Arlington Plastic Surgery, Anthony Tran, Arlington, Texas

Board Certified by the American Board of Plastic Surgery,
Cosmetic & Reconstructive Plastic Surgery

3300 Matlock Rd.

Arlington, TX 76015

(817) 467-5081

Fax - (817) 557-4646

FAQs

Dr. Anthony Tran, Frequently Asked Questions, Arlington Plastic Surgery

FAQ

Does Zeltiq (CoolSculpting) Really Work for Fat Reduction?

The short answer is that is very consistantly works for a 20-25% fat reduction in the treated areas. It can treats the whole abdomen, love handles, belly, and back fat, inner thighs, outter thighs, under arms, chest fat and under buttock reduction. This is a NO DOWNTIME procedure and almost everyone considers it painless. For no downtime, no pain, no incisions, and no anesthesia, it will be a very popular procedure in the near future.

CoolSculpting absolutely works. But patient selection and appropriate expectations are essential in receiving the best results. Our office is one of the top provider of CoolSculpting in our region. With two CoolSculpting sessions, our treatments are performed at the same time. CoolSculpting is wonderful for removing stubborn areas of fat for people at or near a healthy weight. For people interest in losing a significant amount of weight, CoolSculpting is not the ideal procedure. Results can be seen after a single session, but some patients see an improvement but might desire an additional treatment for optimal results. CoolSculpting takes approximately 1 hour. In order to provide elimination of fat as quickly as possible we do offer CoolSculpting Complete. This includes two systems, for twice the fat elimination in a one hour period. Vibrational therapy increases circulation and lymphatic drainage which my help waste, including damaged fat cells be eliminated with the body more efficiently. Finally, al of our patients receive a compression garment to help with skin quality and comfort.

How Long Does the Coolsculpting Procedure Last and How Many Treatments Are Needed?

The fat cells that are killed during the CoolSculpting freezing do not grow back. But not all fat cells die and if you gain weight then the fat will have some place to go, both in the area treated and non-treated areas. But if you maintain a good exercise regimen and diet then the results should be long term. Some people need only one treatment as they’re happy with 30% fat reduction while others do three or more treatments that can be repeated every two months or less frequently.

What happens during the treatment?

To initiate the treatment we will position the device on your body. The device will then draw the bulge up between two cooling panels. The sensation is a firm pull and pressure – enough of a pull to ensure the selected tissue will be cooled most efficiently. An hour or so later, depending on your needs, you’re done.

Can I return to normal activities after the procedure?

CoolSculpting is completely non-surgical, so typically you can return to normal activities immediately. Some patients experience redness, minor bruising, tingling, numbness or discomfort in the treated area, but this is temporary and will resolve completely. Often times, patients return to work after the session is over.

How Long Until the Average Zeltiq Patient Starts to Notice Results?

“I got Coolsclupting done on 3/29/13. It’s been one month and one week and I really haven’t noticed a difference. I’m 5’2″ and 117 lbs, so I’m thin, but I’ve always had larger than expected love handles / lower stomach. I’m starting to get worried that I’m not seeing results, as many patients report that they saw a difference after one month. Is it normal that I’m not seeing anything yet? I know that they say the full result isn’t until 4 months after, but when should I first start to see it working?”

After using CoolSculpting for over 1 year, we have found that only a few patients will show results in as soon as 1 month, but a more consistent finding is that it takes 2-3 months to see the final result. There are some patients who can begin to see changes even earlier and this is more frequent with the large applicator.Clinical trial data has shown for most people, a 2nd treatment within about 2 months of the first does lead to greater reduction. So we typically see patients for follow up between 8 – 10 weeks. At that point, we can make an assessment if the treatment worked well for them, if they need another treatment in the same area or if they would like to treat a different area.

Are the results permanent?

During CoolSculpting, the treated fat cells are eliminated. As long as you maintain a healthy lifestyle, long-term results should remain stable.

How does CoolSculpting compare to other similar devices?

