CoolSculpting, liposuction, or tummy tuck for abdomen? CoolSculpting, laser or mini lift for face and chin? (Photo)

I'm a 48 yr old female, approx 145 lbs standing about 5'4" who has never had kids. I've always had an issue with my weight and tummy over the years but now I don't look proportional. My arms, legs are good and I don't even have a "bra bulge" but I have almost a "barrell" shape around my abdomen that I'd like to change and don't know what procedure may be better for me as I am older. I also have jowls and a sloping neckline which is unattractive. hope you can help which procedure may be best!

Doctor Answers 6

Options for face and body.

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Thank you for the question,. Thank you for the photos.  CoolSculpting has an attachment that is appropriate for the area under the chin.  It is not approved for use on the face.  It is FDA approved and has applications throughout the body, (arms, abdomen, legs, etc.).   In your case I would recommend an in-person meeting for an appropriate evaluation.    Best to see a Board Certified Plastic Surgeon to evaluate what your options, (liposuction, abdominoplasty, face/necklift), might be.


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Thank you for the photos, and the detailed history. At this point I would suggest that you have an in person consult with a board certified dermatologist or plastic surgeon who also has a Coolsculpting machine in their office. Due to the multitude of areas that you are wanting to improve, I believe that  this may be an option for you, if you do not want or desire to go under the knife.

Steven H. Dayan, MD
Chicago Facial Plastic Surgeon
4.2 out of 5 stars 31 reviews


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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. In office evaluation is necessary to evaluate if you are the right candidate for this procedure and which hand piece will offer you the best result.

My best,

Sheila Nazarian, MD, MMM

Beverly Hills, Board Certified Plastic Surgeon


CoolSculpting vs. Lipo vs. Surgery

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To get the best results in both areas you need to remove the underlying fat collections and get good skin tightening.  Unfortunately as you increase your effectiveness you also increase risk of complications, scarring and costs. On one end of the spectrum you have CoolSculpting.  This is non-invasive, very safe, low complication rate and no scarring, but only a 20% reduction in fat and minimal skin tightening.  Surgery (tummy tuck and mini-lift) on the other end of the spectrum will pull the skin tighter than your other options, remove fat, but has the highest complication rate, the most risk, the most expensive and leaves unsightly scars.  Liposuction, especially laser assisted liposuction is intermediate. It offers excellent fat removal, moderated skin tightening, miniscule scarring and very low complication/risk profile. Based on your height and weight your BMI is 25.  All 3 choices are reasonable options for you. If safety is your number on priority- CoolSculpting, If skin tightening is your number one priority-Surgery.  If overall value is your priority-Laser Liposuction.  I am a "value guy", my bias for you would be the laser assisted liposuction. Hope this helps!

Coolsculpting and Board Certified Dermatologist for Best Results

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I would recommend Coolsculpting for you do have the best cosmetic results.  You can have the cool-mini for your neck and the Cool-Advantage to treat your abdomen and flanks in only 35 minutes each.  Please consult an expert which is certified by Coolsculpting and a board trained dermatologist to evaluate the situation.  Results differ and only a board certified dermatologist with expertise in Coolsculpting will deliver the best cosmetic results.  Best, Dr. Green

Invasive vs Non-Invasive Options

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Hello Lily1967!

Anytime I see patients that could benefit from different treatment options, I always like to see what the patient is willing to undergo. How's their lifestyle? What down-time can they afford? What is their budget? Do they want dramatic results or subtle results? When having this discussion with patients, we usually can easily figure out together what is the best treatment plan for them.  

By looking at your photos, I would say CoolSculpting is a great, non-invasive treatment for helping to treat unwanted fat around the mid section and under the chin,  keeping in mind that more than just "one cycle" or even more than one treatment in the same area might be necessary to reach your ultimate desired outcome. Results will take time to show, but no downtime will be associated with the treatment. No garments. No incisions. Minimal swelling, numbness, and bruising are always a possibility. Most places, like my practice, offer a discounted package deal for multiple areas being treated.  

Considering you haven't had children and your skin doesn't appear to be loose, I would say a Tummy Tuck is not necessary. If you are willing to undergo anesthesia, have about a week off work or activities, withstand some moderate discomfort, willing to have incisons and wear a compression garment for several weeks, then liposuction might be your best option for a more dramatic result for both the midsection and also under the chin.

I always recommend starting out with a consultation where you are able to speak face to face with a certified and experienced surgeon to go over your options and help you make the most well-informed decision. 

Best of luck!

Dr Arash Moradzadeh 

Arash Moradzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 15 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.