The story behind fat freezing who invented it

 30th October2024

 

The Story Behind Fat Freezing: How Two Harvard Scientists Changed the World of Cosmetic Fat Reduction

In the crowded world of cosmetic treatments, few innovations have captured the public’s attention quite like fat freezing, or cryolipolysis, as it’s formally known. The procedure offers the tantalising promise of reducing fat without surgery, needles, or any significant recovery time. But while the concept of freezing away unwanted fat might sound like the stuff of science fiction, its origins are grounded in an unexpected scientific observation and the ingenuity of two pioneering researchers.
This is the story of Dr. Dieter Manstein and Dr. Rox Anderson, the two Harvard scientists who transformed a curious phenomenon into a multi-billion-dollar industry. Their invention, which now powers the widely popular CoolSculpting machine, has become one of the most sought-after non-invasive fat reduction treatments across the globe.

The Accidental Discovery: From Popsicles to Medical Innovation

The journey to fat freezing began with an unexpected observation—one that, on the surface, had little to do with medical research. Dr. Rox Anderson and Dr. Dieter Manstein, both researchers at Harvard Medical School’s Wellman Center for Photomedicine, noticed a peculiar occurrence in children who regularly ate popsicles. The cold from the frozen treats seemed to cause the development of dimples in the children’s cheeks, but this wasn’t just a cute aesthetic quirk.
The condition they observed was known as popsicle panniculitis—an inflammation of the fat cells beneath the skin caused by prolonged exposure to cold temperatures. In children, this temporary fat loss resulted in cheek dimples, but Anderson and Manstein quickly realised there might be more to it than an innocuous, ice-induced dimple.
The question that drove their research was simple but profound: could cold temperatures selectively destroy fat cells, leaving surrounding tissues like skin, muscles, and nerves unharmed?

The Science of Cryolipolysis: How Cold Kills Fat

Armed with this idea, Anderson and Manstein dove into the science behind fat cells. They knew that fat tissue, or adipose tissue, responds differently to cold than other types of body tissues. Fat cells are particularly sensitive to cold and can be damaged or destroyed at temperatures that leave skin, muscle, and nerve cells unaffected. This discovery was key.
The team hypothesised that by exposing fat cells to controlled cooling, they could trigger apoptosis—a form of programmed cell death—while sparing other tissues. Once the fat cells were destroyed, they would be gradually removed by the body’s natural processes, leaving a thinner layer of fat in the treated area.
This was a groundbreaking idea: the potential to reduce fat using nothing more than the body’s response to cold. Unlike traditional fat reduction surgeries, such as liposuction, which physically remove fat cells, this technique would allow the body to naturally metabolise and eliminate the dead fat cells over time, creating a much less invasive solution.

Turning Research into Reality: The Birth of CoolSculpting

Anderson and Manstein’s research was promising, but turning their idea into a viable medical treatment was no small task. They needed a way to apply the concept of cryolipolysis in a controlled and effective manner, safely cooling fat cells to the right temperature without damaging the skin.
Their next step was to develop a device that could make this possible. They partnered with Zeltiq Aesthetics, a medical technology company, to transform their research into a commercial product. The goal was to create a machine that could precisely target and freeze fat cells while ensuring the safety and comfort of patients. It was during this time that CoolSculpting—the device that would eventually become synonymous with fat freezing—was born.
The machine used a vacuum-like applicator to gently pull a section of skin and underlying fat into a chamber where it could be cooled to just above freezing. This cooling process would crystallise the fat cells, causing them to die off. Over the following weeks, the dead cells would be gradually flushed out by the body’s lymphatic system.
The non-invasive nature of the procedure made it an attractive alternative to more aggressive fat reduction techniques, and the absence of needles, scalpels, or anaesthesia meant minimal downtime for patients. In 2010, CoolSculpting was FDA-approved for use on the flanks (the area just above the hips, known as love handles), and the treatment quickly took off.

