CoolSculpting: Surgery or Not?

January 13th, 2020 / Back to Blog »

Athletic woman in black and white bathing suit leaning against a wall

The “Love Handle”. The “Pooch”. The “Jelly Roll”.

We all know what it is – a stubborn, unpleasing contour of the lower abdomen or side that makes bathing suits, tight pants, and form-fitting dresses seem like a bad idea. Whatever name we give it, it’s something that makes us want to run for the cover of our favorite baggy sweatshirt.

Unless you live under a rock, you know that as of this writing there are about 8,327 (give or take a few) different products or techniques you can try to get rid of this little area, all of them offering a quicker, better, and more affordable solution than the rest. In fact, there is so much “noise” that many people don’t know what to believe and simply quit listening. The assumption is that that nothing really works since there are so many things out there; if you can’t exercise it away, then it’s there for good. If you’re not one of those people and you are still reading – thanks!

 

The Solution to the “Pooch”

One of the common complaints I hear often from fit (even skinny) moms is that since children, they have a “pooch” under their belly button that they can’t get rid of. Most women first ask about non-invasive body contouring (CoolSculpting, SculptSure, etc). Some have even had those treatments performed, with the only reduction they see is one in their pocketbooks. In this subset of women, the problem isn’t fat. The problem is that the muscles of the abdomen have stretched with pregnancy and haven’t “rebounded” to what they once were – they usually do after baby #1, but after the second, the damage is oftentimes permanent. The solution to this is tightening the muscles, not trying to “freeze” or otherwise eliminate fat. This can often be done through an incision similar in size, shape, and location to a c-section scar (even using the old one, if it’s there) and repairing the muscles. The small amount of extra skin in that area is removed, as well. This is what people refer to when they talk about a “mini” tummy tuck. It’s a great option for women who need a little tightening of the muscles of the lower abdomen and have very little extra skin. And, just in case you are wondering – as a general rule, if you’re skinny and your skin doesn’t sag, then you don’t have much (or any) that needs to be removed.

 

What Are “Love Handles?”

That brings me to the second complaint I frequently get – how to get rid of “love handles”. The answer to this question really depends on what we’re talking about when we refer to “love handles”. For small, isolated, stubborn little areas around the hips, this is where the non-invasive body contouring devices fit in. These areas can be in the abdomen, waist, hips, or neck – the non-invasive devices are finding ways to be used all over the body. The way these devices work is by destroying fat cells underneath the skin – either with cold or with focused radiowaves or ultrasound. One of the problems with these technologies, though, is that they are not as predictable as a surgical result. You get treated and have to “wait and see” how things look in 3-6 months. They are designed – and work best – for small areas of isolated fat. These are also the same areas that do best with liposuction. Really, the choice between the two methods is one of predictability and downtime. If you are more concerned with downtime and can live with the uncertainty of the outcome for a few months, the non-invasive procedures win out. If you want a much more predictable result and are willing to put up with a week or so off of work, liposuction is the way to go.

While liposuction can – and is – used to rejuvenate entire areas of the body, it is a mistake to try and use the non-invasive methods that way. Non-invasive body contouring should be thought of as “spot treatments”, and not a way to totally change the shape of the abdomen. I see patients in my office who are dissatisfied with results from these non-invasive body contouring methods, and for two main reasons: they either have excess skin that the non-invasive devices can’t treat or made worse, or they were not good candidates for the procedure in the first place because they had “too much” fat that needed to be treated. Many times, it is a combination of both of those reasons that leave people dissatisfied with the non-invasive body contouring methods.

 

Look to Dr. Hall for Your Answers at His Practice

When it comes to body-contouring, I am reminded of a saying my grandmother used to use:

“When all you have is a hammer, the whole world looks like a nail.”

As a board certified plastic surgeon, I (along with the other board-certified plastic surgeons in the area) am trained to diagnose your specific problem and discuss possible solutions to fix it. Sometimes these are surgical. Sometimes, a non-surgical option might be best. Those are decisions you and I make together after talking about pros, cons, and expectations. However, if you go looking specifically for a certain procedure without understanding the indications and limitations, and you see someone who only has one way to fix the problem, you may end up paying for a procedure or service that is ineffective, or, worse, causes long-term problems.

The take home from this article is two-fold: first, healthy, active women should know that there is a fix for the post-baby “pooch” – the “mini” tummy tuck. If it’s not fat that is causing the “pooch”, then the muscles must be re-tightened surgically…it’s a simple, predictable, permanent solution to a problem faced by many youthful moms. Secondly, non-invasive body contouring definitely has a role in changing the contour of the abdomen. However, I’d encourage all women (and guys) who are interested in this to see a board-certified plastic surgeon first.

We can discuss both surgical and non-surgical options, and help steer you in the direction that will best benefit you in the long-term during your initial consultation. Contact us today to schedule yours at (865) 973-9500.