Freezing Off Your Fat Could Actually Produce More Fat

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We’re still doing this, huh?Photo: Keystone/Getty Images

Of all the ways to melt off your fat, fat freezing (aka cryolipolysis) is a new-ish one that people like because it’s a nonsurgical alternative to liposuction. You may know it by the name CoolSculpting, but that’s only one brand. The theory behind this procedure is that frozen fat cells will get broken down and absorbed by the lymphatic system. But now doctors are saying that it could actually backfire and create new fat cells in their place just a few months later.

A 2014 study in JAMA Dermatology found that fat-freezing procedures could lead to “paradoxical adipose hyperplasia,” or more fat in the treatment area about three months later. But they said this side effect was rare: There had been 33 confirmed cases reported to the manufacturer through March 2014, 15 in men and 18 in women. The authors estimated the incidence as 0.0051 percent, or about one in 20,000 patients.

A follow-up study published last year in Lasers in Surgery and Medicine said that figure is an underestimation. A group of doctors reported two cases of paradoxical adipose hypertrophy (both in men) out of 422 treatments done in their practice, which works out to a rate of 0.47 percent or, more simply, one in 221 patients. This is 100 times higher than what the device manufacturer reports. Both patients eventually had corrective treatment with liposuction, one of them after trying fat freezing a second time and again having the fat come back.

People talked to two cosmetic surgeons who disagreed about cryolipolysis. Robert Rey, M.D., said he would continue to perform the treatment and just make sure patients know about the rare risk. But Richard Ellenbogen, M.D., told People: “I have heard [from colleagues who use CoolSculpting] that in some cases the fat does increase in volume or the area becomes lumpy or uneven, and that even with repeated applications no discernible result can be seen.” Instead, he recommends liposuction, which can be done under local anesthesia as an outpatient. Another option? Leaving your fat alone altogether.