CoolSculpting is the only non-invasive fat-reduction technology that targets, cools, and eliminates fat cells through controlled cooling. Other treatment modalities such as lasers, radiofrequency, and focused ultrasound may affect other adjacent tissue, muscle, and nerves. Delivering heat through the skin can result in traumatic cell death (necrosis). These methods are not comparable to CoolSculpting’s safe, effective, and painless process to reduce stubborn fat.

Slim Lipo vs. Cool Sculpting for Belly Fat and Love Handles?

“What is the best treatment to remove belly fat and love handles? Both treatments get about 80% of thumbs up on this website. The photos of smart lipo show better results, ie. more fat removed. It also seems to me that the coolsculpting in the end will be very expensive because you need 3-4 treatments while from the slim lipo only one. What do doctors that offer both treatments recommend? Thank you!”

For patients who are truly looking to just fine tune and sculpt stubborn areas either treatment is a good option. Which one is best truly depends on the patient and what they want. For some, the idea of any surgery is out of the question and prefer non-surgical, non-invasive procedures and don’t mind waiting to see results. For others, they want the more immediate gratification and prefer lipo. It’s great to be able to offer both to patients especially since we aren’t sacrificing efficacy by recommending one over the other.

How much does CoolSculpting cost?

As far as the price it will depend on the size of the applicator. The larger applicator which is commonly used for the abdominal area is $1,250 and the small and medium applicators which are commonly used for the love handles, back and bra fat is $650 per side. We offer free consultations and seasonal package sale price at our Arlington Plastic Surgery office., who has extensive experience with Coolsculpting and has treated over 400 treatments in the metroplex area and even out of state regarding Coolsculpting. During your free consultation you will receive a full treatment plan, which will include affordable price.

Call our office for Free consultation appointment: 682-217-1080

CoolSculpting Vs Laser Lipolysis

“I have heard about zeltiq (CoolSculpting) alot but i wonder how is the end result compare to any laser lipolysis? dont tell me one is invasive n noninvasive, someone told me cryolipolysis result is almost same with laser lipolysis, is it true?”

Both treatments are noninvasive, although Lipolysis is reportedly much ore painful. I think the mistake a lot of patients are making is assuming that both of these treatments have the same benefits regardless of the area being treated and the amount of fat in that area. It is important to recognize that Coolsculpting is great for treating larger fat deposits. If you can grab a handful of fat, you generally will benefit much more from Coolsculpting. If you can only pinch an inch, and the skin is tight and can’t be sucked into the Coolsculpting applicator, you might be better off doing Lipolysis. Coolsculpting can be done on the abdomen, love handles, and back. Lipolysis is normally done on the abdomen and love handles. Price point is comparable. Results may be seen sooner in Coolsculpting, in 4-6 weeks where as Lipolysis takes 3-6 months.

Coolsculpting is much different from Laser Lipolysis

Think of laser lipolysis (which is rarely done as a stand alone procedure, it is almost always a combination of regular liposuction plus laser lipolysis) as a way of popping fat cells with a tiny hot poker (!). The fat cells release an oily substance that is sucked out with standard liposuction instruments. There are definitely incisions and not uncommonly there is pain and bruising. Numbing injections are used during the procedure to dull the pain. The results are good.

Now think of Coolsculpting as freezing the fat cells, literally a giant suction cup sucks the skin along with the underlying fat. The “sucked in” area is then chilled for an hour. The fat cells don’t pop, they undergo a slow death and are processed like any cell that dies in the body. The elimination of the damaged cells takes a few months. There is no pain or anesthesia, no incision and usually no bruising. The recovery is a bit of soreness, possibly some short term numbness.

Cost wise the Coolsculpting is less expense and the downtime is zero. The results are moderate. If you want a dramatic result go with the old fashioned liposuction (with or without laser lipolysis). If you want easy, less expensive and more moderate results Coolsculpting is indeed a good choice.

Zeltiq CoolSculpting – Pain, Bruising, Risks?

