Body Sculpting with CoolSculpting

Featured Physician: Leyda Bowes, MD

Featured Article: Klein KB, Bachelor EP, Becker EV, Bowes LE. Multiple same day cryolipolysis treatments for the reduction of subcutaneous fat are safe and do not affect serum lipid levels or liver function tests. Lasers Surg Med. 2017;49(7):640‐644. doi:10.1002/lsm.22674

Dr. Bowes is a board certified dermatologist with over 20 years of clinical experience in medical and cosmetic skin treatments. In addition to being a highly regarded and sought after dermatologist, she is co-founder and CEO of myDoqter.com. She has published widely in the medical literature and has done extensive research on cryolipolysis, the technique underlying body-sculpting with CoolSculpt. She sat down with us to give us some background on the science of body sculpting with CoolSculpt.

How does CoolSculpting work?

myDoqter: Thank you for taking the time to speak with us about body-sculpting with Coolsculpt. This is the time of year, that people start thinking about getting summer ready. Can you tell us how it works and is there truth to calling it a ‘fat freezing’ procedure?

Dr. Bowes: CoolSculpting is a completely non-invasive procedure that is able to remove unwanted fat by exposing the fat cells selectively to cold temperatures. We say ‘selectively’ because at temperatures that are low, such as 4° Celsius, we can specifically make the fat content crystallize inside the cells; but these temperatures are not low enough to be able to freeze or crystallize water inside other cells. This is what doctors mean when they say that CoolSculpting is very selective, because it only damages fat cells, and it has no negative effect on all other tissues around the fat, such as the muscles, skin, nerves or internal organs. CoolSculpting has also been commonly referred to as “Fat Freezing”, precisely because at these low temperatures the lipids or fat content of the cells form into crystals, pretty much like tiny ice cubes. This is why the process has also been known as “fat freezing”.

Who is a good candidate for the CoolSculpting procedure?

myDoqter: Patient selection for cosmetic surgery is important and it’s really up to the physician to provide proper guidance to the patient. Who would you say is a good candidate for this fat freezing procedure?

Dr. Bowes: The best candidate for the CoolSculpting procedure is a person that is within a healthy range of body weight, and who has localized areas of excess fat. CoolSculpting is not a treatment for obesity and proper selection of the patient is very important in order to achieve the best results and to create the right expectations among patients.

What areas can be treated with CoolSculpting?

myDoqter: What parts of the body can be treated?

Dr. Bowes: CoolSculpting treatments have been performed in the United States since early 2010. To date, over 8 million treatments have been performed all over the world. At the beginning when we started doing CoolSculpting, there was only one type of applicator, which was placed over the areas of excess fat. The applicator was of a specific shape and size, and was only able to treat areas of excess fat in the flanks or sides of the abdomen. Nowadays, there are over 15 different sizes and shapes of CoolSculpting applicators. This allows us to treat areas of excess fat almost anywhere in the body. These areas include: the chin or submental area, the arms, the bra area, the upper back and lower back, buttock, abdomen, flanks, inner thighs, outer thighs and more.

Is CoolSculpting safe?

myDoqter: Your article is on the safety of cryolipolysis which is the technology behind CoolSculpting. What can you tell us specifically about the safety of CoolSculpting from the perspective of medical data?

Dr. Bowes: CoolSculpting is a very safe procedure that is performed externally on the body by placing an applicator over the area of excess fat that we would like to reduce. There are no needles involved, no scalpels or incisions, and no anesthesia is required. CoolSculpting is truly a completely non-invasive procedure.

In the areas that are treated, 20% of the fat cells are permanently damaged and will die. Typically, each CoolSculpting treatment can destroy approximately 20% to 25% of the fat cells in a given area. Once the fat cells die, the contents of the cells, including the lipids (fat), are removed gradually throughout the lymphatics, and eventually excreted or eliminated in the stools and the urine. We conducted a multi-center study that showed that even after multiple CoolSculpting treatments are performed at the same time in a patient, there is no significant rise in the levels of cholesterol, triglycerides or the liver enzymes for several months after the treatment. These findings continued throughout all the period of elimination of fat cells. This corroborates our clinical findings that indicate that CoolSculpting is a very well tolerated procedure, and that it is not associated with any significant serious metabolic side effects.

Is there skin sagging after CoolSculpting?

myDoqter: What about after-care with the procedure? And when CoolSculpting removes the excess fat, what happens to the skin in that area?

Dr. Bowes: Body sculpting procedures are generally very well tolerated although there may be some redness, swelling, skin sensitivity, and tenderness for several days. Longer term issues such as dimpling of the skin or indentations have been rarely reported but at are exceedingly uncommon.

As for the skin, it does not sag after CoolSculpting. In fact, many patients and physicians have noticed that months after the CoolSculpting was performed, not only is the fat reduced, but the skin in that area appears to have tightened and improved in appearance. This may be explained in part by the fact that the fat removal is a gradual process and, therefore, this allows the skin to accommodate as well as to possibly undergo a modest level of skin tightening. This is why it is so crucial that patients receive a proper evaluation before doing CoolSculpting, in order to determine if they are good candidates for the procedure. For example, patients who have a small amount of fat, but a lot of excess skin that is sagging in the specific area of concern, will not be good candidates for CoolSculpting. Those patients instead will require a surgical procedure known as abdominoplasty or ‘tummy tuck’ to remove excess skin.

Where are the top 5 things to know about CoolSculpting?

1. Patients who are interested in having the CoolSculpting treatment should always search for a CoolSculpting-certified practice that is led by physicians. You should have a medical consultation to discuss all options and determine the best treatment plan for you.
2. There are several body sculpting devices and some may be more optimal for you so it is best to have a medical evalution. In some cases, body sculpting devices may not produce the desired outcome and the lipo-sculpture procedure may be more effective.
3. Each CoolSculpt treatment is reported to treat about 20% of the fat in the area so you could have repeated treatments for a cumulative effect.
4. You can treat the double chin.
5. The idea for the treatment came from the finding of fat loss on the cheeks that had been seen with prolonged popsicle contact!

For more information or to find a physician, you may refer to www.CoolSculpting.com.