Coolsculpting is described as a non-surgical and non-invasive procedure that reduces the fat content of the area treated through controlled cooling of the tissues.
Typically, coolsculpting is used to improve areas of the body that have some excess fat accumulation that’s resistant to diet and exercise, including the abdomen, arms, love handles and the inner and outer thighs – as well as the area under the chin.
This guide takes a look at how coolsculpting works, what it’s used for and its overall effectiveness, according to experts. We also include the potential risks and side effects, do’s and don’ts, and the cost of coolsculpting treatments.
We’ve interviewed several experts on this topic, including board certified plastic surgeons, a Chief Medical Officer, and board certified dermatologist, who offer details about coolsculpting so you can decide if this treatment is right for you. We’ve also included before and after pictures submitted by our experts, so you can see the results for yourself.
Keep in mind that this article is not intended as medical advice. Before you undergo a coolsculpting treatment, it’s important to consult with your medical professional first.
What Is Coolsculpting and How Does It Work?
Coolsculpting is the most popular non-invasive treatment to remove unwanted fat, according to Dr. Kally Papantoniou, a board certified dermatologist specializing in cosmetic, laser and surgical dermatology in New York City, Queens and Eastern Long Island.
“It works by controlled cooling of the skin to temperatures that form ice crystals in the fat cells,” Dr. Papantoniou explained. “This damages the fat in the area treated and then the body metabolizes this fat and heals and repairs the treated area.”
Dr. Christie Prendergast, a plastic surgeon with Finesse Plastic Surgery in Southern California, described coolsculpting as a non-surgical treatment that freezes fat below the skin.
Coolsculpting works by freezing the targeted areas of fat, and the treated fat cells die at coolsculpting temperatures, Dr. Prendergast explained.
“These fat cells are slowly eliminated by the body leaving you more sculpted in the target areas,” Dr. Prendergast said. “In general, you can expect to have a 20 to 30 percent gradual loss of fat in the treated areas with optimal results seen within six weeks.”
Since we do not produce new fat cells, the number of fat cells that die is a permanent result, Dr. Prendergast added.
“That being said, it is still possible to gain weight because surrounding fat cells can still expand with weight gain and optimal results are best achieved with a complimentary diet and exercise plan,” Dr. Prendergast said.
Basically, coolsculpting is a non-surgical and non-invasive procedure that reduces fat content of the area treated using controlled cooling of the tissues, said Dr. Yuly Gorodisky, owner of the West Coast Plastic Surgery Center in Southern California who is board-certified by the American Osteopathic Board of Surgery.
“Through experimental research, it was found that fat cells are more sensitive to cold than other tissues, and by lowering the temperature of an area that has fat, the fat can be reduced by about 20 to 25 percent without any long-term negative effects on any surrounding structures,” Dr. Gorodisky explained.
Dr. Lain noted the term “cryolipolysis,” which involves the gradual cooling of fat cells to elicit their death and eventual removal via the body's lymphatic system.
“Fat cells are particularly vulnerable to cold temperatures, and are the first to respond to cooling as compared to the other types of tissue in the body,” Dr. Lain said. “Coolsculpting uses precise cooling and feedback technology to ensure reduction of fat cells without damaging the surrounding cells.”
By cooling the area that contains fat, the fat crystallizes, and after the area defrosts, the crystals rupture and release fat into the bloodstream which is then excreted through the liver elimination process, Dr. Gorodisky explained.
“The fat cells are permanently eliminated, but the process may take two to three months to complete,” Dr. Gorodisky said.
What Is Coolsculpting Used For?
Coolsculpting is great for target areas that do not improve with diet or exercise, Dr. Papantoniou said.
“Popular areas to treat are the belly, love handles, upper arms, back fat, jowls, and the inner and outer thighs,” Dr. Papantoniou said. “It is a great tool to re-contour the body.”
Coolsculpting is best used to improve fat-resistant areas and enhance body contouring, Dr. Prendergast said.
“It is typically used to treat flanks, rolls below the buttock – also known as banana roll – inner thighs, upper arms, lower abdomen, and beneath the chin,” Dr. Prendergast noted. “These are areas that will typically not have the desired fat reduction with diet and exercise alone.”
Coolsculpting is currently approved for the mid abdomen, love handles, inner and outer thighs, upper arms, and double chin, Dr. Lain said.
“However, many physicians will also recommend coolsculpting for other small areas of fat, such as bra fat,” Dr. Lain noted.
Most people will require two to three sessions depending on the size of the area being treated, Dr. Papantoniou added.
“The machine works by cool contact, with controlled temperatures that read the skin temperatures to maintain the safe effective temperature,” she explained. “Depending on the body area and the model of the machine, an area may take 35 minutes to one hour and 15 minutes. The newer machines are more comfortable and work faster, shortening treatment times.”