“Does Zeltiq hurt? What are the risks? Does it depend on how much suction/temperature doctor uses as to if there is bruising/pain afterwards? Can Zeltiq cause nerve damage? Cause Other problems? Can the suction pressure be controlled by the dr? Is the Bigger suction more painful than using 2 smaller suctions for the stomach? Pre/post treatment care? How long has it been being used in the states? in Europe? What are the complications?”

Coolsculpting is very well tolerated during and after the procedure. The first 10 minutes of the treatment is definitely uncomfortable and bordering unbearable for some. This sensation goes down quickly. I have found that the abdomen tends to be the the most uncomfortable both during the procedure and afterwards. The overall discomfort does depend on the amount of tissue stretch that accompanies the suction of your tissue into the Coolsculpting probe. The more tissue is pulled into the probe, the greater the overall initial discomfort and chance for post-procedural discomfort. This is one of the reasons the abdomen may be more sensitive. I have also prescribed Neurontin at times for people who have high degree of discomfort due to hypersensitivity as the nerves recover from their stretched state. This may last ~10 days give or take a few days. The other perspective that I share with patients is that the overall level of discomfort is still much less than a surgical procedure such a liposuction or a tummy tuck. Almost everyone returns to work immediately. Liposuction requires at least a few days off, and a tummy tuck can require a good week or two off of work.

Bruising is patient specific and normal. It is a consequence of patient selection and is also location specific. We find that some patients bruise more than others and to a varying degree in different locations.

Skin Changes— Most patients experience transient skin changes at the treatment site after the procedure. When the applicator is removed, the tissue appears red and raised, and feels cold and firm. Transient mild bruising may occur around the edges of the site. These changes begin to resolve within a few minutes of the procedure. Mild bruising, and/or minor swelling may arise in the days following the procedure but typically resolve within a week. Occasionally, a patient may have an atypical skin reaction. For example, bruising or swelling may take longer to resolve or the site may become red, warm and tender. These atypical reactions may be due to individual characteristics that make the patient more sensitive to the procedure.

Can Zeltiq Cool Sculpting Be Used for Upper Arm Fat?

You can treat arm fat with Zeltiq – however, you have to be wise with patient selection. The handpieces do not easily attach to most people’s arms. With the smallest handpiece, you can treat some patients arms. You also don’t want to get rid of the fat in the arms if there will be too much laxity in the skin once some of the fat is gone.

Zeltiq (CoolSculpting) to Treat Fat On Upper Outer Thighs?

Whether coolsculpting will work on the outer thighs depends on the physical exam. Coolsmooth is the new applicator just came out last July 2014. Yes, the result showed that your fat on outter thighs can be treated.

Long-term Effects of Coolsculpting?

“I’m seriously considering getting Coolsculpting done on my love handles and stomach. I’ve read up on it, but can someone explain to me why it only damages the fat cells and nothing else? And also, does it ever come out “lumpy?” I’m worried about long-term side effects. Also, are the results more dramatic or thinner people or those with more weight to remove? Thanks :)”

To date there are no long term negative effects of CoolSculpting.The reason it only damages fat cells is that fat cells will freeze at higher temperature than other tissues. The reason the other tissues such as skin, nerves and blood vessels are not frozen at these same temperatures are that they are water based. The device carefully controls the cooling process so that the temperatures achieved are such that the only the fat will freeze but are above the freezing point of other tissues inside the applicator. Regarding your second question, CoolSculpting gives a very NATURAL looking reduction without issues of lumpiness nor hanging excess skin. Finally, the ideal patient is the one who is close to their ideal weight with moderate to small bulges. However, that is not to say that the procedure does not work in larger individuals. As with all procedures proper expectations are critical. I have treated individuals who are less than ideal and they have been extemely gratified by their results. One does have to ensure that they understand that complete elimination of their bulge will not happen and if desired multiple procedures can be performed for additional fat reduction. Having accepted this, they are more than thrilled to produce undeniable results with one treatment that does not require any surgery, needles, anesthesia nor downtime!

Zeltiq CoolSculpting – Are There Any Side Effects?

