Hi! I’m Dr Loo Keng Shien.

Here's Episode 27 of the Patient Mailbox series, where we collect handpicked questions submitted by patients suffering from various skin diseases and condition, and personally answer them with our best efforts. I hope to help any one of you who faces challenges from similar situations.

Editor’s Note: Dr Loo Keng Shien is a Consultant Aesthetic Physician with a special interest in Dermatology and Aesthetic Medicine. She has highly certified qualifications from the American Academy of Aesthetic Medicine, American Academy of Anti-aging Medicine, and in Practical Dermatology from Cardiff University. She currently practices at Peter Ch'ng Clinic Skin & Laser Specialist in Desa Park City.

Question:

I’m Tracy, 35 this year and is a working mom of two, 3yo and 1yo respectively.

Work takes up a major portion of my daily activity. After work, my time is taken up by kids. My body skin condition and shape became worse after the second delivery.

I am lucky as I don’t have stretch marks, however, I have typical post pregnancy stubborn fat around my tummy, thighs and arms, as well as sagging breasts.

I am 67kg / 1.65m now, and I do hope to get back to 58kg. I am looking for non-invasive treatments, and recently had heard about fat freezing procedure from my friend.

Is the treatment safe or painful? Does it yield results similar to fat removal surgery? How about its lasting effect and will the skin sagging issue return?

Answer:

Hi Tracy,

I truly understand that it's never easy being a working mom trying to juggle a full-time job with a family life (trust me, I'm a mother of four myself).

On the other hand, getting back the body shape after pregnancy can be a struggle when we hardly have the time to exercise diligently or practise a diet.

Don’t panic. Getting your body back after having a baby is not as hard as you might think.

To start with, we need to know more about how exactly body fat works.

Losing Weight vs Losing Fat

We read a thousand of messages and articles about how to reduce fat, but do you find yourself confused with how fat loss works?

Let's get your confusion clarified right now.

Body fat provides us energy, assists in absorption of vitamins and regulates body temperature.

Body fat consists of visceral fat (fat that is stored around the internal organs) and subcutaneous fat (fat that sits under the skin).

During infancy and adolescence, adipose tissue (body fat) grows by increasing in number of fat cell and size. During adulthood, fat cell numbers stay constant when the body weight is stable.

Do you actually lose fat when you drop the pounds?

When we lose weight, both muscle and body fat can be reduced as well. However, losing body fat itself may maintain the muscle mass.

When we are exercising and dieting, the number of fat cells remains but the size of the fat cells shrinks.

It simply means that losing fat does not imply losing weight. So, don’t put your blame on the scale anymore.

You might have a question on your mind. How can we get rid of the fat then?

Subcutaneous fat beneath the skin can be removed either by invasive (surgical) or non-invasive treatments such as CoolSculpting.  

How does a non-invasive CoolSculpting works?

CoolSculpting is the first solution that I’d recommend for the safest and fastest way to slim down pesky areas of stubborn body fats typically found in the abdomen, thighs and buttocks.

Let’s look at the science behind CoolSculpting so you can see the incredible value of this treatment.

It uses a unique freezing process (or we called “Cryolipolysis” technically) to target and kill fat cells in your treatment area. Those fat cells will become a waste and then eliminated from our body through the lymphatic system.

Please bear in mind that Coolsculpting treats only subcutaneous fat and does not go deep enough to treat visceral fat.

So, consult a qualified doctor to understand not only how CoolSculpting works but also your area of concern.

A body composition assessment will be carried out to determine areas of treatment first because different body parts require different CoolSculpting applicators. Let’s go through some common ones.

• Double Chin – CoolMini
• Abdomen – CoolCore Advantage
• Flank - CoolCurve+ Advantage
• Underarm and inner thigh – CoolFit Advantage
• Outer thigh - CoolSmooth Pro

There are 2 newer applicators, namely CoolCore Advantage Plus and CoolPetite Advantage, which are used to target bigger and smaller body area respectively.

The latest CoolAdvantage technology reduces the treatment time to 35-minute cycles, instead of the usual 60-minute treatment cycles. Despite the shorter treatment time, the new technology has bigger treatment area thus more effective.

 

New Mommy's Question - "How soon can I have CoolSculpting after giving birth?"

As soon as 6 weeks after a normal delivery.