Now that we’ve discussed what coolsculpting is and how it works, let’s take a look at its overall effectiveness.
Is Coolsculpting Effective?
Coolsculpting delivers great results, which is why it is such a popular option for someone looking for re-contouring without having liposuction, Dr. Papantoniou said.
Coolsculpting can be very effective in the right patient, according to Dr. Prendergast.
“The ideal patient is one who is in good physical shape and health with extra fat pockets without too much skin laxity,” Dr. Prendergast said.
Before and after 8 weeks: Dr. Christie Prendergast’s patient who underwent a coolsculpting treatment to flanks.
Before and after 8 weeks: Dr. Christie Prendergast’s patient who underwent a coolsculpting treatment to flanks.
Hundreds of studies have been performed to verify the effectiveness of cryolipolysis – or coolsculpting – to reduce fat, Dr. Lain said.
“The scientists who developed this technology were intrigued by small children developing cheek dimples after eating popsicles,” Dr. Lain explained.
This simple observation led to the discovery of cryolipolysis.
“Once it was determined that cryolipolysis could be used in other areas of the body, safety testing and technology innovations eventually led to coolsculpting,” Dr. Lain said.
Coolsculpting is effective as a nonsurgical way to reduce the fat content, Dr. Gorodisky said.
“The target is to remove about 20 to 25 percent of fat in the area treated, and some patients who have more excess fat may need to have the treatment repeated more than once,” Dr. Gorodisky noted. “Liposuction may be a more effective way to eliminate more fat faster, but is a more invasive option. Weight loss is usually recommended first for patients who are overweight.”
Patient treated at West Coast Plastic Surgery Center by Dr. Yuly Gorodisky. This image shows Coolsculpting of the abdomen, before and eight weeks after.
Keep in mind there are potential risks with undergoing coolsculpting, which we discuss in the next section.
What Are the Potential Risks and Side Effects of Coolsculpting?
After a treatment, there is an occasional bruise, and the area can feel numb for several weeks after a treatment but completely resolves, according to Dr. Papantoniou.
“Rarely there can be discomfort after a treatment with hypersensitivity for a few weeks,” Dr. Papantoniou explained. “We treat this with over the counter pain medications such as ibuprofen. The extremely rare side effect is the development of a nodule, which can be treated.”
Coolsculpting in general is a very safe procedure; however there are side effects of pain, redness, bruising, numbness or tingling in the treatment areas, Dr. Prendergast said.
“Typically these are only temporary and resolve with time,” Dr. Prendergast noted. “There is also a risk of getting contour irregularities which is why it is important to select the right candidate for the procedure and have a trained operator.”
Dr. Lain said that after a coolsculpting treatment, many will experience redness and possibly bruising for a few days, tenderness and mild swelling in the area for about five to seven days, and slight numbing that improves over the next few weeks.
“People with certain rare, cold-sensitive diseases or conditions are not candidates,” Dr. Lain advised.
Dr. Gorodisky agreed that a common side effect after coolsculpting is numbness and tingling after treatments.
“This is a temporary effect due to cold effects on the nerves,” Dr. Gorodisky explained. “As the nerves wake up from the numbing effects of the cold, some patients experience a lot of sensitivity that may need to be treated with medications.”
The good news is that this sensation resolves after a few weeks, Dr. Gorodisky added.
“Another very rare side effect is thickening of the fat in the area of treatment,” Dr. Gorodisky warned. “It is a paradoxical effect that may occur in one out of 20,000 patients and needs to be treated with liposuction.”
Now that you’re aware of the potential side effects of coolsculpting, let’s discuss the costs associated with this procedure.
How Much Does Coolsculpting Cost?
According to Dr. Papantoniou, the cost varies depending on areas treated.
“General pricing starts at $750 and is up to $1,000 per site treated,” Dr. Papantoniou said.
In Dr. Prendergast’s practice, coolsculpting typically costs $600 or more per treatment area.
“However the price can vary widely,” Dr. Prendergast said.
“Keep in mind that if you have two areas that you are treating – both arms, thighs or flanks – you would double the costs,” Dr. Prendergast noted. “Additionally, it can take more than one treatment to get desired results.”
Dr. Lain said the cost of coolsculpting varies widely across the country, “but most patients treating one or two areas will pay between $1,500 to $5,000, depending on the amount of fat that needs to be treated.”
In Dr. Gorodisky’s practice, the price depends on how many treatments are performed, and the cost can range from $750 to several thousand dollars for multi-area treatments.
“Each treatment covers an area of about the size of the person’s palm,” Dr. Gorodisky explained. “So the cost for someone who is slimmer and only needs one or two areas treated will be much lower than someone who is larger and needs multiple treatments.”
