Coolsculpting Vs Lipo Regarding Fat Structure?

Does Coolsculpting destroy the fishnet structure of fat underneath the skin the same way lipo does? Basically, I've heard that fat cells do not return to the same area where lipo was done for some people but not for all people, because the fishnet structure has changed/been damaged. However, for those who do have fat return to the same area, it's because the structure is still in place. How does the fishnet structure of fat underneath the skin change with Coolsculpting, if at all?

Doctor Answers 6

CoolSculpting vs. Liposuction for fat removal

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Adipocytes, or fat cells, grow together in aggregates that are separated by very fine collagen walls called septae. Usually, liposuction, which uses a blunt-tipped cannula, does not destroy these walls, neither does CoolSculpting. The freezing of the fat cells, which causes the fat cells to die in Zeltiq's CoolSculpting, does not change the collagen walls. The framework is usually not changed with either technique. If someone gains weight after either procedure, weight is randomly distributed to the remaining fat cells but there are less in the area of treatment than surrounding non-treated areas.

The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Coolsculpting vs. Lipo

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Liposuction has been the gold standard in fat removal and body sculpting for many years.  The benefits of Lipo are simple: up to 5cc of fatty tissue can be safely removed (as an outpatient, more for inpatient), the area of the body can be sculpted to the desired shape, and excess tissue can be removed.  There are three layers of fat cells; the deep layer and the subcutaneous layer, then the visceral fat.  Liposuction targets the visceral fat.  Once the fat cells have been aspirated,  no more will return in its place. 


In my office, I feel Coolsculpting works best on patients who want to lose up to 15lbs, and rid themselves of the lumpy, bumpy, unsightly skin.  Coolscultping uses a freezing method to kill fat cells, which will be slowly (over 8-12 weeks) and naturally eliminated from the body.  The procedure is non-invasive, and removes about 20% of the fat tissue in the targeted area.  When more is desired, repeat treatments maybe performed. 


Just like Lipo, Coolsculpting gets the fat cells out of the body, therefor removing a place for future fat to be stored.  The problem, with either procedure, is that if you do not eat correctly and do not exercise, fat will deposit in all of the neighboring  fat cells - so they will still accumulate in your body.  Both procedures can rid the body of fat cells, and will eliminate new fat from accumulating in their spots.  The ultimate determination will be your post procedure diet and exercise program. 

CoolSculpting Process of Removing Fat

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Since the fat cells of the body are vulnerable to extremely low temperatures, the CoolSculpting technology cools down the fat above the freezing point by placing gel pads and using specialized applicator to the target area. The fat in the body then turns from liquid into a solid state which results to apoptosis, a process that causes the fat cells of the body to shrink. A few weeks after the CoolSculpting procedure has been performed, the treated fat cells are safely and gradually removed from the body by way of a natural metabolic process. It’s so safe and free from discomfort that the patient won’t notice that the fat removal process is currently in effect. As the fat cells naturally leave the body, shrinkage in the circumference of the treated area becomes noticeable.

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CooSculpting and Fat Structure

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 Because fat is more susceptible to freeze injury, it can be removed without damage to blood vessels and fibrous septae. Nerve "damage" may result in temporary numbness.

William M. Ramsdell, MD
Austin Dermatologic Surgeon
4.7 out of 5 stars 3 reviews

Coolsculpting vs. Liposuction for Fat Removal

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Coolsculpting and Liposuction both reduce fat.  Liposuction uses a  cannula to surgically remove the fat in a given area.  Coolsculpting is a non-surgical procedure to freeze the fat in a given area.  Neither procedure removes the "fishnet" structure of fat.  Coolsculpting targets the deeper subcutaneous layer of fat by reducing the temperature and freezing it. Weeks later, through the body's own metabolism, the fat cells are excreted.  Coolsculpting is both safe and highly effective and reduces the fat in a given area by 25%. Please consult a board certified dermatologist who is an expert in coolsculpting for the best cosmetic results.

Coolsculpting question

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Coolsculpting works best in those patients that do not treat "visceral" or fibrous fat areas. Your physician can easily assess your fat and differentiate these qualities. Patient selection is critical to great results.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.