Does cryolipolysis rely on the actual presence of fat in the adipocytes to work?

In other words, will the procedure cause the apoptosis of empty fat cells in relatively lean individuals? I am currently fit (and I keep myself so through a very strict diet), but I used to be very fat and I regain weight very, very easily. I would like to permanently get rid of the excessive adipocytes in my abdominal area, but I would hate to have to gain weight again before I can achieve that.

Doctor Answers 5

Does Coolsculpting rely on presence of fat in the cells to "work?"

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You are asking a technical question that shows much insight and thought about how this process works, so I won't bore you with "standard" marketing answers such as "see a qualified doctor for a personal examination," or "see a Dermatologist (or Plastic surgeon)" depending on the respondent's specialty. Let's try to give you a science-based answer.

Cryolipolysis depends on having adequate fat and skin laxity to draw the treated tissue into the Coolsculpting probes, though they are constantly developing smaller and contact probes that can help treat areas otherwise previously inaccessible (or less so). If you have lots of deflated cells, you don't have a very thick layer of fat to act as a "buffer" to prevent freezing of deeper tissues like muscle, nerves, and capillaries. Skin is more durable than fat, which is why it breaks down last in pressure sores, etc. Deeper tissue are much more susceptible to freezing, compression causing circulatory compromise, etc. which is how Coolsculpting works to kill the fat and preserve the only-partially-damaged skin.

But herein lies part of the answer: You are asking about trying to destroy a layer of deflated cells that have little to no bulk, but not destroy all of them, which would potentially cause a loss of too many or even all of the fat cells in a treatment area. And how does the operator assess proper freeze time and levels where there is no fat (or very little), just skin, between the freeze probes? Could end up giving you skin stuck on muscle like a skin grafted burn victim, or worse, dead skin that ends up requiring real skin grafts! Truly not a desirable outcome.

You certainly don't want to have to gain weight to kill fat cells, but it strikes me that the problem is not the cells, but the intake that causes you to "regain weight very, very easily." I do not recommend either Coolsculpting in this specific setting, nor gaining weight so you can try to kill some, not all, of the fat cells so that you have a slim, even, smooth result. Won't happen, and you could end up with a disaster here.

I certainly hope this helps answer your question. Best wishes and keep up your hard work at maintaining your weight loss! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Coolsculpting for prevention

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Coolsculpting requires some inflated fat cells to work.  If you are a very lean person, you are not a good candidate for Coolsculpting unless you have a stubborn area to treat.  It is not a preventative procedure.
My best,
Sheila Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews


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Thank you for your question.  It is hard to answer your question without a photo.  I would suggest a CoolSculpting consult with a Board Certified Plastic Surgeon who can further assess you to determine if you would benefit!

Best of luck!

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Cryolipolysis and Coolsculpting

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Cryolipolysis actually describes the process where the fat cells are frozen and then actually destroyed through Coolsculpting.  The best candidates are ones that have a stubborn area of fat that they wish to treat.  Please consult in person with a board certified dermatologist with expertise with Coolsculping.  Best, Dr. Green


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I appreciate your question.
Coolsculpting will selectively get rid of fat cells and not others.
However, if its made to get rid of excess stubborn fat.
If you are thin, then the normal fat you have is giving you a natural contour.

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

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.