Fat necrosis post cryolipolysis: a case report

Cryolipolysis has been marketed as a safe and effective alternative to invasive procedures for reduction of subcutaneous fat and body contouring. Some complications include erythema and paradoxical adipose hyperplasia. We present a case report of bilateral flank lumps post 2 sessions of cryolipolysis. Literature search was performed for “Cool sculpting” AND “adverse effects” OR “Side effects” OR “Complications” OR “cryolipolysis” AND “Fat necrosis”. Histopathology slides were also reviewed by a senior consultant pathologist. The mechanism of action of each non-invasive fat reduction modality differs; cryolipolysis works by apoptosis, not necrosis. However, on review of the histopathology slides, necrosis was a predominant feature of the bilateral flank lumps that were excised. This is the first known publication of fat necrosis following cryolipolysis and while fat necrosis is incongruent with known complications, we propose that in persistent lumps following cryolipolysis, fat necrosis should be part of the differential. Level of evidence: Level V, risk/prognostic study.