In addition to fat layer reduction, CoolSculpting can noticeably reduce skin laxity. The mechanism by which CoolSculpting induces skin tightening is not known. The improved appearance in the skin may not actually be skin tightening but perhaps dermal thickening, resulting in an improved appearance to thin, crepey skin. We recommend EmTone and Exilis for skin tightening and CoolSculpting for stubborn fat reduction.