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The Skinny On Fat Freezing

By New You Editorial
Posted On Mar 23, 2012

By: Jag Carrao
Test-Driving the Zeltiq at the Bella Skin Institute

Fat burning is so 2011. The wave of the future? Fat freezing. It’s a non-invasive new technique employing the recently FDA-approved Zeltiq machine, which operates on a similar principle as frostbite, targeting stubborn pockets of body fat with precisely controlled cooling—but without damage to surrounding tissue.

The Zeltiq procedure, also known as CoolSculpting, is still too new to have gained deep market penetration beyond Hollywood celebrities. I’d learned about it while researching innovations in liposuction, and thought, “This sounds interesting.” In contrast to the surgical removal of fat via liposuction, Zeltiq employs cryolipolysis—literally, the freezing and flushing of fat cells.

I was surprised to find that only a handful of Beverly Hills plastic surgeons were offering Zeltiq. But after a bit of asking around, I set up an appointment with Dr. Anna Guanche—affectionately nicknamed “Gadget Girl”—who prides herself in having the latest technological gear for cosmetic and anti-aging procedures in her Calabasas-based Bella Skin Institute just north of Los Angeles. Guanche is a beauty whose youthful appearance belies her long experience in the field of cosmetic dermatology.

“By being able to call on the entire gamut of dermatological procedures, including injectables, lasers and surgery, I’m able to take advantage of the broadest possible range of options, often combining treatments to deliver results ranging from the subtle to the dramatic,” she says.

The Zeltiq originally intrigued Dr. Guanche because of the time spent completing her medical residency in chilly Minnesota, where she witnessed instances of fat injury in people exposed to extreme cold temperatures. By tightly controlling and isolating the area of freezing, Zeltiq turns that injury into an advantage, allowing patients to achieve a more sculpted appearance. This appealed to me. Though I had liposuction 11 years ago, and was thrilled with the results, I noticed more recently that no amount of diet or exercise could rid me of the layer of stubborn fat that had settled along my lower back.

According to Dr. Guanche, this made me the ideal candidate: “Zeltiq is best for those who are already in relatively good shape, but have some areas that might benefit from spot reducing.” She helped set expectations in advance: On average, each Zeltiq procedure results in a 20% reduction of fat in the treated area. It’s certainly not as dramatic as liposuction, but there’s no downtime, no scarring, no need to limit activity or wear support garments. Also, at roughly $1,000 per treatment area, it’s also a lot more affordable.

She also walked me through the science of how Zeltiq works: The machine cools fat cells so that some actually crystallize and self-destruct (apoptosis). The body’s natural inflammatory response eliminates these dead cells through the liver. Remaining fat cells condense, reducing the visible fat layer.

Dr. Guanche first covered the area to be treated with a cool gel patch. Then came the suction cup, of which there are three different sizes: small, medium and large. She selected the medium size, then positioned me on my side so my “flank” (the lower back area) would be accessible. Not having oodles of excess body fat to begin with, we had a bit of a challenge getting the medium size cup to maintain its seal. Fortunately, I prevailed over her suggestions that we switch to the small cup, as I wanted to freeze as many of those fat cells as possible!

The cup uses strong air suction to draw the fatty tissue into the cup. This is not painful at all, but as the freezing sets in, the sensation is a little odd. Once I calmed down and was assured I wasn’t going to freeze my kidneys, I settled in for the hour-long process, trying my best to relax, play with my iPad, etc. The weirdest part of the treatment was the end when the cup was removed, leaving a reddened, congealed, utterly frozen-to-the-touch and completely numb lump of fat. Still, even after doing both back flanks, I was able to return to the office and take an exercise class that evening. The redness soon disappeared, though the area remained numb for several days.

While some patients experience dramatic results after just one session—a receptionist in Dr. Guanche’s office dropped two pant sizes in the three weeks following her procedure—others opt for additional sessions to optimize the reduction they seek. I fell into this latter group, and went on to treat the same areas again three months later. There was no disputing the fact that my fat mass was smaller; I’d gone down a suction cup size, and had to use the smaller attachment (even I recognized this!).

Weeks after the second procedure, I could tell that the waist closures of my pants and skirts felt noticeably looser. The fat that remained felt firmer, more compact.

Other areas that Zeltiq is used to treat include the arms, abdomen, thighs, buttocks and even neck. With proper diet and exercise, results are simple to maintain. Zeltiq may never replace liposuction entirely, but given the ease, efficacy and relative affordability of this incision-free procedure, its popularity is sure to expand, as fat cells across the nation shrink away.

In terms of my experience with Dr. Guanche, I was impressed not only with the depth of her technical knowledge about the Zeltiq and other devices in her vast anti-aging arsenal, but also with her ability to visualize a better, younger-looking you and to bring that out. “If I hadn’t become a doctor, I would have liked to have been an artist,” Dr. Guanche told me. “Yet I feel I’m still able to fulfill that artistic side of me in my work. Instead of paint and palette, I have fillers and lasers and other tools that I employ to enhance beauty.”


Procedure: CoolSculpting/Zeltiq
Cost: Up to $1,000 per area (Guanche offers each area for $750 or four or more areas for $500 per area).
Time in: An hour per area (two arms = two hours)
Time down: None
Anesthesia: None
Pain: More a feeling of strange numbness, very little discomfort
Invasive? Knife-free