Hi sempertyrannis, Thank you for your question regarding the appearance of horizontal folds across the abdomen in a 57-year-old woman who is not overweight. Without seeing pictures, it's difficult to provide a precise diagnosis, but from your description, it sounds like these could be due to excess skin. Ageing, changes in weight, and natural changes in skin elasticity can lead to such skin folds, even in individuals who maintain a healthy weight. If the issue is primarily excess skin, treatments like CoolSculpting, which targets fat reduction, may not be the most effective solution. CoolSculpting is designed to reduce fat cells in specific areas and might not adequately address skin laxity, which seems to be the main concern based on your description. Given your hesitation towards surgical procedures, it's understandable that a tummy tuck might not be your first choice. However, a mini tummy tuck or even a full tummy tuck could be the most effective ways to remove excess skin and achieve a smoother, flatter abdomen. These procedures are specifically designed to address and remove excess skin, tightening the abdominal area for a more toned appearance. There are non-surgical options that claim to improve skin tightness, such as radiofrequency treatments, ultrasound therapy, or laser treatments, which may offer some improvement in skin texture and firmness. However, the results from these non-surgical options are typically more subtle and may not fully correct the appearance of multiple horizontal folds. Ultimately, the best treatment option depends on a detailed physical examination and discussion of your goals and expectations. Consulting with a board-certified plastic surgeon who specializes in body contouring can help you understand the potential outcomes and decide on the best course of action for your specific situation. Sincerely, Dr. J. Timothy Katzen, MD, FASMBS, FICS Plastic and Aesthetic Surgeon