Would cool sculpting work here with 2 treatments? Or is Liposuction necessary? (photos)

I am 37 years old and have stubborn arm fat which hasn't been improved with any type of exercise or diet all mu life. Otherwise I am happy with my body. I am also nervous about the after effects of lipo. I have read many people saying that years after lipo their metabolism seems to shift and they start gaining weight uncontrollably in weird places. I have maintained a weight with 7 lbs of fluctuation through the last 15 years. Multiple angles in pics, one with most skin elbow is rotated up.

Doctor Answers 12


I appreciate your question.
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

It Might Be Worth a Try

Hi there, and thanks for your question. Generally the issue with arms is the excess skin that is present. Surgery is the best way to remove the skin and fat and will give you the best result, but the price to pay is a long scar that may be unsightly. Liposuction will remove the fat but will not directly address the skin. The skin will tighten but may not tighten to your satisfaction. CoolSculpting is a less aggressive version of liposuction. That all being said, I have used the CoolSmooth applicator on arms on a few patients and have realized surprisingly good results with both fat reduction and skin tightening. So my philosophy has changed, and I suggest that patients try the CoolSculpting first before going for a more aggressive treatment. This avoids the long scars and recovery, but it is important to try to temper their expectations prior to the CoolSculpting. Good luck with your decision!

CoolSculpting of The Arm

The CoolSculpting technology is a Class II Medical Device cleared in the United States for treatment of the love handle (flank), abdomen and thigh. The arm is not yet FDA approved, however, the correct treatment for the right patient will deliver great results.
It is always recommended to have a face-to-face consultation with a provider in order to determine if you would be a good candidate for CoolSculpting and how many treatments you may need. Keep in mind that CoolSculpting is not a weight loss method and in no way replaces diet and exercise. It also is not meant to help tighten loose skin.
During the consultation, the health care provider will visually assess the fat in order to determine if the person needs debulking or sculpting. The physician will physically assess the orientation of the fat by pinching and feeling it. There is a 20-25% fat reduction in the treated areas. Patients are usually brought back at the 30 days mark to assess their results. At that point, the patient and physician can communicate and determine if additional treatment might be needed for optimum result.

Depends on the Level of Results That You Want

Thanks for sharing your photos. There is a spectrum of results that can be achieved beginning with a less invasive procedure such as CoolSculpting, then with liposuction, and finally with brachioplasty (excision of excess skin). Brachioplasty, also called an arm lift, may give you the most dramatic improvement, but it comes with a tradeoff of potentially visible scars. I believe you will see perhaps a 50% improvement with 2 treatments per side of CoolSculpting. The advantage is no downtime. Liposuction in your case should provide a very nice improvement of perhaps 70%, and if your weight remains stable I doubt you will see any untoward metabolic effects. Hopefully a consultation with a surgeon experienced in all 3 modalities can guide you toward the result best for your expectations. Good luck with you decision!

Stanley G. Poulos, MD
Greenbrae Plastic Surgeon
4.5 out of 5 stars 26 reviews

Coolsculpting or liposuction of the arms

Generally, arms are difficult to treat. Sometimes people have skin laxity and sometimes they have fatty arms but most times it is a combination of both. A board certified plastic surgeon would be best to evaluate this.  Coolsculpting can be used for the arms but it is currently an off label use but it may be in the works to change that soon.  Liposuction can be done but sometimes when the fat is removed the loose skin hangs more.  Other surgical options may be a mini-brachioplasty or a full brachioplasty. This does involve some scarring that may be visible for the full brachioplasty.  Good luck and chose well.

Fat Arms What is Best, Coolsculpting or Liposuction?

Coolsculpting will not help give much skin lifting, and to get the contour you like you should have liposuction performed properly with contouring.  I have seen a significant increase in skin tightening with laser liposuction, thus avoiding surgery which leaves big scars in this area.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

CoolSculpting, LipoContouring and Arm Lifts

Dear jgmj:

Thanks for sharing your photos. Although they are limited, you seem thin with mild lipodystrophy (fat) and skin laxity of the upper arms. I can appreciate your frustration!

It is best to obtain consultation from a well experienced, Board Certified Plastic Surgeon with all skills for a upper arm contouring and lift so you are not biased by their lack of options. 

Please consider the following:
  1. CoolSculpting 1 or 2 sessions per arm to reduce the superficial fat and possibly (although no guarantees!) obtain some skin shrinkage around the smaller volume. This is very limited to the areas bulging only.
  2. LipoContouring which will provide near circumfirential fat reduction and etching of the upper arm muscles. You may obtain some skin shrinkage around the smaller volume but also skin redraping due to the wider contouring.
  3. A arm(pit) tuck may help in advancing the skin and reducing the skin excess. This option may be performed at the same time as lipocontouring but in your case due to age and exercise may be best 6-12 months later after the lipocontouring has healed and softened. It limits the scar to the armpit but also limits the amount of skin reduction.
  4. A brachioplasty (arm lift). This incision comes down the inner aspect or back or the arm to remove skin excess but leaves a more visible scar. I would also recommend to do this a year later after lipocontouring.
I hope this has been helpful! All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 67 reviews

CoolSculpting vs Liposuction

If you always keep in mind that CoolSculpting directly targets fat and eliminates 30% of the targeted fat versus Liposuction that can eliminate almost 80% of the desired fat in multiple areas you can answer your question yourself.


Hello, and thank you for this question. Based on your pictures you appear to have both some excess fat as well as some skin laxity. Without a detailed physical examination it would be difficult to tell you specifically which would be your best option. I do believe you can get some improvement with the fat removal with the cool sculpting. However, I do not believe you will get any significant skin tightening. We have gotten some skin tightening using the vaser ultrasonic liposuction techniques.

John J. O'Brien, Jr., MD
Saint Petersburg Plastic Surgeon
5.0 out of 5 stars 25 reviews


I prefer Coolsculpting of the arms over liposuction (even though I do both) because the slow fat loss with Coolsculpting allows time for the skin to retract.  Sometimes, when the skin is not very elastic, you can get saggy looking skin after liposuction.  Discuss with a plastic surgeon to see which he or she recommends.

All the best,

Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 44 reviews

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.