But if you went through a caesarean delivery, you have to wait for 8 months. For treatment areas other than the abdomen (for example, underarm) after a post-caesarean delivery, CoolSculpting can still be done after 6 weeks.

Once treatment is done, you can return to your normal activities immediately. You can even have CoolSculpting done during your lunch break!

When will you see the result?

This question is definitely ranked top among CoolSculpting FAQs, however, please be patient with us.

The optimal result will be seen after 3 months as the body requires time to eliminate those dead fat cells gradually. However, there are cases where certain patients start seeing result as early as 2 weeks.

Another must-answer question - Will fat return after CoolSculpting?

Even though CoolSculpting eliminates fat cells from your body, it is still important to maintain your weight. As we know that when you start to gain weight, those remaining fat cells expand again. If you do gain weight, you may gain it evenly all over your body, not just in the treated areas.

Furthermore, a healthy diet and exercise routine can help to reduce the visceral fats which are unable to be removed by CoolSculpting.

Is everyone a candidate for CoolSculpting?

In short, no. CoolSculpting is not for everyone.

If you’re interested in Coolsculpting after reading this article, I'm sorry to tell you that a CoolSculpting may not be the best treatment for you if you are having open or infected wounds, bleeding disorder or chronic pain.

Apart from mentioned, please feel free to understand more on other conditions that rule out the use of CoolSculpting as following:

• Cold sensitivity such as cold urticaria or Raynaud’s disease, perniosis, or Chilblains
• Known sensitivity or allergy to isopropyl alcohol and propylene glycol
• Impaired peripheral circulation in the area to be treated
• Nerve pain such as post herpetic neuralgia (PHN) or diabetic neuropathy
• Impaired sensation of skin
• Recent surgery or scar tissue in the area to be treated
• Hernia in or adjacent to the treatment site
• Skin conditions such as eczema, dermatitis, or rashes in the area to be treated
• Active implanted device such as pacemaker or defibrillator
• Anxiety disorder

And I always tell my patients, CoolSculpting is not a means of achieving drastic weight loss. Hence, people who are far from their ideal weight do not make good candidate for CoolSculpting.

Safety, Risks & Side Effects

CoolSculpting has been a buzz word in the body contouring world for years because it is quick, safe and requires less downtime.

Compared to surgical fat removal process in which fat is removed from the body through incisions and resulting in scars, CoolSculpting is a more comfortable procedure since it is non-invasive and without scarring issue.

Significantly, CoolSculpting is also FDA-cleared.

The not-so-cool side effects of CoolSculpting may include experiencing bruising, skin tenderness and redness following the treatment due to the suction pressure created by the applicator. But all these usually will subside within weeks.

Other combinations of treatment?

Pregnancy is a tough process from the rapid weight gain to ever-expanding skin. 

Besides excess belly fat, women could have saggy skin after 9 months of carrying around a human bowling ball.

How to firm the saggy skin?

Laser Genesis Treatment

CoolSculpting does not treat saggy skin issue, but laser genesis treatment does. The heat from the laser penetrates the skin and stimulates collagen growth, so it can be used to effectively tighten our skin to recover it from sagging.

Radio Frequency Treatment

Radio frequency can also help to eliminate body fat tissues by breaking down fat via the vibration of radio waves to generate heat, and at the same time tightening our skin on the surface.

However, multiple sessions are required.

 

Fat loss can be frustrating and it can feel like a long journey. In fact, it doesn’t have to be in that way.

There are numerous fat burn and weight loss solutions in the market, for example, weight loss drugs (commonly known as slimming pills). These solutions might give users serious side effects, or have the negative potential to inflict dependence and abuse. In this case, the safety of these solutions becomes a big question mark.

So do be wise in deciding how to get rid of your body fat, and please make sure to always putting safety your top priority - it's our top priority, too!

I hope the above can help you reclaim your body confidence and realize your best self.

*Editor's note: If you would like to know more about CoolSculpting or your candidacy for this treatment, please feel free to call us at +6011-22882299, WhatsApp us here, or book an appointment with Dr Loo here!

We’ll be returning to the Patient Mailbox series next week with Dr Peter Ch’ng. Stay tuned!

 

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If you’d like to ask more about your skin condition or have a discussion with Dr Loo, call us at +6011-22882299, Whatsapp us, or book an appointment with Dr Loo here!