Is CoolSculpting The Answer To A Flat Stomach?

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Photo: Raymond Meier/Trunk Archive

I’ve lost 70 lbs., and I’m proud that my efforts have resulted in a strong, healthy body, but as I’m staring down those final 20 to 25 lbs. toward my goal, I’m also staring at some stubborn belly rolls that just won’t budge—even though I know there are hard-earned abs under there. 

A quick search revealed what seemed like a great non-surgical solution: CoolSculpting by Zeltig. This non-invasive procedure hit all the right points, and the allure of sitting in a doctor’s office while a machine that gently freezes unwanted fat via a process called Cryolipolysis is incredibly alluring. The fat naturally melts away from the body without any downtime? Sign me up! Or is it too good to be true? 

In a word, yes. “30-40% of my liposuction patients come to me after they’ve already wasted thousands of dollars on the technology,” says Dr. Paul Jarrod Frank, a top New York Cosmetic Dermatologist. “It just gives a bad name to CoolSculpting, which is actually pretty novel and good, but totally oversold. Plenty of doctors and medi-spas that have a CoolSculpting device aren’t experienced in liposuction surgery, and unfortunately won’t turn away a client for whom it isn’t the best option.”

So, let’s talk about why. “There’s science behind CoolSculpting. It works, but it’s for teacups, not soup bowls; it only removes about a centimeter of fat, which is essentially the width of a fingernail,” says Dr. Frank. “It works well on thinner people who have a couple of trouble spots that might be resistant to diet and exercise: men with hereditary love handles, women who’ve just had a baby, etc. But the majority of people who walk through the door aren’t great candidates for it. Of all the body sculpting technologies I have —and I do 300 liposuctions a year —it’s not often I turn the machine on. People come in thinking that they want it because it sounds so great—and I’m glad I have it—but it’s not for everybody.” 

Which is an important distinction for those of us with stubborn pounds versus a tiny bit of tuning up here and there. “It’s very much a “drive-thru technology,” Dr. Frank says. “People who want to look like they’ve lost ten pounds won’t do well. It either won’t produce the results they want, or they’ll have to go back so many times they might as well do liposuction or a procedure they should have done in the first place. Too many people believe there’s going to be tremendous fat loss, and that simply isn’t the case.”

Let’s talk about that point for a second: it’s not a weight loss procedure. “There is no body sculpting technique that can help shed significant weight. These aren’t huge weight loss procedures; they’re contouring methods. People who want to shed serious body mass need to understand there’s no body contouring procedure that can help with that. There are procedures that can help with that resistant last five-to-ten pounds, but these aren’t the answer to the larger problem.”

There’s another significant point: for those of us who have lost considerable weight, that “fat roll” we’re trying to lose probably isn’t fat; it’s skin. “For people who’ve lost a tremendous amount of weight, a lot of what you’re feeling when you “pinch an inch” is skin and connective tissue that was between the fat cells that you got rid of on your own. There’s a lot of connective tissue—a fibrous network of collagen, elastin, etc.—in between all that fat, and when you lose weight, the fat cells shrink or disappear entirely, but the fibrous network remains as thickened tissue. Also, when you’re heavier, your skin is stretched out. When it deflates, the remaining skin is thicker from being overextended. So, what feels like a fat roll could really be thickened skin.”

“I have not found that people who’ve had significant weight loss (30 lbs. or more) have had any success with these non-invasive technologies, especially when you’re working with stretched skin. Technologies like SmartLipo or Vaser Lipo are the answer to reducing that layer of thickened tissue and producing the results you want. There’s no science that supports that the CoolSculpting device does anything for skin tightening.” 

Candidates for CoolSculpting should have the service performed at the hands of a licensed dermatologist or plastic surgeon. “CoolSculpting is popular because its a skill-less procedure: you attach the suction device and it does the work,” explains Dr. Frank. “You can have this done at a gynecologist’s office, a medi spa, and it doesn’t require anywhere near the same skill as liposuction or surgical procedures. Anytime you go in for a consultation, make sure they have a range of options available. If a doctor only has one option for you with any type of procedure, it means their scope of expertise is limited. This is true with anything, from injectables to body sculpting to fat removal.”

Looks like I’ll continue my religious use of SkinCeuticals Body Tightening Concentrate ($78), which has kept my abdominal skin from getting too loose during my weight loss journey (even Dr. Frank was amazed at the tautness of my abdominal skin), and stick with the diet and exercise plan that’s working, happy to bask in the glow of all my hard work.