Targeted tissue destruction via necrosis induced by subzero temperature with liquid nitrogen
Direct cellular damage due to ice crystal formation:
Ice crystal formation begins in extracellular system → water leaves the cell resulting in intracellular dehydration and cell membrane shrinkage
Crystallization then forms inside the cell with subsequent expansion and tearing of the cell membrane; ice crystals also result in damage to organelles
Indirect damage: cold-induced damage to capillaries causing local ischemic necrosis
Rapid freezing with slow thaw is desirable as this produces intracellular ice crystallization; repeat freeze/thaw cycle creates further cell damage
Melanocytes and vascular tissue are very susceptible to cold temperatures
