Cellulite Gadgets & CoolSculpting - Get Off My Lawn Part 3

Announcer (00:02):
You are listening to Alabama the Beautiful with cosmetic surgeon, Dr. James Koehler and Kirstin Jarvis.

Kirstin (00:11):
We're back with more hot takes from Dr. Koehler.

Dr. Koehler (00:15):
It is.

Kirstin (00:15):
Okay. We're moving on from neuromodulators and fillers and injectables to energy. So some cellulite devices that are on the market. We've had a couple people come through here trying to sell us some cellulite devices. Do you remember the first cellulite miracle treatment?

Dr. Koehler (00:40):
Yeah. There wasn't one. That's what the answer is. If there was, it would still be there. No, all I'm going to say about cellulite is this. We're not going to talk about all these different machines and the reason we're not going to,

Kirstin (00:53):
Because there's hundreds.

Dr. Koehler (00:54):
Yeah. And we're not going to talk about all these different things. And the reason we're not, okay, so here's the test. Call five offices and say, I've got cellulite. What do you recommend for it? They're either going to say, well, we don't offer anything, or they offer something. But if you call the next office, it's not going to be the same thing that the office you just talked to has. And you can call the next one, it's not going to be the same thing as the other office you just called. And the reason for that is because nothing works well. I didn't say it shouldn't work. It doesn't work well. And because when something really works, for instance, Botox or Dysport, everybody has it because why? Because patients like it. Because it works. And when things don't work very well, now sometimes things aren't offered at an office because a cost a device might be really super expensive.

(01:51):
So for instance, there are some decent lasers out there for tattoo removal, for instance, but a lot of offices don't carry these lasers for tattoo removal. Perhaps because the device is very expensive and whatever. There could be reasons. So I'm not saying it doesn't work at all, but yeah, when it comes to cellulite, a lot of the treatments give you a temporary relief of symptoms. But 85% of women have cellulite. So it's a really common problem. And if anybody solves this Rubik's cube, they're going to win some kind of Pulitzer Prize, whatever it is. They're going to be known, the guy that cured cellulite or a woman. Get off my lawn.

Kirstin (02:39):
Alright. So, get off my lawn.

Dr. Koehler (02:39):
Cellulite, there's injectable treatments, there's some surgical treatments. All I will say is I think those things can be helpful. They're just, long term, I don't think they're a permanent result. And for some people who have some pretty bad cellulite, it may actually be worth it for them to do those treatments to soften it and everything. But I also understand though, I have some women, they're like, oh, my cellulite is awful. And I'm like, oh, okay. Show us what your cellulite, you're looking at it and you're like, oh, yeah, no. It's like one dimple.

Kirstin (03:13):
Their legs are super smooth.

Dr. Koehler (03:13):
Yeah, it's the smoothest skin I've seen. And there's like two dimples there. You're like barely two dimples, and you're like, yeah, no, that's not cellulite, I mean, it is, but. So anyhow, I mean, it depends on the severity and all that stuff. I don't like to talk totally in absolutes because there's always an indication sometimes for these things. And anyhow, there are treatments. They're semi affective. That's it.

Kirstin (03:37):
Okay. All right. Next thing is CoolSculpting. Let's talk about the technology and what it does so people know what CoolSculpting is.

Dr. Koehler (03:46):
Yeah. Basically the bottom line is these devices chill the fat down to where the fat cells start to basically die. And you, in theory, get a 20% reduction of the fat. It's not like you stand in a machine and your whole body loses 20% of fat. I mean, these are devices that are kind of, they're certain size and they put the device on the body. It chills that particular area, and you have to use multiple heads to treat multiple areas. So it is an effective way to treat a targeted area to decrease fat. But really, truly, as a surgeon, it doesn't excite me because I know what I can achieve with liposuction. And a lot of the people that we'll see for CoolSculpting are people that sometimes they need a tummy tuck, they've got loose skin. Well, it doesn't tighten loose skin. It gets rid of fat.

(04:50):
Sometimes they have other problems like hernias or other things, so they're not good candidates for it. So cool sculpting, yes, again it's something that if a person says, I absolutely don't want to do surgery. I've got a trouble area of fat, not that I'm overweight. That's a different problem. Weight loss is different from targeting fat in an area. And same thing with liposuction. Liposuction is not a weight loss treatment. It's a, I've got a problem area, please, can you fix that contour? That's what CoolSculpting is for people who are unwilling to do surgery, and I've seen some really great results from it. I've seen some questionable results. And then you sometimes have some people that have that paradoxical adipose hyperplasia where they get the opposite effect. Instead of the fat shrinking, it grows. How lucky are you? And then you gotta get liposuction to get it removed. So I don't know. It's okay. I can't say that. I love it. It's an option. It's a non-surgical option.

Kirstin (05:50):
Okay. There you have it. We'll be back with more hot takes from Dr. Koehler.

Announcer (05:56):
Got a question for Koehler? Leave us a voicemail at AlabamatheBeautifulPodcast.com. Dr. James Koehler is a cosmetic surgeon practicing in Fairhope, Alabama. To learn more about Dr. Koehler and Eastern Shore Cosmetic Surgery, go to easternshorecosmeticsurgery.com. The commentary in this podcast represents opinion and does not present medical advice, but general information that does not necessarily relate to the specific conditions of any individual patient. If you enjoyed this episode, please share it and subscribe to Alabama the Beautiful on YouTube, Apple Podcast, Spotify, or wherever you like to listen to podcasts. Follow us on Instagram @EasternShoreCosmeticSurgery. Alabama the Beautiful is a production of The Axis, theaxis.io.