Can I get CoolSculpting after Vaser Lipo to help improve some residual fat and lumpiness?

Question

Hello - had Vader liposuction in my lower front abdomen in august of 2017. I’m generally happy with the result but there is a bit of leftover lumpiness, and a small fat pad that I’d like to improve. I spoke with my Dr who did not recommend a repeat surgery and basically said to live with it. Diet and exercise will not spot reduce this area. I was thinking that perhaps coolsculpting this area would offer the improvement I desire. Any experience with Coolsculpting after lupo? Risks/effectiveness?

William Groff, DO · Answer

You’re still healing from your liposuction. Give it at least another month. If you’re still not happy, there are many possible solutions to help even out your figure.
CoolSculpting works well after liposuction, provided there is enough fat to treat with the applicators. If it’s a very small amount of fat, microliposuction with mini cannulas or even off-label Kybella might be the best solution. Depending on how uneven the area is, it could also be resolved with a bit of diluted Sculptra. Be sure to consult a board-certified dermatologist who has experience using a variety of techniques to give you your ideal figure.

Vaishali B. Doolabh, MD, FACS · Answer

Hi.  Generally speaking, the results of liposuction continue to change for several months so small areas of fullness may resolve altogether as healing continues.  It would be premature to reoperate or try Coolsculpting right now.  Notwithstanding, there is no risk of trying Coolsculpting or Kybella injections after liposuction has healed.  If there is fat there, both will reduce the fat.  If it is scar tissue or loose skin, neither will work unfortunately.  You can achieve good skin tightening with the J Plasma or Cool Helium Plasma device.  Good luck!

Edward Stokes, MD · Answer

CoolSculpting can be a wonderful way to treat the lumps, bumps and pockets of fat that get missed by Liposuction. It is important to wait the appropriate amount of time post treatment with Lipo before treating with CoolSculpting.  You will want to discuss this with your physician. Additionally, you would want to schedule an in-person consultation with a reputable CoolSculpting provider to be sure that you are a good candidate. Good luck with everything!

Vinay Aggarwal, MD · Answer

You are still healing from your liposuction, so give it another 3-4 months before deciding if you feel you need another treatment. Are you wearing a compression garment and are you massaging the area? If not, please take to your doctor about implementing these into your recovery. Both may help even out the areas of concern. If you still have remaining fatty areas, CoolSculpting can definitely be considered, as long as there is enough to fit in the applicator.

Lauren Chavez, MD · Answer

We have reduced isolated fat pockets after liposuction, at times, with Ultrashape. It's not perfect, but, it may provide "enough" improvement to not be so bothered by it, anymore? :)

Sameer Bashey, MD · Answer

If you don't have enough fat to fill the CS applicator it won't work. In your case, if there is contour irregularity- you require fine tuning manually- so in this case I would perform another liposuction if you were my patient. If it is very fine spot reduction you can also try off-label use of kybella

Adrienne E. Stewart, MD · Answer

If you have areas of fat which remain after your original treatment i.e. lumpiness and other irregularities we would typically not use CoolSculpting to correct this. We use ultrasound delivered through a device known as Ultra Shape. Some patients are fearful of ultrasound because heat based ultrasound is very painful. The type we use is not painful. We often use this to clean up these types of problem areas. Adrienne Stewart MD FAAD

Mary Beth Mudd, MD · Answer

I like to tell patients that they will see their full result of permanent fat removal from invasive body sculpting treatments at 6 months, so it is very possible that you may see some of this leftover lumpiness smooth out once more of your swelling is gone. If any of this is due to skin laxity, I have seen skin improvement up to 1 year following LaserLipo treatments and suspect the same may be possible from Vaser since this also uses heat from the ultrasound. I agree that diet and exercise will not spot reduce. That being said, I definitely think that either CoolSculpting or even off-label use of Kybella may be possibilities to further improve your area but I would wait until you are 6 months from your original treatment to make sure you have achieved the full result. Best wishes,  Mary Beth Mudd

David A. Sieber, MD, FACS · Answer

Thanks for the great question! Coolsculpting generally works well to remove focal areas of increased fat. These areas typically need to be large enough to fit into one of the coolsculpting applicators. It sounds like the lumpiness you have is something called a contour irregularity. These can usually be improved by doing another round of surgical liposuction to smooth out the irregular areas. I would recommend having a consult with another surgeon of a second opinion. Best of luck!~Dr. Sieber

Phillip J. Din, MD - Account Suspended · Answer

I would persue the coolsculpting first and wait at least 6 months after your liposuction to see if any irregularities smooth out. Coolsculpting will definitely bring volume down to areas that you feel were left behind. This would be a more cost effective approach then going right back to liposuction again. We offer patients a touchup at 6months with Smartlipo at our practice for any locations that may need a slight reduction or smoothing for the cost of fibers etc. Perhaps your Vaser physician will allow this as well at 6months?

Can I get CoolSculpting after Vaser Lipo to help improve some residual fat and lumpiness?

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