How Cool Is CoolSculpting?

Dr. Furnas (00:07):
This is Skintuition. And I'm Heather Furnas here with Josh Korman. Linda Evangelista just released photos to the public of herself with areas of fat that she doesn't like that she says came from CoolSculpting. What do you think, Josh?

Dr. Korman (00:26):
Well, it's kind of interesting cuz Linda Evangelista, first of all, it's not very often that a prominent figure will release these kind of pictures. Obviously it bothers her a lot. I think it's interesting because CoolSculpting is designed to freeze fat. That's the whole concept, that it freezes fat and then the fat gets absorbed by the body and clears out the system and you actually lose the fat cells and you get thinner. Sometimes you get this thing called paradoxical hyperplasia where that the fat comes back bigger. Now that doesn't happen very often, but what it does, it's a different kind of fat and it requires surgical intervention, meaning liposuction. But the bigger question is what does CoolSculpting do and what does it not do? I think we all want to have the least invasive, least expensive, longest lasting result for any of this stuff. But I think there's a lot more to CoolSculpting and fat than we think about. There's fat, there's skin, there's muscle. And I think we gotta know, and we have to be honest with ourselves about what we have going on because we have different kinds of quality of skin as we get older. And we just have to know what's what, what we have to work with, and then treat it accordingly.

Dr. Furnas (01:42):
So let's say I am 25 years old and I've put on some weight. I've been through college and graduate school, put on some weight and I can't seem to lose it. I haven't had kids. Would I be a good candidate for CoolSculpting?

Dr. Korman (02:01):
Well, you might be. I mean, I think the idea is it's, you know, Elizabeth Taylor used liposuction as a method of weight loss for 50 years. That's not really the concept when you're 25. You have youthful skin, that's good. And if there are pockets of fat that are a problem, yes, that could be something that you might be a good candidate for. Obviously, if you had put on a lot of weight and lost weight and put on a lot of weight and the, and there's a lot of stretch marks or you had kids, things like that, that might come into play. But at 25 I think it, you could be a really good candidate for CoolSculpting.

Dr. Furnas (02:34):
So say I'm 50 years old, I've had three kids and I don't like my muffin top. I don't like tucking my tummy into my pants. Am I a good candidate?

Dr. Korman (02:47):
So I think you still might be, depends where you want to do the CoolSculpting. And it depends whether you had a C-section with your kids, whether there's any scars on your tummy, how many stretch marks there are. Because stretch marks really a sign of injury to the skin and the skin doesn't bounce back so easily. But you still might be a good candidate. It depends on your overall body type. It's also where do you want the CoolSculpting. Men tend to collect fat in their flanks, meaning the love handles and the tummy. And women can collect it in their thighs and buttocks and tummy. So it really depends where you're thinking about it. And the other thing is that women really would like to have a flat tummy when they sit down, not just when they stand up, because that's how a lot of clothes are made. So it's important to understand what's the goal? Are you trying to look good at 50 in the nude? Are you trying to look good in clothes? And what kind of clothes and what position? So yeah, I would say you still could be a really good candidate for CoolSculpting. You just have to kind of take stock about where do you want it and what you think it'll do.

Dr. Furnas (03:54):
Now when I, I've had my three kids and when I do a sit up, I get a kind of a bulge in the middle, in the midline. Is CoolSculpting gonna take that away?

Dr. Korman (04:06):
So most people that have had kids get this separation of the muscle that is, I think what you're referring to, that bulge. And CoolSculpting really doesn't do that. CoolSculpting literally goes after the fat. I think sometimes we think we want CoolSculpting to go after everything that we, it should tighten skin and it should take away fat and should tighten muscle and we can't really expect it to do all those different things. So I would say probably not. That's if you have a bulge in your tummy when you sit up, that probably means you have a bulge in your tummy and that's maybe laxity in your abdominal wall. Could it be a hernia? It could be, but more likely something called diastasis recti, which is a medical term. But it basically means that your muscles are, your abdominal muscles are separated a little bit. So

Dr. Furnas (04:54):
So, like my, my six packs.

Dr. Korman (04:57):
Yeah, so you're right, that could be. Now there are some noninvasive technologies like Emsculpt, which goes after the muscle to tighten the muscle and that potentially can tighten up the muscle some. But if we're talking just CoolSculpting, CoolSculpting alone might not do it. But it's important to think about all the technologies that are around and see what works in combination.

Dr. Furnas (05:19):
So if I'm a patient, I'm a good candidate, am I gonna get what I expect to get? I want a flat tummy, I wanna be thin, I wanna look as good as I can.

Dr. Korman (05:33):
Yeah, so that's the thing. We all wanna look as good as we can and we all have this idea, you know, can we, we all want this thing that's we want the best and we are hopeful, but at the same time we need to be at the risk of sounding like a medical person, realistic expectations. I think that's true for a lot of things in life that people say or we all say I have expectations, but we secretly hope that it's gonna do everything we want it to do. And I think that's important. Why it's good to um, you know, Google University, internet University may not always be the only source of getting good information. That's why it probably is worth asking somebody who works with this technology to give you an an idea of how it would affect you and what you could expect. Cuz I don't think that we can all just decide, oh I'm a really good candidate for it, because that may not be the case.

Dr. Furnas (06:29):
Now you said don't go to Google University. So how would I find a good place to go to?

Dr. Korman (06:37):
Well it depends what you're looking for. If you're looking for like say CoolSculpting, I think sometimes we get focused on, oh this technology and I want this technology. So then we go looking for that technology and there's plenty of AdWords and plenty of things online trying to pull us into to go to these places that have these, this particular technology. And that's certainly an option. And that's fine. I think that's one way to look at it. I think the other thing is to think about, well what bothers you? Your tummy bothers you. So maybe you should go find somebody who actually treats tummies in a variety of ways like that can look at your tummy and say, yeah, you'd be good for CoolSculpting or maybe not CoolSculpting, maybe you need liposuction, or really maybe you need a tummy tuck. And it's good to, obviously I'm biased because I'm a plastic surgeon, but I think it is a good idea to go to a board certified plastic surgeon who can tell you. And now a lot of people do virtual consults. You can have a consult from the, uh, privacy of your and convenience of your own home, or your car, or your house, or wherever you are. But I think that you want to get a professional's opinion over what would work the best for you.

Dr. Furnas (07:53):
So you said CoolSculpting or liposuction or tummy tuck. Why would you do one versus the other?

Dr. Korman (08:03):
So, like I said before, that you certainly want, we all want what we can do that's least invasive, longest lasting, least expensive, quickest downtime. Obviously we want that and, and CoolSculpting might, would be that. So we would want CoolSculpting for all those reasons. Why would we want liposuction? Well, in reality, CoolSculpting often is multiple sessions and multiple treatments and you get about 20% reduction in the fat. And if you do two sessions, that means you get about 36% reduction in the fat total because 20% comes now brings down to 80% and then you do 20% of the 80% and that's 16%. So for all your math whizzes that's 20 and 16 and that's why you get 36%. So you get 36% liposuction probably would take away 80%. So it all depends on what you're trying to achieve. And why a tummy tuck? If you have too much loose skin, if you have, uh, separation of your muscle, if you really wanna super flat tummy and you're okay with an incision, uh, with a scar that's gonna be low, but pretty long along your midline in a horizontal setup, those would be some of the reasons to choose one versus another.

Dr. Furnas (09:27):
Great. Well, thank you very much Josh. That really helps us understand the difference between CoolSculpting and liposuction and abdominoplasty. And next week we will bring you some more.

Dr. Korman (09:41):
Skintuition. Here we go.