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Fat Removal Without Liposuction?

By Robert Kotler, MD, FACSSeptember 17, 2010
From the WebMD Archives

Several days ago, the FDA approved a new technology designed to accomplish what liposuction accomplishes — but without surgery; without piercing the skin. Sound too good to be true?

The high-tech device by Zeltiq accomplishes this goal by freezing the fat cells underneath the skin. When the fat cells become frozen, they die. These fat cells dissolve and then release their contents. When people have an abnormal accumulation of “fat,” that means their fixed number of fat cells is bulging with liquid fat content.

With CoolSculpting by Zeltiq, the patient sits in a chair and the technician attaches multiple suction cups which, “grabbing” a fold of skin with fat beneath, begin to freeze the fatty tissue. The surface skin, itself, is not frozen. Apparently, you take a snooze or read or whatever. It is described as “just slightly uncomfortable” and that there may be a little bruising or redness for several days.

Because there is a timeline for how long it takes the destroyed fat cells to release their contents to be digested internally by the body’s normal scavenging mechanisms, it may take several months for the results to show. Also, to achieve a desired outcome, several sessions may be required. The areas that typically do the best are those that also do best with liposuction: the muffin top, front abdomen and flank love handle areas for both men and women.

It is going to be interesting to see how well this works now that it is available for body cosmetic plastic surgeons and dermatologists. The company reported 7,000 patients having had the procedure worldwide; I don’t know how many procedures were done in the U.S.

What I have learned about the procedure is what I have read in authoritative articles in the press, particularly The Wall Street Journal and also in the company’s press release. I would have liked to have seen a large variety of before and after photos. Hopefully, we will have access to that shortly.

In the meantime, stay tuned. I want to learn as much as I can about this procedure because if it is successful — and time will tell us that — this is a big achievement.

You’ve heard that one my favorite sayings is “science never sleeps.” Zeltiq is another example. Who would have imagined that one could loose fat by freezing the fat layer of the skin? You know, this could reverse the mass migration to the sunbelt. Suddenly, Wisconsin looks good in the winter!

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