Why did CoolSculpting not work for me? (Photo)

Question

I had the procedure done back in October. I've Lost a lot of weigh and then went to get the coolsculpting in Las Vegas. I did not see results in the first three months. Called them and was told that I should get Kybella injections too. I am wondering if this is a another waste of money. Should I do the chin liposuction instead? Please advise. I am in San Diego

William Groff, DO · Answer

All of the noninvasive and minimally invasive fat-removal techniques such as CoolSculpting and Kybella take at least two to three sessions, sometimes more, to achieve optimal results. This is because only about 25% of fat cells are killed during each treatment. The results of just one CoolSculpting session would be very subtle, because ¾ of the fat is still there. Did you take Before and After photos so that you could compare?At this point, you have a variety of options. You could continue with CoolSculpting (and you should be treated with the CoolMini applicator under the chin) until you get the results you want, or change to Kybella or liposuction. Liposuction removes all the fat at once, but takes longer to recover from and may leave you with loose skin. CoolMini and Kybella work more gradually, so the skin has time to adapt to the volume loss. You can also get an Ultherapy or ThermiTight treatment to tighten up the skin after the fat has gone, no matter which technique you choose. Be sure to consult a board-certified dermatologist who has a variety of fat-removal techniques so you can find the best solution to your frustration.

Jag Chana, MD, FRCS(Plast) · Answer

Coolsculpting is not a good option for the chin area especially if the chin and neck is very chubby in appearance. Firstly coolsculpting needs multiple treatments if there is a lot of fat. Secondly fat in the neck may be under the muscle where coolsculpting cannot reach. There are better options such as vaser liposuction which allows more direct fat removal. 
Also beware since I have seen a few cases where coolsculpting can cause irregularities in the neck .In some individuals where there has been loose skin individuals have been unsuspectingly been sold a coolsculpting treatment which has caused more irregularities and a corrective procedure has to be carried out, Such individuals would have been better off undergoing a necklift, But you are not in that category. 
I have written a piece on why coolsculpting may not work

Janet Allenby, DO · Answer

Hello, Thank you for your questions and photos. Based on the picture, it seems like you would need more than one treatment of CoolSculpting. Kybella can also assist in reaching your goal, however be aware that it has a bit more downtime than CoolSculpting. Good luck!

Martin Jugenburg, MD · Answer

Thanks for your question. The chin is a stubborn area and you may require more treatments to achieve the desired result. I recommend consulting with a board certified plastic surgeon to determine other courses of treatment. Regards,

Andrew Campbell, MD · Answer

I would recommend that you see your provider so they can take some photos and compare them to your before appearance. Virtually everyone gets an improvement with Coolsculpting, though most patients need two treatments in this area to get a really impressive result. Kybella is also an option so have a discussion about this before you consider further treatment. Liposuction is also a great option since it has very little downtime and can be performed in the office using local anesthetic.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

Jason Emer, MD · Answer

you would need multiple treatments with any non invasive device to see SOME outcome.  If yo uwant dramatic improvement you will need liposuction and/or skin removal surgery.  Best, Dr. Emer.

Karen Beasley, MD · Answer

It sounds like you had only one session of CoolSculpting. You will need at least three, based on your photos. CoolSculpting can only remove about 20% to 30% of fat at a time. You can have your sessions spaced two weeks apart. Results do take several months to be apparent – sometimes up to six months. Everybody's metabolism is different. 
I wouldn't advise switching to Kybella yet. Finish your CoolSculpting treatments. You should be treated with the CoolMini handle and receive a manual massage or Zimmer Z-wave radial pulsed therapy after each session. If you don't see a difference after the second or third treatment, that's when you could explore other options, but I suspect you will be seeing results by then. Consulting a board-certified dermatologist who specializes in CoolSculpting will give you the best results.

Harpreet Lotay, MD · Answer

Treatment for chin fat often takes more than one treatment and consideration of the impact of loose skin. As with any treatment there can be over and under responders and treatment quality is affected by massage to break up ice crystals immediately after the cooling phase.  Kybella can be a great addition after the amount of fat has reduced to where Ian no longer fits in the applicator.

Jennifer Harrington, MD · Answer

Thanks for sharing your photos with us. In many cases, up to three CoolSculpting® treatment sessions spaced several weeks apart may be necessary in order to achieve the best results. At our practice, we use the "stacking" technique to get better results in a single session instead. Another possible concern is that CoolSculpting® won’t address excess skin, so if you do lose weight in your chin area, you may notice that the appearance of sagging skin becomes a larger concern. It’s never a bad idea to get a second opinion, especially if you weren’t happy with your initial results. I would suggest consulting another board-certified plastic surgeon for a more in-depth assessment of your needs and the best treatment approach.

Edward Stokes, MD · Answer

Thanks for your question.  The official recommendation regarding treatment of the under chin area with CoolSculpting is that 3 treatments will most likely be needed for best possible results.  We offer a deal: buy two areas and get one free, when treating under the chin.  Each treatment will remove 20-25% of the fat, and this is rarely enough to fully remove a stubborn pocket of fat such as the double chin.  Additionally, it is often necessary to treat this area with side by side, overlapping applications to really cover the entire area.  We always educate our patients during the consultation so that they are aware of how many treatments will be needed and how the applicators will be placed. Although there are other options such as Kybella, it sounds as though you simply need to finish a proper treatment plan with CoolSculpting. Good luck with everything!

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