fr What 25 years of experience have taught us about cryolipolysis
La cryolipolysis is one of the most popular treatments at Forever Institut. Since we added it to our range, along with the CoolSculpting®, We have treated thousands of patients at our clinic in Geneva.
This volume of cases has taught us what clinical studies don't always tell us: why some patients achieve spectacular results, why others are disappointed, and how to guide therapeutic decisions with honesty.
This article is medical feedback, not a commercial promise.
How does cryolipolysis work in practice?
CoolSculpting® is a non-invasive procedure that breaks down fat cells located directly under the skin by administering controlled cooling to the skin surface. The destroyed fat cells are then naturally assimilated by the body over a period of several months.
Visible results appear on average one month after the session. The definitive result takes six months. This is a point that we systematically explain to our patients, as many expect to see a rapid transformation. Cryolipolysis doesn't work like that. It's a slow, biological reduction that takes place over time.
In practice, one session produces a reduction of around 30 % in the volume of fat in the treated area. If the bulge is more than 3 cm thick, we plan two sessions spaced two months apart to achieve sufficient results.
The treatment does not replace conventional methods such as diet, exercise or liposuction. It is a complement for resistant localised areas, not a global weight loss solution.
Situations where cryolipolysis gives the best results
After 25 years of practice, we have identified an ideal candidate profile: a person with one or two localised bulges, resistant to sport and diet, on an overall stable body. The best documented areas are the abdomen, flanks, thighs, arms, submental and submandibular region, back, subgluteal folds, arms and bra area.
This treatment is not suitable for overall weight loss. That is not its role. Patients who arrive with a targeted figure and realistic expectations are the ones who leave satisfied. Those who hope for a spectacular all-round effect are invariably disappointed.
| «The initial consultation is the most decisive stage. In 25 years of practice, I've learnt to refuse certain requests for cryolipolysis, not because I'm overly cautious, but because the wrong treatment always does more harm than good. In aesthetic medicine as elsewhere, rigour comes before complacency».» Dr Luigi L. Polla, dermatologist, founder of Forever Institut |
What we have learned about side effects
Transient side effects are frequent and expected. They occur in the treatment area during the session and in the days that follow.
During the session: sensation of pressure, tightness, intense cold, tingling, cramp - these sensations diminish as the area becomes numb. Immediately afterwards: redness, stiffness, temporary whitening. Over the following one to two weeks: bruising, swelling, itching, numbness that may last several weeks.
Two rare effects deserve particular attention.
L’paradoxical adipose hyperplasia is manifested by an increase in the volume of fat in the treated area, visible between 2 and 5 months after treatment. Its frequency is estimated at around 1 in 3,000 treatments (0.033 %). When it occurs, surgery - liposuction - may be necessary.
La demarcation of the treatment area (approximately 1 treatment in 20,000, i.e. 0.005 %) corresponds to a visible depression in the treated area, the result of excessive localised fat removal.
Very rare effects have also been documented: frostbite (1 in 15,000), hyperpigmentation (1 in 11,000), vagal symptoms such as dizziness or fainting (1 in 30,000), cold panniculitis (1 in 60,000). These data are taken from the CoolSculpting® safety form (Allergan Aesthetics, CH-CSC-210028, November 2021).
These risks are documented in the informed consent form signed by each Forever Institut patient. This is not an administrative formality: it is a guarantee that the decision has been taken with full knowledge of the facts.
| «I've never hidden possible side effects from a patient. Neither bruising nor paradoxical hyperplasia. When a patient signs an informed consent form with us, they really understand what they're signing. It's our way of respecting the people who put their trust in us.» Dr Luigi L. Polla, dermatologist, founder of Forever Institut |
Contraindications that we strictly apply
The safety of the treatment depends on a rigorous assessment before each session. Certain situations constitute absolute contraindications: the treatment must not be carried out.
| Absolute contraindications (CoolSculpting® must not be used) Cryoglobulinaemia - abnormal presence of cryoglobulins in the blood (proteins that precipitate at low temperatures) Paroxysmal haemoglobinuria a frigore - destruction of red blood cells by temperature change (cold to hot) Cold agglutinin disease - an autoimmune disease in which red blood cells are destroyed by exposure to cold. Obesity - CoolSculpting® is not a treatment for overall excess weight Source: Patient Safety Considerations Form, Allergan Aesthetics, CH-CSC-210028, November 2021. |
Other situations do not constitute absolute contraindications, but require a thorough medical assessment before proceeding with treatment:
- Known sensitivity to cold: cold urticaria, Raynaud's disease, frostbite or frostbite
- Reduced peripheral blood circulation in the area to be treated
- Neuralgic pain: post-herpetic neuralgia, diabetic neuropathy
- Bleeding diseases or taking anticoagulants
- Recent surgery or scar tissue in the area to be treated
- Hernia in or near the treatment area
- Active skin disorders: eczema, dermatitis, rashes on the skin area
- Implantable medical devices in use (pacemakers, defibrillators)
- Pregnancy, breast-feeding (no studies available)
- Chronic pain, anxiety disorders
These points are systematically checked during the initial consultation. We sometimes postpone or cancel a planned treatment if a patient informs us of a new pregnancy, an infection or taking anticoagulant medication the day before the session. Safety comes before planning.
