David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

CoolSculpting Confidential: The “Skinny” on Fat Freezing


Whenever I am considering something new, I like to look up reviews to see what other people are experiencing, and I’ll bet you do too. Natasha and I have been looking at online comments, and sometimes our good friend CoolSculpting is being treated unfairly.

Our office was an early adopter of this technology, and with eight years of experience, we can say that this is a superior technology — when used correctly.

[Scroll down to the bottom of the blog for pictures of what I mean.]

CoolSculpting Applicators

But here’s the catch: CoolSculpting is not the right procedure for everyone, and using it on the wrong patient will result in little to no improvement.

The problem that CoolSculpting has run into here in Knoxville is that machines have ended up in the hands of clinics where it is used as the only method of fat reduction or body contouring for that matter.

Since this is all these folks have to offer, they will often treat anyone whether or not they are the right candidate. As we say, “If all you have is a hammer, the whole world’s a nail.”

It does not matter how great a technology is, if you apply it in the wrong manner, or to a problem it can’t treat, it will not give a good result. If I see a negative review, my first thought is that it’s the provider and not the technology.

Before you spend any money, here’s what you should know.

CoolSculpting uses a process known as Cryolipolysis, which refers to the breakdown of fat cells by “freezing” the fat. It is intended to be used for localized areas of fat, which are out of proportion to the rest of your body and areas that are resistant to change by diet and exercise. The process works by drawing the fatty area into an applicator, which will then cool the fat to several degrees centigrade. After about 45 minutes, these fat cells will form fat crystals. These will injure the cell membrane and cause the fat cells to dissolve and their fat excreted. It may take 8 to 12 weeks to see the results of treatment, and in some areas, more than one treatment will be needed.


It is not a weight-loss procedure.

If you are overweight and hoping that this is a great way to get six-pack abs, you’ll be disappointed. However, there are some areas like the chin and the bra line where you may see improvement.


It matters where your fat is.

CoolSculpting can only reach and remove subcutaneous fat, which is the fat directly beneath the skin. Visceral fat (which is internal fat within the abdominal cavity) can not be treated with CoolSculpting (or liposuction for that matter). If you have an endomorphic pear-shape build with primarily visceral fat, CoolSculpting is not going to help you get a flat tummy.


It helps if you can pinch the area.

There are a few people whose fat is very dense. If it can not be pulled into the CoolSculpting adaptor, it can’t be effectively “frozen.” Usually, we can tell this during your consultation and will let you know.


Loose skin will not be tightened with this technology.

While CoolSculpting works well on fat, it has little or no effect on the skin. (Unfortunately, there is no truly effective means of non-surgically tightening skin.) Some people with extra skin may think that they can profit from CoolSculpting, thinking that their issue is excess fat. Unfortunately, this can only be appropriately addressed surgically by removing the loose skin along with the layer of fat underneath.

Natasha CoolSculpting

Natasha, Elite Master Coolsculpting Technician

As you read through these issues that CoolSculpting cannot address, you begin to see why we do not believe CoolSculpting is right for everyone.

As a plastic surgeon, I can recommend other body contouring operations for people who are not candidates for CoolSculpting, like liposuction or a tummy tuck. And we won’t recommend CoolSculpting to people who need something else. Further, if weight reduction is the primary concern, I may recommend no treatment of any type until an appropriate weight has been achieved.

CoolSculpting will always achieve its best results when applied correctly as a part of a more global approach to body contouring. I think this is why we have had such a good experience with it.

Natasha is Knoxville’s most experienced CoolSculpting provider and has treated thousands of patients in the eight years since we’ve had the machines. She is uniquely qualified to know who a candidate is and who’s not.


Here are some of her patients:


Coolsculpting to double chin

She is 5’7” and weighs 162 pounds. Here is a 50-year-old woman before and three months after one CoolSculpting treatment with the CoolMini applicator on her double chin.


CoolSculpting to hips and abdomen

Before and After CoolSculpting to Abdomen and Hip Rolls: She is 5’4” and weighs 129 pounds. Here is a 33-year-old woman before and after two treatments to her hip rolls.


CoolSculpting to Abdomen

Before and After CoolSculpting to Abdomen and Hip Rolls: He is 6’1” and weighs 240 pounds. Here is a 41-year-old man before and three months after two CoolSculpting treatments.


CoolSculpting to armpit puffs

She is 5’9” and weighs 132 pounds. Here is a patient before and six months after just one CoolMini treatment to her underarm puffs—the markings in the picture show exactly where the device was applied.


I hope that CoolSculpting will have a long future with my practice. It is the best non-invasive method of fat removal that has come to the market. If we ever get an effective non-invasive method of tightening skin, we will have it made.

All the non-invasive procedures should be used working together with you, the patient, as a part of an overall plan. Matching the right method with the right person is the only way to get the best results and to treat patients properly.

All the best,

Dr David B. Reath blog signature




David B. Reath, MD

PS: Here are many more of Natasha’s before and after CoolSculpting pictures.

The new 40-page eBook A Very Cool Guide To Coolsculpting is a must-read. It’s a free download.


Download CoolSculpting eBook

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