EFFECTIVENESS OF THE TISSUE RESPONSE TECHNIQUE TO IMMEDIATE HYPOXIA: COMBINED USE OF CRYOLIPOLYSIS WITH CARBOXYTHERAPY IN THE FORMATION OF BEIGE ADIPOSE TISSUE AND ELIMINATION OF INFLAMMATORY FACTORS

*Dr. Jairo Do Carmo Pirajá Junior, Dr. Carlos Ruiz Da Silva

ABSTRACT

Prolonged tissue hypoxia in mitochondrially deficient adipose tissue (white adipose tissue) is associated with several pathophysiological conditions, including chronic inflammation, obesity, microvascular complications, and diabetes. This prolonged oxygen (O2) deficiency in adipose tissue creates a microenvironment that favors inflammation, increased ghrelin and hypoxia-inducible factor (HIF), decreased electrical conduction in sympathetic nerve endings, and initiates cell survival paradigms. Apoptosis-resistant factors (BL1-XL and BCL2) prevail at the site. The induction of immediate hypoxia by freezing lipids through cryolipolysis, combined with elevated carbon dioxide (CO2) levels, which also generate immediate hypoxia in adipose tissue, activates the apoptosis of deficient cells and shifts the tissue environment to "thrive mode," resulting in increased blood flow, O2 supplementation, reduced inflammation, increased angiogenesis, mitochondrial crest formation, and activation of beige adipose tissue. Strategies using electrothermotherapy in aesthetics for body contouring increasingly incorporate systemic physiological manipulations combined with local application. In this study, in addition to demonstrating positive and impactful results with 100% satisfaction among those investigated, we demonstrated the true mechanism of action of these combinations through a literature review. The dual combination of cryolipolysis and carboxytherapy is effective and has already been used in more than 1,000 patients treated between 2022 and 2025, where the author uses the EUROICE terminology. The author explored a range of interventions designed to reduce visceral adipose tissue and prolonged inflammation, including cryolipolysis, carboxytherapy, and breathing exercises. The study involved 20 patients: 18 women and 2 men between the ages of 19 and 56, all with abdominal adipose tissue accumulation and hypotonia of the transverse muscle. An Immediate Hypoxia session was performed, followed by weekly sessions of 40 kHz ultrasound and functional electrical stimulation with breathing exercises. Before-and-after photographic comparisons of the protocol demonstrate visible and evident reductions in lipid deposits and correction of abdominal hypotonia. The treatment goes beyond aesthetic goals, offering a physiologically appropriate alternative for individuals unable to adhere to conventional training or surgical interventions. This treatment model promotes the transformation of white adipose tissue into beige adipose tissue and metabolic reprogramming, in addition to visible postural correction.

Keywords: Cryolipolysis, Carboxytherapy, Body harmonization, weight loss, localized fat, low frequency ultrasound.