Q: Follow-up Question: 38-year-old woman with abdominal fat that won’t go away with diet or exercise. What are my options?
A: Liposuction vs CoolSculpting
Thanks for your question and the photos. You are a very good candidate for laser-assisted liposuction. CoolSculpting is also an option. Liposuction is always a more reliable choice because in this procedure fat is directly removed and is actually quantitated. In all patients, fat removal is successful. The quality of the results is determined by the experience and skill of the surgeon.
In contrast, results from CoolSculpting can vary from patient to patient. Fat cell death after CoolSculpting is a biological process that, probably because of genetic reasons, works better in some people than in others. In those who respond well, up to 20% of the fat tissue exposed to the “fat freezing” will disappear. Unfortunately, there is no way to predict whether CoolSculpting will work well in a given person.
For you, I would recommend liposuction of the upper and lower abdomen and of the flanks. Including the flanks will provide greater reduction of the waistline. There is more fat in the posterior (back side) of the flanks than is evident from the front view. With liposuction, up to 80% of the fat layer between the skin and the muscle fascia can be removed.
Because you have significant stretch marks in the lower abdominal area, you would do better with simultaneous laser treatment in this area (laser-assisted liposuction). Laser treatment enhances skin contraction, which is more needed if the skin tone is diminished by prior stretching. I most commonly use ProLipo or Smart Lipo lasers for this purpose.