Severe abdominal fat necrosis following complications of cryolipolysis: a case report

Cryolipolysis is a non-invasive technique for permanent, localised fat reduction and was first described in 2007.1 It is marketed as a safer alternative for removal of excess adipose tissue and body contouring, avoiding traditional invasive risks associated with liposuction.^1^ Based on principles of cold-induced panniculitis, whereby lipid-rich tissues are more susceptible to cold injury compared to the surrounding water-rich tissue, cryolipolysis relies on cold-induced apoptosis of fat cells translating to a measurable fat reduction.^2^Current literature emphasises its overall safety and patient tolerability, with the majority of complications reported limited to erythema, swelling and minor discomfort to treated regions.^3–5^ There are, however, isolated reports of frostbite-induced cutaneous ulceration from direct thermal injury.^6–9^ These incidents were largely attributed to inexperienced service providers and faulty equipment, and are therefore relatively rare. We report a novel case of a 26-year-old female who sustained an infected, full-thickness abdominal burn with underlying fat necrosis as a complication of her cryolipolysis treatment. This case should serve as a caution to patients and service providers of this potential risk and the possible complications that may ensue and, importantly, emphasise when to escalate care.