Why Does the Fat Keep Coming Back After CoolSculpting?

I have had 5 cool sculpting treatments in the past year. The fat keeps coming back, less each time, but it still comes back. The person that does the treatment says that she has never seen that happen before. I am 5'4", 111 lbs, & 69 yrs old. Why is this happening and should I continue to have the treatments, hoping that they will eventually work?

Update 4/17/2012:

The 5 treatments that I had were on my lower abdomen. I have not gained weight, but the fat is still there. Should I continue with the treatments or have slim lipo or tickle lipo done instead?

Doctor Answers 6

Fat Removal With Cool Sculpting

Dear Sarita,


The Zeltiq - cool sculpting - will freeze the fat cells (cryoplipolysis) without affecting other tissues; the fat in the adipocytes (fat cells) will freeze at a controlled temperature inducing cellular apopotisis (programmed cell death) hence a permanent solution.

That said, not all the adipocytes in the targeted area will commit suicide only about a third of them do. However, with repeated treatments over the same area should induce apoptosis of a third of the remaining fat cells.

So perhaps your treated area is not given enough time to achieve final results before undergoing another round of "cooling". Is that the case?

Thank you for your inquiry and the best of wishes to you.

Dr. Sajjadian

Orange County Plastic Surgeon
5.0 out of 5 stars 196 reviews

Fat reduction with CoolSculpting is permanent

CoolSculpting causes about 25-33% of treated fat cells to commit suicide.  These cells are permanently gone.  However, remaining cells can increase in size, thereby allowing you to gain weight in areas where you have had CoolSculpting.

Did you have all five coolsculping treatments in the same area?  Each time you have it in the same area, 25-33% of those cells will commit suicide.  As you can imagine, each subsequent treatment will result in the loss of less fat cells because you are starting with a smaller number of fat cells. It sounds like you having some volume reduction with each treatment, though not as much as you'd like.  

Has your weight been stable?  Your weight sounds very reasonable for your height, but if you have been gaining weight, then the results of your CoolSculpting treatment will not be as optimal.


Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Coolsculpting Results

Thank you for your question.

After the Coolsculpting treatment, the fat cells are frozen and eliminated from your body so I would say that they may be "coming back" because of your diet.  This treatment  (just as with any surgical treatment) cannot stop you from gaining weight if you are not watching your diet.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Fat Coming Back After CoolSculpting

When you have your CoolSculpting treatment, the affected fat cells are eliminated. As long as you maintain your weight with your normal diet and exercise, your long-term results should remain stable.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

Fat loss and CoolSculpting by Zeltiq

As fat dies when frozen with coolsculpting it will only "come back" if the amount of calories consumed is greater than the energy used by the body. You may need to consume less calories or exercise somewhat more to keep the fat away. Before the Zeltiq you had gained fat because you had a surplus of calories and having the CoolSculpting can reduce the fat that is present but if you don't change the intake vs. energy expended, fat will reaccumulate. We see the same with all forms of liposuction. The fat that dies with CoolSculpting or the fat removed with liposuction is never 100% of the volume of pre-operative fat, purposely. The residual fat cells are able to engorge more fat if the dietary calories exceed the calories needed for your body's minimum functions (basal metabolic rate) and the calories required for muscle movement (walking, exercise, etc.). Ideal candidates for Zeltiq CoolSculpting have a small localized bulge. Those patients with much greater amounts of fat, can reduce the volume, but unless they change their lifestyle the fat will easily reaccumulate. Neither Zeltiq nor Liposuction are replacements for diet and exercise.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Cool Sculpting treatments lead to permanent fat loss

Please follow a routine diet with exercise.

Body reshaping can be performed with a cannula that removes fat via liposuction or with noninvasive technology like Cool Sculpting. With Cool Sculpting there is no cannula inserted into your body. All treatments are performed on the surface from the outside in using technology that freezes the fat. Don’t hesitate to give us a call in Austin regarding a Body Reshaping Consult at the Upper Room. On our Facebook Page there is an Interview I recently did with KVUE, a local news station in Austin, that was picked by affiliates around the United States, including Miami. During the Interview we discussed the technology of Cool Sculpting as well as it application process.

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.