I Have Banana Rolls with Too Much Skin and Fat. What will happen to the already lax skin if more fat is removed?
Will Cool Sculpting (Zeltiq) Address Skin Laxity?
Doctor Answers 46
Skin with good elasticity will tighten after Coolsculpting
Coolsculpting is targeted to reduce fat not affect the top layer of skin which is where much of the natural elasticity of the skin resides. Because the results are seen over a 4 month period, patients with good skin elasticity will often see the skin contract as the fat is slowly lost. Patients who have pre-existing skin looseness (laxity) usually will not see the skin tighten as the fat is lost, because the elasticity is already lost.
Just like when you take off a bra, the elastic band will shrink down as the stretch from the body is removed, if you have good elasticity the skin will shrink down as the fat is removed. If the elasticity in your bra is shot, it won't contract, and if the elasticity in your skin is not good, it won't shrink either.
Your doctor will be able to tell you before treatment whether your natural skin elasticity is good enough to contract as the fat is lost. If it is not, you may need additional treatment that targets the elastic layer, like Thermage. But I have not seen Coolsculpting make the laxity (looseness) of the skin get worse.
Skin Laxity with CoolSculpting
CoolSculpting's primary purpose is to reduce fat cells and volume. You do risk additional skin laxity from the treatment, particularly if it's already pre-existing.
Zeltiq will not address lax skin
If your skin has lost its elasticity, it will probably look even looser after you have zeltiq. A good analogy is the abdominal skin in a pregnant woman. If the skin has lost its elasticity, it can look wrinkly and hang down after the mother has given birth and lost weight. If the skin is tight, it will shrink back after the baby is born. This is why patients with tight skin get the best results with zeltiq. People with loose skin should consider a surgical procedure to remove both skin and fat (eg tummy tuck).
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CoolSculpting Does Not Address Skin Laxity
Younger people who have CoolSculpting will find that their lax skin often comes back to its natural appearance. Older people do not have as much luck with lax skin normalizing. Because of this, in many of our patients, we will do laser skin tightening in addition to CoolSculpting so that when the fat is gone the skin is not as lax.
Skin can retract
when fat is removed below the skin, the skin can retract to match the new contour. however, after severe amounts of weight loss, or yo-yo dieting or multiple or large pregnancies, this ability of the skin can be comprimised. so it truly depends on your skin and how severe the laxity is to begin with.
Zeltiq/Coolsculpting reduces fat NOT skin laxity
Currently, there is no evidence that Zeltiq's Coolsculping will either improve or worsen skin laxity. Skin inherently has some elasticity, so when we gain weight or lose weight, skin will naturally "expand" or "contract" against our body. Likewise, using coolsculpting to reduce the fat layer at the subcutaneous layer, will not affect skin laxity. If you have too much skin laxity after Coolsculpting, then you may require skin excision of the affected areas.
Zeltiq and Skin Laxity
Zeltiq is for permanent reduction of fat. It will not affect the laxity of this area one way or another. If you are already somewhat lax in that area - you will likely remain a bit lax after the treatment. It should not make the laxity worse. You could always have a skin tightening procedure in conjunction with the Zeltiq to help improve the laxity such as Thermage to help improve that area.
Dr. Grant Stevens