Whether it’s a stubborn bulge that just isn’t responding to diet and exercise, a part of your body that is simply a bit thicker than you’d like it to be, or a layer of padding hiding your six-pack from potential admirers, almost everyone has some extra fat that they would like to see disappear. As a plastic surgeon, these are all scenarios in which I’m happy to be able to help. The classic tool at our disposal in the fight against fatty bulges has been liposuction, a technique in which narrow cannulas are inserted through small incisions and the offending adipose tissue is sucked out of the body. Now, however, there is another choice: a choice that offers real results with no incisions and no downtime. I’m talking about CoolSculpting at Coolspa. CoolSculpting is an exciting, new, non-invasive body contouring technology that kills fat cells using very cold temperatures. An applicator cools the treatment area, and the cold temperatures achieved cause fat cells, and only fat cells, to die through a process called “cryolipolysis”. Over the course of several weeks to approximately three months, these injured fat cells are removed by the body resulting in a reduction of fat in the treatment area. Early results are visible after roughly one month, and final results are achieved at about three months. This timeline is determined by how long it takes your body eliminate the affected fat cells. What areas of the body can be treated with CoolSculpting? There is fat all over the body. It is hiding in places you’d never find it (even in your ears!), but, unfortunately, it has some less subtle hiding places as well (I don’t have to tell you where those are). The majority of patients come to us for help in reducing the amount of fat around their abdomen, waist, “love handles”, thighs, arms, neck, and back. Each of these areas is potentially a good site for CoolSculpting depending on the results of an in-person evaluation. Treatment Room CoolSculpting is designed to address superficial fat, the fat that is under your skin but over deeper body structures. It is especially important to keep this in mind when discussing the abdomen. The abdomen, like the rest of the body, has superficial fat under the skin that can be treated with CoolSculpting. We call this “pinchable fat” because it can be grasped between the fingers. There is also, however, deeper fat under the muscles of the abdomen called “visceral fat” that cannot be treated by CoolSculpting (or any other technology). This deep fat can only be addressed by diet and exercise. An important point to keep in mind about CoolSculpting, however, is that it is a machine; the results achieved are dependent on the way the machine is used. This is why it is critical to research your CoolSculpting provider. Plastic surgeons, given their extensive training in anatomy and aesthetics, are uniquely well suited to design CoolSculpting treatment plans that will provide the best possible results. This leads us to another reason why it is so important to have your CoolSculpting evaluation done by a plastic surgeon. While a great strength of CoolSculpting to me as a plastic surgeon is that it will let me help those who don’t want to have liposuction or other procedures achieve their desired appearance, CoolSculpting is not the right answer for every problem. Extra skin is the classic example: no amount of fat removal (whether by CoolSculpting or by liposuction) will improve the appearance of extra skin that might cause rippling or sagging. Extra skin can only be addressed by removing it, as in an abdominoplasty for the tummy or a brachioplasty for the arms. A plastic surgeon is trained to recognize these cases and perform the proper alternative procedure. Other CoolSculpting providers might be more inclined to proceed with CoolSculpting because it is the only technique at their disposal. In short, CoolSculpting is a very exciting technology because it offers a safe, effective and noninvasive way to get rid of fat without any downtime. As one of the largest CoolSculpting providers in one of the largest cities in the world (we’ve performed over 7000 treatments!), we are most impressed with CoolSculpting because we see how satisfied our patients are. We’d love to help you join them! Darren M. Smith, MD has a unique and highly sought-after skillset, having completed the unparalleled aesthetic surgery fellowship at the Manhattan Eye, Ear & Throat Hospital in New York City and a craniofacial surgery fellowship at the world-renowned Hospital for Sick Children in Toronto. Before embarking on fellowship training, Dr. Smith completed an integrated plastic surgery residency at the University of Pittsburgh Medical Center. He was ultimately selected to serve as Administrative Chief Resident in the Department of Plastic Surgery. He grew up here in New York City and graduated from Brown University at the undergraduate and medical school levels. Dr. Smith has also spent 3 years dedicated to basic science research in craniofacial biology, where his work focused on leveraging emerging protein therapy and bioprinting technologies to develop novel approaches to complex dilemmas in craniofacial biology. Additionally, Dr. Smith has an extensive background in applying 3D computer graphics techniques to procedural simulation and planning in craniofacial and aesthetic surgery, generating work that has resulted in the issuance of a US Patent and over 200 peer-reviewed publications, presentations and book chapters. He also served as Technical Copy Editor of the 6-volume Neligan Plastic Surgery text.” Imagery via CoolSpa and Shutterstock. 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