if my fat is reduced by Coolsculpting, will my skin be sagging?

I have heard that although coolsculpting may help with fat reduction, there could be some sagging and loose skin that develops after you remove the fat. For instance, I am interested in having it done around my knees when the pads specifically made for the knees come out this year; however, if my fat is reduced, will my skin be sagging?

Doctor Answers 8

Does skin sag after CoolSculpting?

CoolSculpting has FDA approval for fat reduction since 2010. CoolSculpting freezes the fat cells. Fat cells are more susceptible to damage by freezing than the other cells, (nerve, vessel, bone, etc.), around them. The fat cells die via a process called apoptosis, (programmed cell death). The number of fat cells are therefore reduced. This happens over a period of time, so the body is not overwhelmed with dead fat cells. The body will take these cells up, process them and excrete them, just as any other cell. The remnants are filtered through the liver, and then excreted eventually via stool. Knees can be a challenge with any modality. CoolSculpting has a specific applicator that has been used in this area with good results.  We have had good experience with the skin snapping back.  Each individual is different.  See an experienced CoolSculpting practice, they will determine if you are a candidate.  Would also consider seeing a Board Certified Plastic Surgeon, who can give advice on both CoolSculpting and Liposuction.

Las Vegas Plastic Surgeon
4.5 out of 5 stars 15 reviews


I appreciate your question.
Coolsculpting not only reduces fat but also has a skin tightening effect. This is of course better with good skin quality

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

Loose skin after CoolSCulpting

Hello,  CoolSulpting is a process of fat reduction. Once the fat cells are exposed to the Cryolipolysis® process,  the body recognizes the damage done to the fat cells and the body's own waste system plays a part in flushing itself of "damaged" fat cells. The volume of the fat is gradually reduced over a period of weeks.  Once the fat is reduced it is possible that the skin appears loose, but it definitely is not due to the treatment itself.  Depending on the collagen in the tissue and the area, there can be some natural contraction of tissue.

Mark A. Blair, MD
Phoenix Dermatologic Surgeon
4.8 out of 5 stars 7 reviews

Is Skin Sagging Possible after CoolSculpting

We have performed well over 1000 treatments with CoolSculpting and have not seen any significant skin sagging or excess skin post treatment that was not their pre-treatment.  CoolSculpting treats full thickness fat and also there is a slow gradual loss of fat and volume.  Similar to causing stretch marks there has to be a slow gradual increase in volume like with pregnancies and a quick reduction in volume to create the marks.  Because the volume decrease is so slow, you should not see any extra skin created.

If however you have extra skin to start you will have it afterwards because this system does not treat the skin...your plastic surgeon can discuss options for skin reduction if needed.

All my Best!

Dr Bengtson

Bradley Bengtson, MD, FACS
Grand Rapids Plastic Surgeon
4.8 out of 5 stars 44 reviews

Saggy skin following CoolSculpting?

Dear wrinkles 12:

CoolSculpting (CS) has had a great impact in limited fat reduction for many areas. It provides fat reduction via a process called apoptosis or natural cell death..

In my experience, CoolSculpting does not promise to tighten tissues, nor does apoptosis tighten tissues BUT  I have visualized shrinking of the skin envelope around the fat loss caused by CS probably due to an inflammatory response of collagen formation from the CoolSculpting process. This is mostly observed in thicker skin tissues of the back, tummy and flank regions.

Thinner skin areas such as the inside and posterior arm have less dermis and therefore less potential for shrinkage but there is no greater hanging skin following the procedure.

I have found ”Lasers” for skin tightening to be disappointing. If you wish to have these areas “tightened”, please consider a tummy tuck, arm / thigh tuck or an arm / thigh lift.

 In any case, consult with a well experienced Board Certified Plastic Surgeon for examination and review of what is best for you. All the best! 

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 69 reviews

Fat Reduction by Coolsculpting without skin sagging

Coolsculpting is a fabulous procedure for reducing fat.  The fat is gradually reduced in a given area by 25% and it takes approximately four months to see the results of the process.  Because this is a gradual process, as the fat is diminished, the skin undergoes no sagging.  Unfortunately there is no applicator yet to reduce fat around the knee pads.  Please consult a board certified dermatologist with a great deal of experience with coolsculpting for the best cosmetic results.

Fat is diminished and skin tightens with Coolsculpting

Great question!

Coolsculpting is great for targeted fat reduction but one of the other great effects of the procedure is the skin tightening in the areas treated as well.  This is a great relief for most people to hear because no one wants to trade a slight bulge for sagging, deflated skin.  So, rest assured that you'll see improvement in fat and skin after treatment.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 121 reviews

Loose skin after Coolsculpting

The results of Coolsculpting take place over approximately a four month period of time.  The gradual nature of this allows the skin the majority of patients the time to accommodate to the volume loss.  In a very small percentage of patients with a very large loss of fat combined with poor skin quality, there can be some skin laxity.  However, many of those patients are still quite happy that they look so much better the 99% of the day that we are clothed.  We have had good success in those patients with skin laxity using Ultherapy to rejuvenate the overlying skin.

Marcus A. Jimenez, MD, FACS
Fort Wayne General Surgeon
4.3 out of 5 stars 7 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.