Coolsculpting Can Smooth Out Bumps Without Surgery.
Melissa Haydt has a weighty tale that rings true for many American adults.
The Walnutport woman for some time has been fighting her own battle of the bulge. She’s tried diets and exercising over the years but could not lose those pounds that added a few extra numbers to her six pack. The 59-year-old mother of two also is fighting the hormonal weight-gain battle that many middle-aged women have to confront.
“When you hit menopause,” she said, “forget it.”
So Haydt found herself receptive to an advertising pitch she heard on the radio for Coolsculpting, the newest procedure in the Lehigh Valley to help reshape the body. Approved in 2010 by the U.S. Food And Drug Administration, Coolsculpting is the brand name for a device and procedure created by a California company that claims to reduce bulges in the abdomen and flanks — the “love handles” — by 20 to 25 percent.
For a culture that’s looking for a quick fix, Coolsculpting may be as close as it gets.
An ideal candidate for Coolsculpting is someone looking to firm up a bulging area, not someone looking to cut tens of pounds or more, said Dr. Samina Wahhab, whose Salisbury Township office is one of three in the Lehigh Valley to offer the service.
Each application of the device takes an hour, so a person wanting to slim love handles would require two hours.
However, there’s no anesthesia. No surgery. No recovery period.
There’s also essentially no weight loss.
That’s because Coolsculpting basically “tricks” fat cells in the treated area into naturally dying, and once an adult loses fat cells, they’re gone for good. The fat cells are not dense, so there’s not much weight change, if any, Wahhab said.
Researchers call it the “Popsicle” effect. They found that kids who kept a Popsicle in their cheek had fat cells die off from the cooling. Since fat cells generate in children, they were able to grow them back. That doesn’t happen with adults.
The Coolsculpting device, created and sold by Zeltiq Aesthetics Inc. of Pleasanton, Calif., sucks the flabby area to be treated in a vacuum process and cools it, numbing the site and producing a tingling feeling, said Haydt and Wahhab, who also had the procedure. Patients can read, relax or sleep during the treatment; Wahhab said she did office work during hers.
After an hour, the cooling panels are removed and patients go back to their daily routines.
Patients’ reactions often are along the lines of, “It’s too easy” said Leeann Burton, a lab technician at Young Medical Spa in Upper Saucon Township. She said more than 100 people have gotten Coolsculpting treatments there so far.
Results are not instantaneous. The treatment centers say Coolsculpting requires up to three months to see the fat cells die off in a natural process called apoptosis. The fat cells are carried away through the bloodstream and, according to studies, produce a negligible effect on a person’s cholesterol levels during that time.
The treatment centers also say the results are hard to quantify.
“We take before and after pictures and you can see the results through those,” Burton said.
None of the centers said they could promise a reduction of a fixed number of inches off the waist or hips.
The amount of change “depends on the individual’s specific body type and shape,” she said.
Burton also said Young’s spa will do Coolsculpting “off-label,” on sites not approved yet by the FDA, such as the thigh or the upper torso. The company is working with the FDA to get approval to treat the thigh in the near future.
It’s not for everybody, however. Wahhab said plastic surgery should not be a first consideration for obese people looking to lose weight. In addition, people with abdominal hernias or cold hypersensitivity should not try it.
Further, results won’t be that positive for people with loose skin, said Dr. Jaime Bastidas, an Easton area plastic surgeon who is operating a solo practice after recently leaving a practice with his brother, Alberto, and Dr. Atul Amin.
That still leaves plenty of potential customers inclined toward minimally invasive techniques, which include procedures such as Botox injections, laser hair removal and chemical peels. They made up the vast majority of the 15.1 million domestic cosmetic plastic surgeries in 2013, according to the American Society of Plastic Surgeons. The number of cosmetic procedures requiring invasive surgery, such as implants, liposuction or face-lifts, actually has declined from 1.9 million in 2000 to less than 1.7 million in 2013, it said.
Those customers today have a wider range of options to reshape their bodies. Traditional liposuction requires anesthesia and surgery, but now patients also may choose minimally invasive techniques including liposuction using lasers or ultrasound, or procedures using chemical injections.
Bastidas said he can “tweak” the body shape better with liposuction or laser-guided liposuction.
“There are certain things you can’t get out with Coolsculpting that you can with a procedure,” he said.
The limited studies of Coolsculpting so far have been positive, finding the procedure effective and without long-lasting discomfort. In some cases, patients have reported tingling and numbness on the treatment site, but the symptoms usually dissipated.
FDA reports indicate a trickle of complaints about Coolsculpting, with one customers complaining of lingering pain and another of only temporary results.
Kerrie Jiang, Zeltiq’s director of clinical development, tracks complaints as required by the FDA and said Coolsculpting has performed safely.
“Our company has a very rigorous post-market surveillance program,” she said.
According to the company’s 2013 annual report, Zeltiq received 1,392 clinical complaints about Coolsculpting out of 972,612 individual uses or “cycles.” The most common clinical complaints related to ongoing pain, redness and swelling, it said.
The jury is out on Coolsculpting in the long term, according to Dr. Robert Murphy of Bethlehem, who is president of the Society of Plastic Surgeons.
The procedure seems to be safe and effective, he said, but questions remain. Will multiple treatments be required? Are there late-developing consequences?
“What we don’t have,” he said, “are long-term studies of how effective it is.”
Jiang said it’s one thing to do studies, but it’s another to see how the device is functioning in real-world application, which she does through the surveillance program.
“That’s probably the best study that you will ever have,” she said.
There’s also the issue of lifestyle after the procedure. If patients do not watch what they eat and avoid exercise, their treatment will be for naught.
“Putting on any extra weight would decrease the results,” Burton said. “If you do gain weight, you’re going to gain in the remaining fat cells in that area or the other parts of the body.”
Cost is another issue. The procedure is cosmetic, so it’s not covered by health insurance. Patients pay $650-$750 per treatment site, with prices often discounted after more than two sites are treated.
Haydt found it worth the cost about a month after her treatments.
“I would recommend it to anybody who wants to see a difference in how they look,” said Haydt, who had four sites treated. “I would do it again.”
Doctors want to hear that because Coolsculpting doesn’t come cheaply to them either. The device costs around $120,000, said Wahhab, who has treated about 15 patients so far.
She has it to give people more options.
“I see it more as an adjunct or a choice than a direction,” she said. “It’s nice to give … people more control over what people want to do.”
(Source: The Morning Call)
