What treatment would be most effective to treat what you see - the fat pockets and loose skin? Preferably not surgery. (photo)

I had smart Lipo over a year ago on lower abdomen. Didn't work well. Then tried cool sculpting. They put one large applicator across my stomach which left a permanent dent. Since then I've had several cool sculpting treatments to contour and fix. This is what I'm left with. I'd like to know how I can have this look more even. Not lumpy and loose. I don't want to keep doing this that will just make it look worse. The way it looks now is unbearable.

Doctor Answers 7

Unhappy after Lipo or Cool Sculpting

In this situation I would first of all make sure you have waited at least 6-12 months since the end of any intervention. Make sure you are seeing what is the final result. If the center where you had cool sculpting is overseen by a board certified plastic surgeon then I would seek their opinion on how to fix what happened. Most likely precision liposuction is your best chance at a better contour. In your area I would seek an opinion with Dr. Grant Stevens, my mentor who is an expert in cool sculpting and surgical intervention. I would trust him or his partners for an opinion. Best of Luck.

Columbus Plastic Surgeon
4.9 out of 5 stars 65 reviews


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.

My best,

Sheila Nazarian, MD, MMM

Beverly Hills, Board Certified Plastic Surgeon




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

Fat pockets and best treatment

An in office consultation is really the only way possible to see if you are a candidate for Coolsculpting or one of the other non-surgical methods for removing a fat bulge. Please consult an expert since a non-surgical approach would be the most efficient for you if you are a candidate.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Tweaking results from your past treatments - CoolSculpting, radio-frequency treatments, or liposuction

Given the photo you provided, precision liposuction therapy might be your best bet.  However, CoolSculpting or radio-frequency treatments might be good options too - I would need to examine your abdomen in-person to give you an exact answer.  I recommend you find a Dermatologist or Plastic Surgeon who is experienced with all of these treatments.

Jill C. Fichtel, MD
Columbus Dermatologic Surgeon
5.0 out of 5 stars 16 reviews

Lumpy and bumpy

At this point, you will require a surgeon to artistically fine tune your fat distribution; i.e. taking fat out of areas that are "up" and transfer of fat to areas that are dipped or "down". This requires high definition cannulas which will literally sculpt your belly.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Stubborn fat not removed with smart lipo and coolsculpting may respond to Sculpsure or ThermiTight

Without examining  you I can not make recommendations for your condition. In general, physicians can consider other fat reduction alternatives when coolsculpting and smartlipo don't seem to produce the desired result. ThermiTight uses radiofrequency delivered with a small rod to heat and melt the fat and tighten the skin. An internal and external temperature reading is constantly monitored for safety. SculpSure is an external laser-induced heating system that kills fat cells. No guarantees can be given that either treatment will provide the desired result and an examination is important to determine if there is something other than normal fat accumulation as the cause of the bulges.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Not unbearable, but fixable--Coolsculpting vs. VASER for the abdomen

For non-invasive options, I suggest Coolscupting or Sculpsure in combination with radiofrequency treatments such as Vanquish, Venus Legacy or Exilis with Z wave/X wave/Cellutone for best results. However, VASER liposuction can sculpt and contour the body and results can be seen immediately. See an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 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.