Before you undergo a coolsculpting procedure, it’s important to know the do’s and don’ts, which we cover in the next section.
Coolsculpting Do’s and Don’ts
According to Dr. Papantoniou, do have a consultation to see if you are a candidate, and don't think this is a weight loss treatment.
“This is a re-contouring treatment that treats isolated areas of fat,” Dr. Papantoniou said.
Do make sure you see a trained professional who can give you an honest assessment of whether you are a candidate for coolsculpting, Dr. Prendergast agreed.
“I often see patients who are talked into coolsculpting and are unhappy with the results, primarily because they were poor candidates in the first place,” Dr. Prendergast said.
Don’t expect surgical results, Dr. Prendergast added.
“Non-surgical results will not substitute for surgical results and it is important that you have realistic expectations as well as subscribe to a continued health and fitness plan for optimal results and satisfaction,” Dr. Prendergast explained. “Coolsculpting is not a weight loss tool, but rather a body sculpting treatment.”
Dr. Lain agreed: don’t undergo coolsculpting if you want to lose weight.
“It is a fat reduction device for relatively small areas, and is best used by those who are in relatively good shape – within 15 to 20 pounds of their ideal body weight – who maintain a consistent weight, but have persistent areas of fat they cannot lose,” Dr. Lain said.
Also, don’t expect immediate results.
“Once the fat cells have been treated, it takes four to six weeks for them to be processed and removed by the body,” Dr. Lain said.
Do come in with realistic expectations, Dr. Lain added.
“Coolsculpting is not invasive and requires your own body to help with the process of fat cell removal, therefore results can vary,” Dr. Lain said.
There are other factors people should avoid when it comes to coolsculpting, which we discuss next.
What to Avoid
Avoid anti-inflammatory medications before and after treatment to get the most fat reduction, Dr. Gorodisky advised.
“Inflammation is necessary to eliminate fat so this will help achieve the most fat reduction,” Dr. Gorodisky explained. Additionally, “eat healthy, massage the treated area, drink water, and exercise after the treatment to help eliminate the fat from the body.”
Avoid changing your lifestyle or diet, unless it helps to lose weight and improve your health, Dr. Lain recommended.
“I have had many patients consider fat removal as an excuse to eat more cake,” Dr. Lain noted. “Remember that fat cells are still present in your body and will grow in size if you consume more calories than you burn.”
Coolsculpting is such a simple procedure and the recovery is so easy, Dr. Papantoniou said. The recovery is very short, usually with minimal tenderness, and an occasional bruise.
“If we want to reduce risk of a bruise, avoiding alcohol, NSAIDs, garlic supplements and vitamin E prior to treatments is helpful, and supplementing with Arnica montana helps reduce a risk of bruising,” Dr. Papantoniou advised. “If there is an abdominal hernia present or skin condition, coolsculpting should not be performed.”
The Bottom Line
Coolsculpting is an effective treatment to target exercise-resistant fat pockets that can have permanent results in the right candidate, Dr. Prendergast said.
“It is important to have realistic expectations and seek professional consultation to guide you to a treatment plan that helps you achieve optimal results,” Dr. Prendergast advised.
Coolsculpting is a safe, non-invasive method to reduce fat, Dr. Lain said.
“There is no downtime and the risks are minimal for most people,” Dr. Lain noted.
While most achieve results they are happy with, it is not a technology that will work on 100 percent of people 100 percent of the time, Dr. Lain added.
“No technology can promise that, therefore people need to approach this procedure with realistic expectations,” he said.
Coolsculpting is an effective treatment for "fine-tuning” the shape of the body by eliminating excess fat, according to Dr. Gorodisky.
“It works well for specific issues that relate to fat excess and it is up to the technician or the physician who evaluates the patient to determine if the treatment will be beneficial,” Dr. Gorodisky said.
However, coolsculpting is not a replacement for exercise, a healthy lifestyle, or weight loss, he noted.
“It is not a replacement for liposuction – it will not eliminate loose skin,” Dr. Gorodisky said.
To obtain the best results, the limitations of the treatment must be frankly discussed, Dr. Gorodisky further emphasized.
“Patients who expect results of surgery from this non-surgical treatment will be disappointed,” he said. “But those who understand how the treatment works and what they can expect are truly happy and satisfied with their results.”
Some may claim that the coolsculpting treatment does not work, Dr. Gorodisky added.
While there have been millions of treatments performed and many scientific studies supporting the effectiveness of the treatments, some patients may not have the results they expect due to lack of appropriate communication, undergoing the treatment while not being the optimal candidate, and setting unrealistic expectations by the provider, Dr. Gorodisky said.
“A provider that can offer both surgical and non-surgical options can direct the patient toward the most effective treatment for their specific concern,” he said.
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