The Zeltiq Procedure is completely non-invasive, which allows immediate return to normal activities such as work or exercise. Redness may appear in the treated area, and may last from a few minutes to a few hours. Some localized bruising may occur, which clears within a few weeks. Many patients experience a temporary dulling of sensation in the treated area lasting one to eight weeks. Vasovagal Symptoms —- A few patients have experienced vasovagal symptoms during treatment. These symptoms, associated with activation of the autonomic nervous system include: lightheadedness, dizziness, flushing, sweating (diaphoresis), nausea, near syncope, or syncope (fainting). The patient may appear pale, cool and clammy. This type of reaction may be triggered by a variety of factors such as the patient’s anticipation of the procedure, dietary habits prior to the procedure, conditions of the treatment room or a response to the procedure itself.

To prevent vasovagal symptoms, the operator should ensure that the patient has been properly prepared for what to expect during the procedure and that he/she has had adequate food and fluids. The operator should also ensure that the patient is feeling well prior to leaving the room after the start of the procedure and instruct the patient to call for assistance if symptoms develop.

If the patient experiences a vasovagal episode during the procedure, assist the patient to a supine (lying) position with their legs elevated. Offer reassurance, a cool towel to the forehead and sips of fluids. The procedure may be interrupted at the discretion of the operator or if symptoms do not resolve within a few minutes.

CoolSculpting is an FDA approved class II medical device. It is safe for most healthy people. There certainly are some exceptions. CoolSculpting (like most aesthetic devices) has not been tested on women who are pregnant or breast feeding. Therefore, women who are pregnant, breast feeding, or trying to become pregnant are not ideal candidates. There are several other contraindications that your doctors office can discuss with you.

In the office of Anthony Tran MD, we do will not perform CoolSculpting on people with the following conditions:

  1. Pregnant, breast feeding or trying to become pregnant
  2. Fibromyalgia, chronic fatigue syndrome, or currently suffering from any other auto-immune disorder that causes excessive pain, weakness or discomfort
  3. Hernia or history of hernia in the area to be treated
  4. A BMI of 34 or more (Bodybuilders or individuals with extremely muscular physiques could possibly be an exception
  5. Any person currently suffering from chronic pain
  6. Any person who has had body contouring surgery within the last 6 months without written consent from your physician
  7. Any person who has a health condition or injury that prevents them from walking 1 mile each day
  8. Individuals with a history of anorexia or bulimia in the last twelve months
  9. Any person under the age of 19
  10. Individuals with lymphedema or other conditions effecting the lymphatic system

CoolSculpting (Zeltiq) for Cellulite Reduction

“Does Zeltique work for mild cellulite reduction? I work out daily, am 5’4″ and 110 lbs but still have somecellulite on back of thighs.”

Zeltiq is designed for discrete areas of fat. It works very well for the areas that it was intended, primarily the abdomen and flanks. There is no reliable treatment yet for cellulite reduction. Coolsculpting was designed for “problem areas” in patients who diet and exercise and are at a good personal weight. But we have Juvashape machine which works target the cellulite areas on body such as buttock, thighs. Contact us for information: 682-217-1080

Will Cool Sculpting (Zeltiq) Address Skin Laxity?

Skin with good elasticity will tighten after Coolsculpting

Coolsculpting is targeted to reduce fat not affect the top layer of skin which is where much of the natural elasticity of the skin resides. Because the results are seen over a 4 month period, patients with good skin elasticity will often see the skin contract as the fat is slowly lost. Patients who have pre-existing skin looseness (laxity) usually will not see the skin tighten as the fat is lost, because the elasticity is already lost.

Just like when you take off a bra, the elastic band will shrink down as the stretch from the body is removed, if you have good elasticity the skin will shrink down as the fat is removed. If the elasticity in your bra is shot, it won’t contract, and if the elasticity in your skin is not good, it won’t shrink either.

Your doctor will be able to tell you before treatment whether your natural skin elasticity is good enough to contract as the fat is lost. If it is not, you may need additional treatment that targets the elastic layer, like Juvashape treatments offering in our office. But I have not seen Coolsculpting make the laxity (looseness) of the skin get worse.

