Does CoolSculpting provide temporary results?

Question

I had Cool Sculpting three times. The second time I had it, it actually had the opposite effect - even though I didn't gain any weight. Still, since the first procedure worked, so I thought I'd try a third procedure. It worked for about six months, but my fat has returned in the same area where I've had the procedure done three times - lower abdomen. What the heck is going on? Is this just a temporary fix?

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question. Coolscultping as a non-invasive procedure gives you 2-25% reduction in 3 months. This is permanent. It may require an area to have more than 1 treatment, but this is all done while watching tv or working from your computer in our office. PAH is very rare, less than 1%. There aren't any risk factors to look for, but is simply treated with liposuction. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery. Best of luck! Dr Schwartz

Ramandeep Sidhu, MD · Answer

With each application of coolsculpting 20-25% of fat cells are permanently removed and they don't come back. If you end up gaining weight then the remaining fat cells will get bigger but number doesn't increase. It will be best to go back to the practice and review the areas of concern along with the pre and post pictures. Paradoxical hyperplasia can occur but is very rare.

Jason Emer, MD · Answer

This is difficult to answer without before and after pictures and needs an in-person evaluation. I recommend getting a formal evaluation for possible paradoxical adipose hyperplasia. Paradoxical adipose hyperplasia is extremely rare, but it can develop a few months after treatment.  Most patients who experience this side effect will start to have an enlargement of the treatment area around 3-4 months after their coolsculpting treatment. Liposuction is needed to get improvement. However, keep in mind, most people need more than one treatment of Coolsculpting for results and most often need to have it combined with other treatments, like Vanquish, to get good outcomes. I recommend following up with your Doctor for a formal evaluation. Best, Dr. Emer

Scott C. Lindsay, DO · Answer

Thanks for your question!  CoolSculpting is a permanent technology that reduces the fat in the treated area by about 25% with each treatment.  I'm surprised to hear that at the same weight, you feel as though your fat returned.  I would address it with your technician and see what your options are moving forward.  Definitely take a look at the before and after photos to see if there has been any change.  Good luck!

Mariam Cappiello, MD · Answer

Coolsculpting results in a permanent reduction in the number of fat cells approximately 20-25% with each treatment. However, if you gain weight the remaining fat cells can increase in size. There have been cases of Coolsculpting causing a hardening of the fat cells but this is extremely rare. I encourage you to visit your physician for follow up to provide clinical recommendation.

Sameer Bashey, MD · Answer

There is permanent reduction in the fat of the chosen area by 20-30%. However, that does not mean if your diet and exercise is bad that you can't gain fat elsewhere. Coolsculpt is a great option for stubborn areas in someone who understands the importance of diet and exercise.

Marcia Fleming, MD · Answer

Great Question!.  Yes Coolsculpting is a permanent procedure that removes 20-30 % of the fat cells in a specific area which each treatment.  While Coolsculpting is permanent, your results depend on maintaining your weight and participating in a healthy lifestyle.  It is a myth that you can grow new fat cells after the age of about 17 but what does happen is the fat cells remaining in your body will expand or shrink depending on whether you gain or loose weight.  Sometimes people do not realize they have gained a few pounds until the expansion of the remaining fat cells results in changes in their body.

Rosalind Jackson, MD · Answer

This is a great question for everyone to understand.  When a fat cell dies it's gone forever!  Fat cells do not come back.  The remaining fat cells is where the problem lies.  The adipocyte or fat cell shrinks with weight loss and grows with weight gain.  Although the cell death that occurred with the coolsculpting procedure are gone forever the remaining cells can get larger IF  they are over extended meaning you've gained weight or your toxic and need to detox.  Toxins in your body live in your fat cells.  How do you get the toxins out you might ask??   By detoxing.
With the investment you made in your body by having the coolsculpting procedure don't jeopardize  your outcome by eating the wrong foods and not detoxing.  
I hope this helps. 
 My favorite detox is by Metagenics, the 10 day Clear Change Program.  You will clearly see a change in your health and your sculpted areas.
Happy Detoxing.

Hadley Claire King, MD, FAAD · Answer

Unlike weight loss treatments that help you lose weight by shrinking fat cells (preserving the cell’s potential to expand again if a person gains weight) CoolSculpting is a fat reduction treatment, like liposuction, which removes fat cells from the body. Once fat cells are removed from the body they cannot grow back. 
CoolSculpting has been on the market for less than a decade, so there are not a lot of longitudinal studies to substantiate the claim that coolsculpting results are permanent, but there is one longitudinal study published in The Journal of Cosmetic Dermatology measuring CoolSculpting results 9 years post treatment. The study concluded that despite normal weight fluctuations “local reductions in flank fat [after a single CoolSculpting treatment] have significant longevity in these subjects and suggest that results from Cryolipolysis may be very long-lasting.”
This is not to say that weight gain around the treatment area will not obscure your results.

Vincent A Marino, MD · Answer

Although its hard to give you a definitive answer without doing an in-person examination, the CoolSculpting treatment itself does eliminate 20-25% of subcutaneous fat in the treated area, so once its gone, its gone for good. Weight gain can cause the untreated fat cells to expand, which can mask the results of CoolSculpting. I see that you report no weight gain, to which I would recommend returning to your CoolSculpting provider for an evaluation. If you have experienced no weight fluctuations at all in the 6 months since you've been treated, its possible that you may be experiencing an extremely rare side effect of CoolSculpting called Paradoxical Adipose Hyperplasia. With PAH patients can see enlargement of the treated area a few months after their treatment; liposuction is generally recommended to correct this symptom. I would recommend seeking a follow up evaluation with your CoolSculpting medical provider to best understand your results. Best of luck.

Does CoolSculpting provide temporary results?

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