Why Does the Fat Keep Coming Back After CoolSculpting?

Question

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?

Ali Sajjadian, MD, FACS · Answer

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

Tom J. Pousti, MD · Answer

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.

Ron Shelton, MD · Answer

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.

Melissa Chiang, MD, FAAD · Answer

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.

Monika Soni, MD · Answer

Thank you for your question! The CoolSculpting machine freezes the fat cells without affecting other tissues. In one treatment, not all the fat cells will freeze, only approximately a third of them will. That’s why it is suggested to get repeated treatments. Sometimes, without the proper diet or exercise, your body will gain more weight. Best of luck!

Why Does the Fat Keep Coming Back After CoolSculpting?

Answers (7)

Answer: Fat reduction with CoolSculpting is permanent

Answer: Fat reduction with CoolSculpting is permanent

Answer: The CoolSculpting machine freezes the fat cells without affecting other tissues.

Answer: The CoolSculpting machine freezes the fat cells without affecting other tissues.

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Why Does the Fat Keep Coming Back After CoolSculpting?

Answers (7)

Answer: Fat reduction with CoolSculpting is permanent

Answer: Fat reduction with CoolSculpting is permanent

Answer: The CoolSculpting machine freezes the fat cells without affecting other tissues.

Answer: The CoolSculpting machine freezes the fat cells without affecting other tissues.

Browse related questions

Recommended reading

Everything you need to know about CoolSculpting

Our mission is to create a world where every investment in modern beauty is Worth It.