Are the new body sculpting procedures I’ve recently seen advertised in my dermatologist’s office really effective, and are there any dangers?


As we age, some pockets of fat on the body are extremely difficult to eliminate, even with a very healthy lifestyle. Noninvasive fat-reduction treatments such as CoolSculpting and SculpSure promise fat loss in specific areas without dieting, exercise or surgery and, in my experience, they do provide modest visible results.

The key to success with these treatments is expectations. These treatments are made to mildly reduce isolated pockets of fat not to make a person skinny…and results vary from person to person. The areas that can be treated include fat on the abdomen including “love handles,” inner and outer thighs, upper arms and back, and a double chin.

How these treatments work: With CoolSculpting, a cooling applicator is applied across a specific area of skin to freeze fat cells underneath the skin. These fat cells then die and, over time, the body naturally eliminates them through mechanisms in the bloodstream. It takes about 35 minutes to have a single area of the body done.

In a clinical trial published in Clinical, Cosmetic and Investigational Dermatology, CoolSculpting showed up to a 25% reduction in subcutaneous fat in the treatment area. However, the same study found that 14% of patients did not see any improvement.

With SculpSure, a laser (heat) is used to disrupt fat cells in specific areas of the body, which your body then eliminates through its lymphatic system. It takes about 25 minutes to treat one area.

In a study published in Lasers in Surgery and Medicine, there was a 24% reduction in average fat volume in the abdomen three months after laser treatment.

CoolSculpting and SculpSure can be a bit uncomfortable but are not typically painful. Soreness, stiffness, swelling or bruising in the area are common afterward, but go away after a short time. To date, few serious side effects have been reported, but these procedures are relatively new.

These treatments don’t come cheap. For one area, such as the abdomen, it costs about $1,500 to $3,000, depending on where you live in the US.

Preliminary results can be seen after a few weeks, but it can take two to three months to see the final result. Since the fat cells are eliminated, the results should be permanent—provided the patient adheres to a healthy lifestyle. Caveat: Some people need two treatments (at double the cost) to achieve desired results.

CoolSculpting and SculpSure are FDA-approved for basically the same areas. In my practice, I usually prefer SculpSure over CoolSculpting because it can treat up to four small areas at the same time, and there tends to be less discomfort after the treatment.

It’s best to consult a board-certified plastic surgeon to see if you’re a good candidate for either of these procedures. People who are significantly overweight or who have a lot of loose skin are not good candidates, and women who are pregnant or nursing should not have these treatments done. There are also some other conditions for which the treatments are not recommended, so check with a doctor. Treatments should be performed by a trained technician who could be a doctor, nurse or aesthetician.

Note: Liposuction provides more dramatic results than CoolSculpting or SculpSure, but since it is surgery, it comes with the associated risks such as possible bleeding, infection and anesthesia complications.

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