Does CoolSculpting only work exactly where the device is placed? Should the area treated be the same on both thighs? (photos)

Question

I just had coolsculpting done on my outer thighs. They did not mark the area before the procedure when I was standing up. After the treatment I saw in the mirror that each leg was treated in a different area and actually below where I was expecting. Attached are pictures and you can see the marker on each leg where the device was placed.

Melissa Chiang, MD, FAAD · Answer

CoolSculpting is very precise.  Our bodies, in general, are not symmetric, so sometimes the treatments may not be entirely symmetric.  A very important part of the treatment is the evaluation, assessment and planning.  We are lucky in our practice that we have a board-certified plastic surgeon with immense experience in body sculpting who has trained all  of us, including myself.It is very important to have CoolSculpting treatments done in an office that has experience.  CoolSculpting is very effective and creates permanent changes to the fat.  This is awesome, as long as the changes look good!  Correction after inappropriate CoolSculpting has been performed can be difficult and requires expertise (eg a plastic surgeon).

Brian S. Glatt, MD, FACS · Answer

Great question. Judging by your photographs it does appear that your CoolSculpting treatment was performed incorrectly.  When treating the outer thigh area the applicator should be placed directly over the bulge of the saddlebag.  The area you had treated is lower than ideally where the applicator should be placed. I suggest scheduling an appointment with your certified coolsculpting provider to express your concerns. Good luck!

John Tang, MD · Answer

Thanks for sharing your concerns.  Coolsculpting typically treats the area that the applicator is placed.  The outer thighs are tricky in that the location of the fat is different in the standing and laying position.  Normally, the area is marked as the patient stands and this gives the best indicator of where to place the applicator.  This is done this way because people look at you and see the troubled fat when you are standing and not lying down.  From the pictures, it does not appear that the right side was properly placed (too low).  You will have to wait 2-3 months to see how this looks.

Michael A. Zadeh, MD, FACS · Answer

CoolSculpting is not a one-size fits all treatment where you can do a cookie cutter approach for every one that walks through your doors. Proper applicator placement requires knowledge of anatomy and fat distribution in order to get optimal results. I have seen lumps, dents, shark bites, etc. from Coolsculpting treatments performed by in-experienced providers. Based on the markings in your picture, it seems that the outer thigh applicators were placed way too low, especially on the right side. It will take up to 3 months to see the final results of the treatment, however, I would make sure you voice your concerns with your treatment provider. Best wishes.

Vinay Aggarwal, MD · Answer

Thank you for your question. Yes, Coolsculpting typically works where the applicators are placed. I see your areas of concerns and I recommend following up with your practitioner. Keep in mind, it will take up to 3 months to begin to see results after your treatment and some people need more than one treatment to get desired results. All the best, Dr. Aggarwal

Elizabeth F. Rostan, MD · Answer

Hello, It does appear that the markings have missed where the biggest bulge of the outer thigh is.  Sometimes fat pockets are not symmetrical on each side of the body so placement may be a little different depending on how the pocket lies.  But in your case, it appears the pocket was missed.  I advise setting up a follow up appointment with you treatment provider to express your concerns.  Good luck!

Jeffrey Thaxton, MD FACS · Answer

Thank you for your question and photos.  It does appear that the areas marked are significantly asymmetrical and I would be concerned that the areas of concern were not treated appropriately.  If the marks truly represent the area treated it is likely that you are not going to get the results you are hoping for.  I would suggest that you follow up with the treating office and discuss your concerns.  Coolsculpting treats only the area where the device is placed though there may be some extension of effect just beyond the edge of the treated area it would be minimal.

Mary Beth Mudd, MD · Answer

After looking at your photos, I can appreciate your concerns. It does appear that the fullest area in the saddlebag region were not marked. Thighs can be tricky to treat since they look different when we are standing than when we are laying down - the tissue can shift and roll around. I would suggest that you call your treating office to be seen to discuss your concerns, since it is possible you may need additional treatment of your saddlebag fullness to get the best result. Best wishes,  Mary Beth Mudd

Emerico Csepanyi, MD · Answer

When it comes to treating the outer thighs, marking is a very import part of the process. While the patient is standing, an X should be placed at the peak of the fat bulge as a place holder. Once the patient is comfortably seated, the center of the outer thigh stencil should be aligned with the X and then the boarders of the stencil should be traced in a way that covers the majority of the fat bulge. At this point, the foam boarders should be placed along the edges of the markings to hold the applicator in place during treatment and prevent them from sliding down. If this marking protocol is followed, the applicators should have proper placement. From your photos, it looks as if both sides and especially the right side were placed too low and you may want to have a corrective treatment with appropriate applicator placement. Best of luck to you!

Erasable Med Spa · Answer

The markings are usually just a guide. The redness you see following treatment is the best indicator of where exactly the applicator ended up. With the applicators for the thighs, they sometimes move up/down, side to side away from the original site. Hopefully you saw that the erythema (redness) following treatment was where you wanted results.

Does CoolSculpting only work exactly where the device is placed? Should the area treated be the same on both thighs? (photos)

Answers (10)

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