Not enough suction to receive second round of CoolSculpting?

I went in today for a second round of coolsculpting on my abdomen, but the tech was unable to get a good fit on the small or large either applicator head. The tech suggested waiting one month (3 months post first round) and coming back for evaluation and to see if I wanted to just use the flat plate (without suction) since I am obviously seeing results from my first session (her words, not mine). I'd like to hear if anyone else believes this is a good plan?

Doctor Answers 10

Not enough suction to receive second round of CoolSculpting?

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Thanks for your question. This sounds like you had a great result from your first procedure. I agree that waiting a few more months to see the final result sides like a great plan. Congratulations on your treatment. 


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I appreciate your question.
It appears your have had a great result thus far.
If you dont have any pinchable fat you can try the flat applicator for some more contouring
I would wait 3 months between sessions
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

Second round of CoolSculpting

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It sounds like you have lost a significant amount of fat in the treated area - Congratulations! Since it takes up to three months to see full results from CoolSculpting, I agree that waiting the extra month is appropriate to see whether additional treatments are necessary. The flat applicators are typically used for the thighs but your provider can evaluate whether your abdominal area can benefit from this modality. Some other non-invasive fat removal devices include Liposonix and Zerona and these do not require suction.

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Different patients can respond a bit differently to the treatments, what you are describing is not the most common situation but it certainly does happen from time to time and is an indication that the treatment is working better than expected. Congratulations on having fat that responds so well to treatment. With regard to next steps, that would depend on you and your goals. Are you still displeased with the area that was originally treated? If so the CoolSmooth may very well be a viable next step. If you are content with the progress and want to finish out the result with some good old fashioned diet and exercise you may be able to apply the credit towards the treatment of another trouble area. Best of luck.

More CoolSculpting Without Pinchable Fat

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Hi Lisa. You should be proud that you have lost enough fat to render you untreatable with the suction based applicators! If you still have some fat, but it can't be pulled into the suction based applicators then you can use the non-suction based CoolSmooth applicator. We typically use this applicator for the outer thighs, but it can really be used anywhere that there is non-pinchable fat with decent results (provided that there is actually fat present in the areas you want treated). The other option would be to consider other fat reduction treatments such as Vanquish, Ultrashape, etc. 

Coolsculpting Results , Switch to Ultrashape If there Is Not Enough Suction

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If there isnt enough suction then switching to something like ultrashape/velashape would be a better options for contouring and more fat reduction.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 202 reviews

If you want more fat reduction after 1 Coolsculpting procedure

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You have to be able to get fat into the suction for Coolsculpting to work. If there is not enough in the applicator, then a flat handpiece CAN be used. This handpiece takes longer than the others but it does work. Other devices that can be used include Vanquish, Ultrashape, TruSculpt, and Liposonix. There is a new device called Sculptsure that was recently FDA approved. I don't know how the results turn out with this device.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.8 out of 5 stars 52 reviews


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It takes 3 months to see your final results . Did the tech measure you while your sitting down ? she might be able to get a pinch and can use a 6.2 applicator

Suction is needed for CoolSculpting treatments

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Suction is needed for CoolSculpting treatments. The treatments can not be done with "flat" plate. The idea is to cool fat that has been sucked into the hand piece and not just the skin.

Coolsculpting and Abdomen

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Coolsculpting is a great procedure especially for the abdomen. The abdominal area is the most popular area now being performed.  Since you had good results after the first treatment and the full results can take up to four months, I think it is a good plan to wait one more month.  The flat applicator can be used but it really depends on what type of fat you will be treating. For the best results please consult a board certified dermatologist who is an expert in coolsculpting for the best results.

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.