Aesthetic Plastic Surgery

, Volume 43, Issue 2, pp 453–456 | Cite as

Supercooled Liquid Serum Physiologic Solution Instantly Crystallized on the Nurse Table Used for Cooling of Periorbital Region During Rhinoplasty

  • Aret Çerçi ÖzkanEmail author
  • Erdem Güven
  • Berna Toktaş
  • Uygar Kızanlık
  • Onnik Agbulut
Original Article Rhinoplasty



Formation of less periorbital ecchymosis in post-operative period of rhinoplasty is a popular trend. We present the use of instantly crystallizing supercooled serum physiologic solution for periorbital cooling.

Physics of Supercooling

There are circumstances in which water temperature drops below its freezing point, but no phase transition happens while water remains in the liquid phase. This is called supercooling. Pure water can be supercooled below the freezing temperature without transforming into ice. Tap water will not supercool because it contains impurities that serve as nucleation sites for crystallization. For freezer temperatures in the range of − 4 °C, − 6 °C, and − 8 °C, nucleation was not observed and pure water remained in the supercooled condition for a long time.

Description of the Technique

Sterile serum physiologic solution at + 5 °C can be supercooled in the freezer at − 14 °C only between the 257 and 277 min time interval. But when it is supercooled in the freezer at − 8 °C it is possible to save it in liquid form for at least 7 days as we have observed in our trials.

Clinical Use and Discussion

It is easily possible to transform this supercooled liquid sterile serum physiologic within a few seconds into moldable snow-like ice that can be used safely and more nicely rather than solid ice for periorbital cooling in rhinoplasty operations. Its sterile inner bag is held tight and struck over the sterile nurse table and it crystallizes within a few seconds. For frozen solutions, tearing of the inner plastic bag and extracting the ice and then crushing of big masses of ice to small pieces is exhaustive and a time-consuming process. The temperature of the supercooled fluid will be zero at the moment of nucleation with no risk of frostbite. The crystallized serum physiologic solution preserves its ice-gel form for nearly 25 min.


The instant crystallization of supercooled liquid serum physiologic solution can be applied as a tissue cooling method in rhinoplasty and in several other surgical procedures.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Supercooling Rhinoplasty Cooling Ice 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no financial disclosures no conflict of interest.

Supplementary material

Instant crystallization of a supercooled serum physiologic solution by striking over a counter. (MP4 12730 kb)

Clinical application of the instantly crystallized supercooled serum physiologic solution in rhinoplasty. (MP4 42608 kb)

Non-practical but exhaustive and a time-consuming process of preparation of solid ice cubes. (MP4 63837 kb)

Pouring of a supercooled serum physiologic solution into a frozen metal bowl and its instant crystallization in the bowl. (MP4 10853 kb)

Supplementary material 5 (MP4 35062 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Private Practice in İstanbulBakırköyTurkey
  2. 2.BeşiktaşTurkey
  3. 3.Scrub Nurse in a Private HospitalBahçelievlerTurkey
  4. 4.Institut de Biologie Paris-Seine (IBPS), CNRS, UMR 8256, Inserm ERL U1164, Biological Adaptation and AgeingSorbonne UniversitéParisFrance

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