What is the Difference Between TruSculpt, Liposonix, and CoolSculpting?

“I got different recommendations at different consultations. For fat reduction of the same area, some told me to do Liposonix, and some told me to do CoolSculpting. Also, when I was doing some research on the internet I read about truSculpting, which seems to be something quite similar. So I’m just confused. What is the difference between truSculpt, Liposonix, and CoolSculpting? Which one is more cost effective, and which one gives results more quickly?”

They all reduce fat – just with different methods.

Liposonix is a high frequency ultrasonic energy and Coolsculpting is a targeted cooling process to eradicate fat cells. TruSculpt is a technology that uses a comfortable heat and can treat anywhere from the shoulders down. Trusculpt causes a “natural” cell death and results are seen in 4-6 weeks. Everyone is a candidate for TruSculpt as there is no “pinch rule” or need to have enough skin/fat to suck up into a handpiece. In 30 minutes your treatment can be performed with zero pain, discomfort or downtime. Patients may resume their daily activities right away. I have seen 20-30% reduction from each treatment session and it is wonderful to have a painless, fast technology that has the patient back their daily routine without any disruption or side effects.

Stomach Pain After Zeltiq (CoolSculpting)

“I Have Tenderness After Coolsculpting on my Stomach It has been 4 days since and It feels like I have been doing a million sit ups? is this common? It actually really hurts i am quite worried i had it done on my lower stomach,i only have a small amount of fat there im not a big person its just a pot belly, i also wanted to know if i have to go on a strict diet or the fat should go away by itself not worring about what i eat? I know i have to wait 4-8 weeks though just curious? :)”

During the CoolSculpting procedure, there will be intense cooling for a few minutes. Some people find this uncomfortable, but the area soon becomes numb and people can relax and feel quite comfortable during a treatment. Following the treatment most people continue with their day normally with little to no discomfort. Over the course of a few days, some people feel mild discomfort similar to the feeling one might have after a workout. On occasion, significant discomfort has been reported. The patients who experience significant discomfort are almost always patients who have had treatment with a single large applicator administered to the lower abdomen area. In my practice, we offer compression garments like the ones we use for patients following tummy tucks or liposuction. This has seemed to provide additional comfort and support to patients. On occasion, a patient might find relief with a non-narcotic pain medication called Neurontin. This can be prescribed by the doctor or the physician assistants and nurse practitioners in the practice. However, most patients do not require medication following a CoolSculpting procedure.

Is Abdominal Swelling Normal After CoolSculpting?

“I had Cool Sculpting done three days ago…the large device on my lower abdomen and small one on upper abdomen. My abdomen is noticibly swollen. I have actually gained about 1.5 lbs even tho I am eating less and healthier. Is this temporary water gain from swelling normal?”

Most patients experience transient skin changes at the treatment site after the procedure. When the applicator is removed, the tissue appears red and raised, and feels cold and firm. Transient mild bruising may occur around the edges of the site. These changes begin to resolve within a few minutes of the procedure. Mild bruising, and/or minor swelling may arise in the days following the procedure but typically resolve within a week. Occasionally, a patient may have an atypical skin reaction. For example, bruising or swelling may take longer to resolve or the site may become red, warm and tender. These atypical reactions may be due to individual characteristics that make the patient more sensitive to the procedure.

Zeltiq CoolSculpting – Extreme Side Effects

“8 days post Zeltiq for my abs (lrg device). Immediately I had EXTREME swelling. Day 8 & I’m still VERY swollen (hot to the touch). 4 days ago this 24/7 SHARP bee sting-like pain started. Not all over, random ‘spots’. Nothing helps (creams, pain relievers, ice). I haven’t slept in 3 nights. Went back to the doc today. She said inflammation is the body’s natural response & this may indicate a better result. Does this make sense? Stinging pain is from inflammation pinching nerves? RX’d steroids?”

For whatever the reason, the prolonged suction during the treatment or the exposure of the skin and it’s nerves to the cold treatment, a small percentage of patients will have pain as you describe. Typically, a few days and topical analgesics work well to resolve the discomfort.