3 months post CoolSculpting, loose skin is getting worse even though weight remains the same, is my procedure a flop?

Question

I had CoolSculpting done 3 months ago, spent 7 hrs and $4500 with pain afterwards. I am in my 50's, had 3 c -sections, and loose skin in lower abdomen. After 2 months start having loose skin under my breast, middle abdomen, lower abdomen, and back bra roll. It got worse and I've started feeling very uncomfortable when sitting and bending forward. I look like Michellen tire cartoon and it has been worsening  even though my weight remains 140 lbs ( height 5'5") and activity and diet remain same.

Paul Vitenas, Jr., MD · Answer

Thank you very much for your question.
CoolSculpting can provide an excellent fat elimination option for many people.
Unfortunately, once the fatty tissue is eliminated, lax skin will remain. Good
tissue elasticity is necessary to ensure the skin bounces back to its original
shape once the fat dissolves. From your description, it sounds like you may be
dealing with excess, stretched skin around your mid-section. A tummy tuck or
body lift may be needed to eliminate this lax tissue. I recommend bringing your
concerns to your CoolSculpting provider, for their advice on how to proceed.

Andrew Campbell, MD · Answer

It seems like the Coolsculpting has reduced the amount of fat in the treatment locations, only to reveal the excess skin and make it look worse. Unfortunately, Coolsculpting doesn't do much skin tightening, it only reduces the fat in the area. I recommend you discuss your concerns with your provider and even consider seeing a plastic surgeon for a second opinion. Considering you are only 3 months out from your treatment, you may see some additional changes / improvements over the next 3 months.Andrew Campbell, M.D.Quintessa Aesthetic Centers

Sheila S. Nazarian, MD · Answer

Coolsculpting is an excellent form of non-invasive  fat reduction for
the right patient. Some applicators take 1 or 2 hours but the new advantage
applicators take only 35 minutes and have significantly less risk for delayed
onset pain (especially in the abdomen). Results are seen at 2 months and
typically 1-3 treatments will be necessary on each area to achieve ideal
results. The number of treatments depends on the amount of fat there and the
patient's goals.  There is not downtime and the results can be impressive
in the right patient.  We also use the Zimmer Z-wave for improved patient
comfort and added results. The best candidates are those who are in pretty
good shape with areas of stubborn fat that won't go away no matter what.It is hard to evaluate if you are a good candidate for this without a picture or in person evaluation.

My best,

Sheila Nazarian, MD, MMM

Beverly Hills, Board Certified Plastic Surgeon

Jason Emer, MD · Answer

This is tough to answer without before and after pictures.  With Coolsculpting, I recommend adding a combination of radiofrequency treatments like Vanquish, Venus Legacy, Exilis Ultra for skin tightening and with Z wave/Cellutone for skin smoothing in order to get the best results. However, it sounds like you have greater skin laxity which would make you a candidate for a tummy tuck and VASER liposuction, which could be done at the same time. I recommend VASER HI DEF in combination with ThermiRF, ultrasound and fat grafting to get the most fat removal, contouring and skin tightening. I recommend getting a formal evaluation with a HI DEF physique expert. Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question. Coolsculpting is a great non-invasive way to reduce pinchable fat. It seems like the procedure has reduced fat in the treated areas, and has now left you with loose skin. Unfortunately, Coolsculpting does not tighten skin. I recommend having an in person consultation with a plastic surgeon to discuss your desires.

Edward Stokes, MD · Answer

Coolsculpting is a very effective way to sculpt and shape the body.  It is ideal for those who are around 10-20 pounds from their goal weight.  For most individuals who experience Coolsculpting, there is post treatment swelling, some discomfort and then the results emerge by 90 days. Some patients will experience skin laxity post treatment with CoolSculpting. The skin is no longer filled out with fat that has been removed and they will require some form or tightening procedure or possibly even  a tummy tuck. We frequently use Ulthera Ultra Sound method to treat the loose skin, and have achieved very smooth beautiful results.  
I would highly recommend scheduling a follow up visit with your provider to see what options they have for tightening the loose skin, or if they can refer you to someone who can get you the help you need.  Good luck with everything!

Hardik Soni, MD · Answer

Thank you for your question. Coolsculpting is a great non-invasive way to reduce pinchable fat. It seems like the procedure has reduced fat in the treated areas, and has now left you with loose skin. Unfortunately, Coolsculpting does not tighten skin. I recommend having an in person consultation with a plastic surgeon to discuss your desires

Jeffrey M. Hartog, DMD, MD · Answer

CoolSculpting eliminates the fat cells, but does not usually tighten already loose skin.  The skin may appear looser because there is less fat in the area to fill it out.  See a board certified plastic surgeon to see what your best options may be.  An abdominoplasty can help tighten the skin in the area for the result you might be looking for.

Paul Pietro, MD · Answer

Hello hadrab,Thank you for sharing your question and concerns. I am a little confused as to what you are asking and would like to achieve because it sounds as though the areas treated with CoolSculpting did in fact reduce the fat of your abdomen and bra rolls which led to the appearance of saggy skin. CoolSculpting is not a tool to tighten skin only reduce the fat cells under the skin. There are many RF technology machines available to help with skin tightening and improving overall contour however your desire may outpace the technology and to achieve your desired outcome may need to proceed with liposuction and "tummy tuck". Have a consultation with a surgeon who performs both the surgical and non-surgical procedures we are discussing to plan your next move. Best wishes.

Robert Graper, MD · Answer

Sounds like the coolsculpting was a success in removing fat, but there was extra skin in the treated areas that is now loose after the fat removal. Coolsculpting was never intended to tighten skin and does not tighten skin. There are procedures to tighten skin invasively like tummy tucks or non-invasively like Thermitight. Give the areas time to settle down and speak to your surgeon when all is stable and go from there. Good luck.

3 months post CoolSculpting, loose skin is getting worse even though weight remains the same, is my procedure a flop?

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