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Dual-energy x-ray absorptiometry for evaluating body composition following cryolipolysis

Journal of Dermatology & Cosmetology
Geisa Ribeiro Machado Costa,1 Daniela Carvalho Borges,1 Geovana Guerra Marques,1 Ricardo Tadeu Villa,2 Ligia Piccinini Colucci,3

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Objectives: Cryolipolysis provides a nonsurgical treatment option for reducing excess
subcutaneous fat. Although widely used, clinical outcomes such as photographs, patient
questionnaires, and caliper measurements may be affected by subjectivity and operator-
dependency. The current case series study evaluated changes in body composition using
dual-energy X-ray absorptiometry (DEXA) in patients who underwent cryolipolysis
Methods: between 2019 and 2020, 5 patients underwent cryolipolysis at a dermatology
practice in São Paulo, Brazil. Patients were treated in different body regions using a
cryolipolysis medical device (CoolSculpting®; ZELTIQ Aesthetics, Inc., Pleasanton, CA,
USA) with the CoolAdvantage™ or CoolAdvantage Plus™ vacuum applicators (ZELTIQ
Aesthetics, Inc). Pre- and post-treatment, body weight and abdominal circumference were
recorded. Fat and lean mass measurements were also obtained using a total body scanner.
Results: five patients (4 females, 1 male; mean age, 34 years) were treated in a total of 8
areas (2 cases in the flank, 3 cases in the abdomen, and 3 cases in the back). Three months
post-treatment, body weight was reduced in 3 out of 5 (60.0%) patients, and abdominal
circumference was reduced in 2 out of 3 (66.7%) patients. Most patients showed reductions
in total fat mass (80.0%) and lean mass (60.0%). The percentage change in body weight
was also correlated with the percentage change in total fat mass (R=0.81). Region-specific
alterations in fat content were also observed.
Conclusions: most patients showed changes in body composition, including lower fat
mass (5%-36% reductions) 3 months after cryolipolysis treatment. The results suggest
that DEXA can be used to objectively visualize and quantify body composition changes
following cryolipolysis treatment.


body contouring, subcutaneous fat, cryolipolysis, dual-energy X-ray absorptiometry (DEXA)