At the same time, CoolSculpting is a strictly cosmetic procedure and isn’t effective as a means of weight loss, says Joshua Zeichner, MD, the director of cosmetic and clinical research in the dermatology department at Mount Sinai Hospital’s Department of Dermatology in New York City. Because the cold temperatures delivered by the device penetrate only the upper layers of fat below the skin, the procedure is best used to eliminate small areas of stubborn fat. CoolSculpting can’t change a person’s overall body composition. CoolSculpting may be a good option for people who want to reduce subcutaneous fat in a specific area, and for whom surgery might be too risky (for example, organ transplant recipients), says Dr. Matarasso. But it can’t remove as much fat as surgical options like liposuction, and it won’t remove excess skin that may develop after childbirth or significant weight loss. Excess skin requires surgical removal, Matarasso says.
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“This is terrible, because they had someone who wanted a minimally invasive procedure,” he says, “and then they end up with a big scar.”
Separate options for noninvasive fat removal, such as Trusculpt, involve radiofrequency devices that “melt” fat cells. For very small pockets of fat, injectable treatments like Kybella may be an option, says Zeichner. Matarasso recommends liposuction or common procedures such as the “tummy tuck” for more extensive fat removal. “[CoolSculpting] is never going to be as dramatic as liposuction,” Matarasso said. “I took more off one patient in an hour yesterday than you could ever do with CoolSculpting.” Another word of caution: Practitioners who aren’t trained in a variety of fat-loss techniques may oversell the abilities of the tools they have at their disposal, Matarasso says, and this may be particularly attractive to patients who are anxious about undergoing more invasive procedures. “If all you have is a hammer, the whole world is a nail,” he says. “You want to go somewhere where someone can offer you options.”