Why do results vary from one patient to another?
This is the question we hear most often after a treatment. Two patients, same apparent morphology, same area treated: one is delighted, the other expected more. There are many reasons for this.
Firstly, the composition of the bulge. Some bulges contain more fibrous tissue than pure adipocytes, which reduces the response to cold. Lifestyle also plays a direct role: the effects observed persist over time only if the patient maintains a balanced diet and regular physical activity. Otherwise, the remaining fat cells can compensate for the loss of destroyed cells.
Cryolipolysis reduces the number of adipocytes in a given area. It does not alter overall metabolism or eating habits. This point, repeated at each follow-up consultation, is the key to lasting satisfaction.
Our medical view of growing demand
In the space of just a few years, cryolipolysis has gone from being a confidential treatment to a common request, fuelled by social networks and sometimes misleading before-and-after images. We are seeing an increase in misdirected requests: patients who wish to treat unsuitable areas, or who downplay the medical information needed to speed up treatment.
Our position has not changed since 1997: we only accept treatment when it is medically justified and clinically appropriate for the patient. Not to fill a diary, nor to follow a trend. The results we achieve over the long term are the direct consequence of this rigour.
Dr Polla's view
Founder of Forever Institut in 1997 and dermatologist specialising in laser medicine, Dr Luigi L. Polla has been practising cryolipolysis since its introduction in Switzerland. His view of this treatment, beyond the protocols :
| «What strikes me is the distance between what patients see online and clinical reality. Before and after photos are circulated without context: we don't know what the initial morphology was, how many sessions were carried out, or whether the result has been maintained two years later. My work often starts by re-establishing realistic expectations.» Dr Luigi L. Polla, dermatologist, founder of Forever Institut |
| «Cryolipolysis is an excellent treatment when it is properly indicated. When it is not, it is at best useless, at worst a source of disappointment or undesirable effects. That's why we don't offer it to everyone, even if the patient asks for it.» Dr Luigi L. Polla, dermatologist, founder of Forever Institut |
| «In 25 years, I've seen technologies come and go. Cryolipolysis has kept its promises over time - as long as you use it for what it can do, and no more.» Dr Luigi L. Polla, dermatologist, founder of Forever Institut |
Make an appointment for a cryolipolysis consultation
Consult one of our doctors in Geneva to assess whether cryolipolysis is right for you. Book directly on forever-beauty.com or call +41 22 319 09 60.
Frequently asked questions about cryolipolysis
Is cryolipolysis effective on all types of rolls?
No. It is effective on localised, «graspable» fat. Clinically validated areas include the abdomen, flanks, thighs, arms, submental and submandibular region, back, gluteal folds and bra area. Very firm bulges or bulges with a low adipose component respond less well. The initial consultation at Forever Institut makes it possible to accurately assess the match between the patient's morphology and the treatment.
How many sessions are required?
In most cases, one session per area is sufficient. If the thickness of the bulge exceeds 3 cm, two sessions spaced two months apart are necessary to achieve the desired reduction (approximately 30 % of fat volume). We establish this protocol during the initial consultation, depending on the area and the patient's objectives.
Does it hurt?
During the session, the suction-operated applicators may cause deep pressure, tugging and slight pinching. The intense cold, tingling and cramping at the start fade as the area becomes numb. After the session, bruising, tenderness and numbness may persist for up to several weeks. Severe pain may occur in approximately 1 in 6,000 cases (0.017 %).
When will we see the results?
The first changes are generally visible as early as one month after the session. The final result is obtained after six months, once the body has eliminated all the fat cells destroyed. The effectiveness of the treatment should not be assessed before this time.
Can cryolipolysis replace diet or sport?
No. Cryolipolysis reduces the number of adipocytes in a localised area. It does not alter metabolism or eating habits. For the results to be maintained over time, a balanced diet and regular physical activity are essential after the treatment.
Where can I make an appointment for a consultation?
You can book a consultation at our clinic in Geneva directly online via forever-beauty.com, or by telephone on +41 22 319 09 60. The initial consultation confirms the indication, assesses the area to be treated and defines the protocol best suited to your situation.
