Will a percentage of the fat cells that are eliminated after Coolsulpting return?

Question

I have read that approximately 10% of fat cells in our body die off naturally and are replaced annually. So if a Coolsculpting procedure reduces the fat in a area by up 25%, will the body replace these fat cells over time regardless of diet and exercise? I am hesitant to invest in this procedure if my result will be eventually compromised.

Kimberly Butterwick, MD · Answer

I have been performing CoolSculpting for more than 5 years. My patients who maintain their weight have also maintained their CoolSculpting results during that period. It’s true that all of our body’s cells die and are replaced continuously — including fat cells. But during a CoolSculpting session, up to 35% of fat cells are killed all at once. The body does not replace this huge volume of destructed cells. Instead, the lymph system breaks down the components of the cells as they die, and gradually filters and eliminates them. The cells do not grow back. The remaining cells in your body will continue to die and replace themselves at the normal rate. 
As long as you don’t gain weight, there is no reason why your newly contoured body can’t last a lifetime. If you do gain weight, the existing fat cells in the area can expand in proportion to the rest of the body. So as always, it’s important to maintain healthy habits for your lifetime. Please find a board-certified dermatologist who has been certified by Zeltiq as a CoolSculpting practitioner and who also offers Zimmer Z-Wave radial pulsed therapy to improve fat-killing and enhance the uniformity of your results.

Tina B. West, MD · Answer

Approximately 20-25% of the targeted fat cells will be eliminated after a CS treatment.  Once these cells die, they are gone for good! Hope this puts your mind at ease.  Best of luck!

Shahriar Mabourakh, MD, FACS · Answer

The number of fat cells in body do not change with changes in weight. Fat cell become larger with weight gain and smaller with weight loss. Contrary to what you may have read fat cells do not regenerate. After Coolsculpt treatment one can expect to loose approximately 20 to 25% of fat cells in area treated per session. Treatment is targeted toward stubborn areas. Once treated this cell do not return.

Edward P. Miranda, MD, FACS · Answer

Cryolipolysis is the non-invasive cooling of fat cells to induce lipolysis without damage to other tissues or structures and no surgery or downtime. This precise cooling induces fat cell apoptosis followed by natural dissolution of the cell. It is the world's #1 non-invasive fat-reduction procedure with over 3 million treatments performed worldwide.
When fat cells are exposed to cold temperatures they become terminally injured and gradually die (cellular apoptosis). The cells die within the first 2-3 days and begin to collapse. Macrophages digest and consume the dead fat cells and lipids within the cells. This debris is cleared through the lymphatic system.
Fat cell numbers are fairly set at puberty (new fat cells can only be generated if they reach a “critical” size). When you lose or gain weight, the volume of fat cells change but the number of fat cells remain the same. Only possible biological instance of growing new fat cells is during pregnancy and in cases of extreme obesity. CoolSculpting eliminates on average 20-25% of fat cells treated.
Like a cut, what we’re doing is inducing that natural cellular response. Body sends digestive cells eating away at those cells (apoptosis). CoolSculpting "cuts" the fat cells, the macrophages are sent in and clean out those damaged fat cells and they're metabolized.
I hope that helps! Let us know if you have any further questions.

Martin Everhard, MD, PhD, FACS · Answer

The fat cells that are treated with CoolSculpting will be removed from the body for good after your appointment. Only about 25 to 45 percent of fat cells in the target area will die off after treatment, but results vary.

Edward Stokes, MD · Answer

Thanks for your question. CoolSculpting will permanently remove 20-25% of the the fat cells fro the areas that are treated. If a healthy diet and lifestyle is maintained post treatment with CoolSculpting, you will not see an increase in fat cells. This is a non invasive and very safe procedure which yields very smooth, natural looking results. Having treated tens of thousands of patients, we have never seen anyone have the fat cells return. I think you can feel confident that you are making  good investment.

Jeffrey C. Dawes, MD, FRCSC · Answer

Each treatment on average eliminates 15 to 20 % of fat cells in the area treated, once these fat cells are gone from the body they will not return if a healthy lifestyle is maintain. Hope this helps!

Anthony P. Terrasse, MD · Answer

Thank you for your question. Luckily, the short answer to your question is no - the fat cells will not return if you maintain a stable weight. By the time we reach adulthood, the number of fat cells in our bodies has reached a fixed number - as we gain and lose weight, the cells shrink or expand, but no new fat cells are created. CoolSculpting kills off fat cells, and they are then completely eliminated from the body. It is likely that the 10 percent statistic you are concerned about refers to the renewal of existing cells, not the creation of new fat cells.

Hadley Claire King, MD, FAAD · Answer

I can sympathize with wanting reassurance of long term results before investing in coolsculpting. The statistics you are citing originate from a 2008 study published in Nature. The researchers of this study found that about 10% of fat cells within the body undergo a renewal process each year, however the study is quick to note “the number of fat cells stays constant in adulthood in lean and obese individuals, even after marked weight loss, indicating that the number of adipocytes is set during childhood and adolescence.” The body then, does not create new fat cells, it replaces existing fat cells, according to the study. 
There are a few emerging studies that suggest the body can generate new fat cells in response to extreme weight gain. But there are also recent studies that contradict this claim. 
The truth is, there is still a lot we do not know about fat. 
What we do know is CoolSculpting destroys fat cells by freezing them and by doing so triggers the literal removal of those fat cells from the body through the natural processes of the lymphatic system. It is believed that once removed from the body, those fat cells cannot grow back and the body does not generate new fat cells to make up for the cells that were removed via CoolSculpting. 
One longitudinal study substantiates the claim that coolsculpting results are long lasting, published in The Journal of Cosmetic Dermatology measuring CoolSculpting results 9 years post treatment. The study concluded that despite normal weight fluctuations “local reductions in flank fat [after a single CoolSculpting treatment] have significant longevity in these subjects and suggest that results from Cryolipolysis may be very long-lasting."

Vincent A Marino, MD · Answer

The key to understanding why fat cells don't "return" after CoolSculpting is twofold. First, CoolSculpting is a targeted treatment that eliminates up to 25% of specific stubborn fat pockets per treatment.The remaining 75% of untreated fat cells can still expand when you gain weight, and shrink when you lose weight. Second, the remaining fat cells (including visceral fat behind the muscle wall that CoolSculpting does not treat) still undergoes natural cell turnover. Barring the body reaching obesity, this attrition rate is low and consistent, and the body doesn't overproduce new fat cells. So, the idea is that even with cell expansion and natural cell turnover the results are proportional, and still 25% smaller than when you started.
FDA studies show over many years and even with weight fluctuation the treated areas are smaller and more sculpted than when the patient started. Since most patients are happiest after two treatments in any given area, your results will far outweigh any natural cell turnover!
Best of luck!
Vincent Marino, M.D.

Will a percentage of the fat cells that are eliminated after Coolsulpting return?

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