My Experience with Liposuction on Patients Who Have Had CoolSculpting

As a board-certified plastic surgeon with almost twenty years of experience, I feel obliged to go to seminars set up by various companies promoting non-surgical options.  Cool sculpting has been and continues to be one of the major players in the non-surgical market for body fat reduction.  According to the company’s presentation, the idea for freezing the fat came from an article in which the author had noticed a permanent fat reduction in cheeks of children who had very cold frozen treats.  The machine has metallic plates which are applied to the area of concern, and the plate reaches very cold temperatures, thus allowing the fat to freeze.  At most, up to 25% of fat is frozen, which is then absorbed by the body over a period.  I have been to 2-3 seminars given by the company, but was never impressed enough to splurge on a machine which costs as much as a high-end luxury car.  As a surgeon, I can achieve a much better and more predictable result in one session.  Furthermore, for patients who require more than one treatment, the cost, in most cases, is more expensive than performing the procedure under local anesthesia.

I have also had experience with several patients which have had cool sculpting and have requested liposuction.  In two patients, I have seen paradoxical fat hypertrophy (PFH), which is now a recognized complication of this treatment.  This is most common in the abdomen, and the patient presents with a “ball of fat”.  The only viable option is liposuction.  In my experience, the liposuction of this localized hypertrophy of fat has not been more difficult than regular liposuction.

In others, however, who have not had PFH, liposuction has been extremely difficult.  The tissue is very dense, almost “concrete” like, as though the patient has had a previous liposuction with extensive scarring.  The result is sometimes unpredictable and post-operative skin irregularity may be more common than a previous liposuction.

I understand there are patients who are afraid of surgery.  These patients, by default, may also have lower expectations in terms of result.  Cool sculpting is certainly a viable option.  However, please keep in mind, if future surgery is desired, the procedure and recovery may be more difficult than traditional liposuction.

Michael A. Jazayeri, M.D. is a board-certified plastic surgeon in Santa Ana with offices in Santa Ana, California.  To schedule a complimentary consultation, please call (714) 834-0101.