The Skinny on Fat Removal

January 12, 2023 | Plastic & Reconstructive Surgery


Wouldn’t it be great if we could just freeze away unwanted fat while lying on a spa table?! Or how about injecting something under our chins to get rid of a turkey neck?! Cool Sculpting and Kybella may sound like a perfect solution to stubborn fat, but buyers beware!

At best, these non-operative procedures will be a waste of your time and money. At worst, they will leave you with scarred and damaged tissue that can cause lumpiness, pain, and in some cases open wounds and severe deformities.

Cool Sculpt is being promoted by non-surgeons who are unable to offer the safe surgical procedure for fat removal. The machine freezes the body tissue and essentially causes death and destruction of fat cells (and other cells!) within the body. This tissue destruction then triggers an inflammatory response by the body which can cause scarring in the target areas. While for some people this may give the appearance of shrinking tissue temporarily, Cool Sculpt is actually creating scar tissue that over time can increase in size and can make it unsafe to surgically remove the fat cells from that area down the road.

Kybella is even worse! Kybella is a toxin that is injected into fat cells to destroy them. (If you read the packaging from Kybella there is warning against injecting this toxin within 2cm of any important structures such as blood vessels and nerves because of the damage it can cause. In your neck, there are many important structures in a very small area.) Similar to Cool Sculpting, after a Kybella injection, the destroyed cells are not removed from the body but are left there for the body to try to get rid of them. This essentially means the body’s immune system is again triggered to attack these damaged cells, and once again scar tissue is formed. Scar tissue is not healthy and can create hard, painful areas where you really don’t want them.

If you really take the time to think about this, the only way to minimize fat is to lose weight or surgically remove the fat cells. While weight loss is a great way to slim down, sometimes fat remains in problem areas even when you are a healthy weight. For these areas, surgical removal of the fat cells through liposuction is the only definitive way to treat the problem. While surgery sounds scary, new techniques in liposuction can make the procedure quick, safe, and with minimal down time. Power assisted liposuction can be done through small, 2-4mm scars, with 1-4 days of at home recovery depending on the volume of fat removed. Sometimes, like for under the chin, the procedure can be done under local anesthesia.

So, before you decide to drop thousands of dollars on a procedure that will cause formation of scar tissue, do some research and consult with a surgeon who is certified (or eligible to be certified) by the American Board of Plastic Surgery. This is the only board that certifies surgeons who have been fully trained in the surgical technique that can safely and effectively remove unwanted fat cells.

In fact, ask your care provider who is offering you Kybella and Cool Sculpting if they have completed an accredited Plastic Surgery training program. And if they have, ask them why they would use gimmicky products that create scar tissue when they could actually remove the fat cells.

And one final thought, when you get on an airplane, I am sure you trust that the pilot is fully trained and licensed and able to handle any emergencies that might occur while you are 50,000 feet above ground. Wouldn’t it be terrifying to find out that your “pilot” is actually the air traffic control manager who learned to fly on video games and flight simulators but feels comfortable flying your airplane…

– Dr. Kelly Sullivan & Dr. Emily Clarke-Pearson