CoolSculpting may do more than selectively reduce fat pockets. It may also tighten skin, Plastic Surgery Practice editorial advisor board member W. Grant Stevens, MD, writes in the Aesthetic Surgery Journal.

In a letter to the editor, Stevens, a Los Angeles plastic surgeon and the medical director of Marina Plastic Surgery, provides details on two CoolSculpting patients who achieved visible skin tightening in the treated areas.

This is the first report of cryodermadstringo, or skin tightening following cryolipolysis. A study is now under way to obtain quantitative objective measurements of skin tightening and to establish the mechanism of action.

The improved appearance may not actually be skin tightening, but dermal thickening that results in an improved appearance to thin, crepey skin. The change in skin firmness may be the result of stimulated collagen production, new elastin formation, fibrosis, or tissue compaction.

Cryolipolysis produced significant volume reduction and skin tightening after 4 months in one female patient. For the second female patient, the large fat volume loss did not result in skin laxity. Instead, 4 months after treatment, the tightened skin adhered well to her new body contours. Pronounced skin folds, evident in pretreatment photos, were no longer visible post-treatment, Stevens reports.

“At this point, it is unknown how predictable the skin-tightening results are and how other factors, such as patient age, skin condition, number of cryolipolysis cycles, and duration after treatment, may affect the resultant skin tightening,” he writes. Additional histology analysis from clinical studies is needed to further investigate the changes to the skin and fat layers following cryolipolysis.