Coolsculpting did not work

Coolsculpting and fat freezing options have rapidly become a sought after treatment option for fat removal. However, these treatments may not deliver what is promised and there is an increasing number of individuals who have had a less than ideal result or were overpromised. Worse still, they may have had complications from the treatment.

The fact that in the UK any clinic owner can purchase a machine and offer the treatment to individuals does not help. In many cases the treatment may not be suitable for any one individual who has been ill-advised or sold a treatment via marketing. There are even dentists marketing fat removal in their aesthetic clinics and who would think that a dentist is trained in body contouring!?

In general any treatment for fat removal needs to be considered in the context of the overall weight of a patient, level of obesity , skin quality and also skin laxity in the treatment area. All too often the practitioner ‘selling’ the treatment has no deep knowledge of how these factors influence treatment success. As such they are unable to advise on appropriate alternatives and options. As a consequence  patients are unable to make a fully informed decision as to whether the treatment is right for them.

If you are considering any fat removal treatment it is advisable to seek the opinion of a Plastic Surgeon since you will be getting honest advice from a highly trained professional who has a deep understanding of ALL treatment modalities and is offering advice on an independent basis with your own interests in mind. The advantage is that a Plastic surgeon will have knowledge of all types of treatments including liposuction and its variants, skin excision techniques such as tummy tuck options and skin tightening procedures such as Laser.

A plastic surgeon will also be able to inform you of all the risks of all procedures and whether there is an underlying issue which may limit the effectiveness of coolsculpting.  For example, a simple examination to find that a patient has a muscle weakness or muscle split contributing to an abdominal protuberance can determine that fat freezing will not correct this and that the fat freezing is unlikely to provide a flatter appearance.

I am increasingly seeing individuals coming to my clinic after unhappy experiences with fat freezing treatments that have been delivered at high street clinics. The reasons for these failures are numerous but also in many cases patients have had their expectations set too high. The other factor for unhappiness is that fat freezing requires multiple treatments and even then the degree of fat reduction does not begin to compare with degrees of improvement that can be achieved with liposuction. Along with multiple treatments is the significant costs of repeat fat freezing.

In order to understand why Coolsculpting may not be effective it is important to understand how coolsculpting works.


So how does fat freezing/ Coolsculpting / Cryolipolysis work ?

Coolsculpting works by an external paddle applied to the skin which transmits a cold temperature to the underlying fat. This fat then freezes and in the process of freezing the fat cells are destroyed. This process is called cryoplipolysis.  The frozen and dead fat cells are then removed by the body as debris over the following several weeks. For this reason the result is not seen for some time.

Since the freezing action is applied externally the fat cells are not physically removed and it is difficult to determine the extent of fat cell destruction.  The effect after one treatment is mild which is why many patients may be unhappy. Usually several treatments are required to produce a visible reduction.

Who is suitable for fat freezing treatment ?

Since coolsculpting only addresses very small amounts of fat you need to be well within your ideal weight range to see a proportional result. Your BMI ( Body Mass Index) needs to be under 30 but even better if it is under 25. Since fat freezing targets very small areas of fat the more overweight you are the less of an effect will be seen. Also, the treatment area is best localised to very small areas such as inner arms, the bra fat roll, love handle fat etc.

Since this is not a bodycontouring procedure you should not expect changes to large areas of your body and even in the treatment area the fat reduction effect is small and will still likely need to be repeated. For this reason it is not a quick fix and any such expectations may result in unhappiness.

You should only consider coolsculpting and fat freezing options if  you do not have time for a liposuction procedure, cannot have time off work , are too hesitant about having a more extensive procedure or have significant health problems . At the same time you need to be suitable for coolsculpting by not being overweight and only having very small localized areas of a fat bulge.

Unhappiness with the cost effectiveness of coolsculpting ?

The price of the procedure varies from clinic to clinic can be from £500 to £750 per site for each treatment session. If you need multiple treatment areas and need repeat treatments the price can quickly mount to several thousand pounds. After this if you have still not got the result you wanted you have to wonder whether a single liposuction procedure would be better value for money

Examples of why patients are unhappy with coolsculpting

A typical example of a coolsculpting/fat freezing patient who is unhappy is one who is slightly overweight with some excess skin as shown below


You can see that after coolsculpting there is a mild reduction in fat but the overall appearance has not changed significantly. This patient has a skin fold and some skin laxity. She would have been better advised to undergo liposuction with a mini-tummy tuck which would have provided a great result.


This is a very common scenario where patients either from having been overweight in the past or post pregnancy have fat excess around the tummy area. The perception is that undergoing coolsculpting will flatten the tummy but this is simply unrealistic. The reason is that there is skin laxity and coolsculpting does not cause skin contraction.

It should also be stressed that fat freezing does not help muscle weakness. There may be a muscle weakness or rectus diasasis contributing to the protuberant appearance especially post pregnancy. In these situations it is far better to seek the advice of a Plastic Surgeon who would advise on more effective alternatives. I have seen many cases where patients simply have not been examined adequately as the coolsculpting  practitioner was not trained to understand and identify such issues.


Problems with coolscuplting in this skin

Another situation is where coolsculpting has been applied to body areas where there is thin skin and delicate soft tissues. One particular area is the neck where my opinion is  that fat freezing can particularly cause bad results. I have seen many cases where fat freezing has caused irregularities under the chin and neck. In these situations I have had to perform corrective surgery with further vaser liposuction to even out the result. Some patients with thin skin and skin laxity would have been better to have undergone a necklift to redefine the contour since the fat freezing has simply caused the skin to appear even worse. Unfortunately I am seeing this more frequently and having to perform corrective surgery with necklifts.

Alternatives to fat freezing/coolsculpting

Modern forms of liposuction such as VASER liposuction can be performed as day case surgery usually under local anaesthetic ( often with some sedation ) and recovery times can be quite quick with minimal bruising and swelling . VASER is an ultrasonic technique of fat removal which does not damage the surrounding tissues such as blood vessels and nerves. Therefore it has reduced collateral damage with minimal bruising and discomfort compared to traditional liposuction. At the same time VASER has some mild effect at skin retraction. Large amounts of fat can be removed smoothly with the results far exceeding than what can be  achieved with coolsculpting.

In other situations skin removal may be necessary to achieve the best results. This may involve abdominoplasty (tummy tuck) where coolsculpting is unsuitable. In areas such as the inner arms and thighs, liposuction with or without skin removal may be more suitable such as an arm lift or thigh lift.

Get the best advice !

In order to be well informed about how to achieve the very best results it is recommended to seek the advice of a Plastic Surgeon since only such a professional will be experienced in all of the above techniques and therefore in the best position to advise you what is most suitable in your individual circusmstances. After all, if you get advice from a non-medical fat freezing practitioner and that is all they know about it is very likely it the only treatment you will be offered whether it is suitable or not.

For honest and impartial professional advice Contact the office on the contact form below.

More information with before and after images on Instagram @mrjagchana

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