CoolSculpting by Zeltiq

Who is a candidate?

CoolSculpting Procedure The ideal individual for this procedure is within 20-30 pounds of their ideal body weight, and are maintaining or in the process of losing weight. This is because CoolSculpting does not suck the fat out or cause weight loss.  It simply destroys fat cells and your body needs to metabolize the fat or it will just get stored somewhere else.   This is explained more thoroughly below.

The area to be treated is a “fat bulge” or something you could grasp with hand and squeeze.   This is because the machine uses suction to pull on the fat and put it between two cooling plates.   Examples would be the lower abdomen bulge or the “love handles”.  If you pinch more than a couple of inches, it may be too thick to fit in the machine, and would be best to lose weight first. 

How does it work?

CoolSculpting by Zeltiq uses cold energy to permanently destroy fat cells. The CoolSculpting machine works by pulling your fat bulge into a device that has two cooling plates.  The fat is held by a strong vacuum.  The cooling plates are activated to the specific temperature where fat cells are vulnerable and die, and your skin, nerves, blood vessels, etc are fine.  This process takes an hour per area.  Multiple areas can be done at one time in some cases. 

Where does the fat go?

After the procedure, you will be the same size, as it takes a few weeks to shrink.  Your fat is actually held inside of cells, which are more or less little tiny packages that enlarge and shrink as you gain and lose weight.  During the coolsculpt procedure, about 20% of these fat cells are killed, and they release the fat which is slowly absorbed over several weeks.  The fat that is released from the fat cells is no different than any fat that you eat.  Fat is storage form of energy. This fat can be burned off as calories to keep you warm, propel you while walking, make your lungs work to breathe, etc.  That is what will happen if you are at a stable weight or losing weight.  If you are gaining weight, then the fat will just mix in with the fat you are eating and get deposited somewhere else.

It is important to know that this is not a weight loss procedure.  CoolSculpting refers to “sculpting” or shrinking down stubborn areas.  If you are not able to get the weight off, this is not going to help.  Your weight will not change as a result of the coolsculpt procedure, you have to eat right and exercise to accomplish that.

How safe is it/What are the risks?

The procedure has been performed hundreds of thousands of times, with an extremely high level of safety compared to other fat reduction methods.

Common Side Effects:  Temporary numbness, mild soreness, and mild bruising.  Most people say they feel essentially nothing after the procedure, but these symptoms happen, are mild and don’t require medication or time off work or activities.

Rare side effects:  CoolSculpting is supposed to be virtually painless, but occasionally, some people experience pain that may require pain pills.  It seems it is about one out of 100 people that experience this, so not that often, but still can occur.  If we compare this to liposuction, about 100 out of 100 people would experience pain, so this rare side effect is accepted.  The numbness can last longer than a week or so in some patients, and there has been a case of frostbite reported as of the time of this writing, and the frost bite did resolve without a problem.  Bruising is usually absent or minor, but the device does you suction, and a “hicky” type effect can occur with more noticeable bruising, but this is not common. 

Why choose CoolSculpting over liposuction?

This is a personal choice, not really a true medical decision.  There are millions of people who have fat bulges that they’d like to get rid of, but only a small percentage (maybe 5-10%) of those people would consider surgery.  This is the first ever FDA approved device that works for the other 90% of people.

If you are interested in liposuction, and understand the risks, downtime and benefits (liposuction is safe and effective in the proper hands, but is really a totally different commitment) that is your best option.

But if you do not want to go through with lipo, don’t want the downtime, the compression garments, potential time off work, swelling and at least temporary disfigurement, than the coolsculpt procedure is right for you.

Is it really permanent?

Yes, you typically do not grow new fat cells as an adult, and the fat cells are destroyed.   Let’s say you shrink 20% by destroying 20% of the fat cells.  It is still possible to gain weight and grow that area again.  But then by getting back to your previous weight, you would still have the benefit.  Again, this is not a miracle, the coolsculpt procedure destroys bulges of fat, and is not a solution to weight gain.

Can it be repeated?

Yes.  We are typically seeing 20-25% of shrinkage after a single treatment.  The results are finished after about 2-3 months, so that is when repeat treatment is usually considered for additional benefit. 

Is there any downtime?

No.  This is a no downtime procedure in the vast majority of people.  In the side effects discussion, we talked about the fact that infrequently there can be pain requiring pain pills, or bruising, but that is uncommon.  Typically, no one will be able to tell you had a procedure done but only notice gradual reduction of fat in the area treated.

Who can perform the procedure?

The coolsculpt procedure is a medical device, and should only be done in a doctor’s office. 

Why choose CoolSculpting over (Non surgical) lasers and other devices?

CoolSculpting is unique in that it permanently destroys fat cells.  The other devices do work, but don’t do the same thing.  Laser and radiofrequency cause the fat cells to become leaky, or tighten the connective tissue holding the fat cells in place.  There is no permanent reduction of fat or fat cells with other devices.

There is a procedure where injections of medication are used to destroy fat cells.  This is referred to as “mesotherapy” or “lipodissolve”. These do work, but much less effectively than a single coolsculpt procedure.  When there are areas of fat that are not appropriate for the machine (the machine has a shape that doesn’t work on all areas), then the injections are appropriate. 

What will happen to my skin?

The skin has the ability to expand and contract.  But this is not endless.  Mild skin laxity or droopiness will typically contract just fine.  The droopiness is from being stretched by the fat, previous pregnancy, or previous weight issues.  The skin and connective tissues maintain much of the elasticity and will contract.  However, more severe skin laxity (such as bad stretch marks, tissue paper consistency, skin that is deflated and hangs like an apron) may not contract much or at all.   Your health care professional has the experience to predict what will likely happen with your skin.  In most cases the skin just shrinks right along with the fat. 

 

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