The Rise of a Global Phenomenon

The launch of CoolSculpting marked the beginning of a new era in non-surgical cosmetic fat reduction. Word of mouth spread quickly, bolstered by the allure of a fat-loss solution that didn’t require patients to go under the knife. Advertised as a "lunchtime procedure" with no recovery time, CoolSculpting catered to the growing demand for body contouring treatments among individuals looking to fine-tune their appearance without the risks and downtime associated with surgery.
Dr. Manstein and Dr. Anderson’s initial discovery, rooted in that popsicle observation, blossomed into an international phenomenon. By 2020, millions of CoolSculpting treatments had been performed around the world. Celebrities, influencers, and everyday people alike began sharing their before-and-after photos, fueling the treatment’s popularity. Clinics offering CoolSculpting treatments popped up in cities worldwide, capitalising on the trend.
What made CoolSculpting so attractive was its simplicity: a non-invasive, painless (albeit cold) treatment that promised results. Each session could reduce fat in the treated area by about 20-25%, with minimal side effects beyond temporary redness, swelling, or numbness. The treatment was especially popular for tackling stubborn fat in areas like the abdomen, thighs, chin, and upper arms.

The Science Behind the Success

The core of fat freezing’s success lies in its underlying science. Unlike traditional fat-loss techniques that involve physical removal or destruction of fat cells, cryolipolysis operates on a more subtle principle. By cooling fat cells to a temperature between -5°C and 5°C, the CoolSculpting device induces crystallisation, a process that disrupts the integrity of the fat cell membranes. This triggers inflammation, which ultimately leads to cell death.
What happens next is a key part of the process. Once the fat cells have died, the body’s immune system takes over, sending white blood cells to break down the dead cells. These are then transported to the lymphatic system, where they are gradually eliminated through the liver over the course of several weeks.
Because the process is gradual, results are not immediate, which differentiates cryolipolysis from other treatments like liposuction. Patients typically see the first signs of fat reduction within three weeks, with the full effects becoming apparent after two to three months. The fat loss is permanent—once the cells are gone, they don’t come back—but it’s not a substitute for weight loss. As Anderson and Manstein intended, it’s more about fine-tuning body contours than dramatic transformation.

Beyond CoolSculpting: The Legacy of Cryolipolysis

Dr. Manstein and Dr. Anderson’s invention of cryolipolysis has left an indelible mark on the field of aesthetic medicine. Since the launch of CoolSculpting, the technology has been adapted and refined, with new versions of the machine and different applicators designed for more precise fat targeting and shorter treatment times.
CoolSculpting remains the market leader in cryolipolysis technology, but other devices and treatments have emerged, riding the wave of fat freezing’s popularity. Competing machines with similar cooling mechanisms are now available, offering slightly different approaches but based on the same principle of freezing fat to destroy it.
In 2017, Zeltiq Aesthetics, the company that developed CoolSculpting in partnership with Anderson and Manstein, was acquired by Allergan, a global pharmaceutical giant, for a staggering $2.4 billion. This acquisition further cemented cryolipolysis as a cornerstone of non-surgical cosmetic treatments.

Challenges and Controversies

Despite its success, fat freezing has not been without its challenges. While generally considered safe, cryolipolysis does carry some risks, including paradoxical adipose hyperplasia (PAH), a rare side effect where the treated fat cells enlarge rather than shrink. Although this condition is uncommon, it has garnered media attention, particularly after high-profile cases involving celebrities who experienced PAH after CoolSculpting treatments.
Still, the overwhelming majority of patients report satisfaction with their results, and cryolipolysis continues to be a go-to treatment for those seeking subtle body contouring without surgery.

Conclusion: A Cool Discovery with Lasting Impact

From the simple observation of dimples caused by popsicles to the development of a cutting-edge, non-invasive fat reduction technology, the invention of fat freezing is a testament to the power of curiosity-driven research. Dr. Dieter Manstein and Dr. Rox Anderson’s work has transformed the way we think about fat reduction, offering an option that’s less invasive, more convenient, and, for many, highly effective.
What began as a Harvard lab experiment has grown into a global industry, helping millions of people contour their bodies and reduce stubborn fat. And it all started with two scientists and a popsicle.

 

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