What is the best alternative to CoolSculpting besides surgery? (photo)

Hi Pina.  I think you may not have had enough fat for the CS treatments to be as effective as you wanted.  You should be able to achieve the results you want with a minimally invasive SmartLipo procedure.  See your surgeon to discuss this option.
Best of luck. 

For best results in achieving a thigh gap, I recommend a hi definition procedure like VASER liposuction. I use VASER HI DEF with ThermRF and fat grafting to get the most fat removal, skin tightening, contour and definition. This combination will give you the most toned result. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer

Your thighs appear muscular. Perhaps you do not have much fat. All similar types of treatment will not help if there is no significant fat. Only an exam could tell. Best Wishes, Maurice Vick MD

Hi Lisa, You present a challenging question. In our office we use many different procedures for fat removal and tightening. Unfortunately looking at your picture I'm not sure any of them would be effective. It appears that you do have a fat layer but it might be very minimal? We often do RF and Ultra Sound in combination with CoolSculpting. You might consider going to a clinic that has a total body center with many devices for an opinion. It also might be necessary for you to seek a surgical solution. Dr. Adrienne Stewart MD FAAD

Dear pina76:
Thanks for sharing your photo. You look lovely. I do see the mid-upper thighs touching with an air-gap above. Without an in-person examination, I cannot offer you an opinion as to why CoolSculpting did not work in this area for you. Some of the thoughts may be:

True lack of fat in that area
Muscle bulge which does not respond to CoolSculpting
Wrong choice in applicator or machine failure
Wrong placement of the correct applicator
If you have no substantial fat, none of the alternatives you mention including TruSculpt, Sculpsure, Kybella will help.

If it is laxity of the skin which is “bunching” in this area and tightening which could help you, then Sculptra and ThermiTight may help.

In any case, see consultation from a Board Certified Plastic Surgeon with experience in all these minimally invasive and surgical options to best offer what is optimal for you.

I hope this is helpful. All the best!

An alternative treatment, such as truSculpt 3D, can be considered. Both CoolSculpting and truSculpt result in apoptosis of fat cells. However, your body may respond differently to different treatment modalities.  

It could be because of you size that the reduction in fat was not as noticeable as you would see in a larger patient.  There are other non invasive therapies that would probably give you similar results.  At this point you may want to get a surgical consult. Liposuction would probably give you the results that you want.