PKA, an effect previously discovered by the Longo team to extend longevity in simple organisms and which has been linked in other research to the regulation of stem cell self-renewal and pluripotency — that is, the potential for one cell to develop into many different cell types. Prolonged fasting also lowered levels of IGF-1, a growth-factor hormone that Longo and others have linked to aging, tumor progression and cancer risk.
“PKA is the key gene that needs to shut down in order for these stem cells to switch into regenerative mode. It gives the ‘okay’ for stem cells to go ahead and begin proliferating and rebuild the entire system,” explained Longo, noting the potential of clinical applications that mimic the effects of prolonged fasting to rejuvenate the immune system. “And the good news is that the body got rid of the parts of the system that might be damaged or old, the inefficient parts, during the fasting. Now, if you start with a system heavily damaged by chemotherapy or aging, fasting cycles can generate, literally, a new immune system.”
Prolonged fasting also protected against toxicity in a pilot clinical trial in which a small group of patients fasted for a 72-hour period prior to chemotherapy, extending Longo’s influential past research: “While chemotherapy saves lives, it causes significant collateral damage to the immune system. The results of this study suggest that fasting may mitigate some of the harmful effects of chemotherapy,” said co-author Tanya Dorff, assistant professor of clinical medicine at the USC Norris Comprehensive Cancer Center and Hospital. “More clinical studies are needed, and any such dietary intervention should be undertaken only under the guidance of a physician.”
“We are investigating the possibility that these effects are applicable to many different systems and organs, not just the immune system,” said Longo, whose lab is in the process of conducting further research on controlled dietary interventions and stem cell regeneration in both animal and clinical studies.
- Chia-Wei Cheng, Gregor B. Adams, Laura Perin, Min Wei, Xiaoying Zhou, Ben S. Lam, Stefano Da Sacco, Mario Mirisola, David I. Quinn, Tanya B. Dorff, John J. Kopchick, Valter D. Longo. Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression. Cell Stem Cell, 2014; 14 (6): 810 DOI:1016/j.stem.2014.04.014