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Why Do Some Coolsculpting Patient Report Little Pain and Others Report Severe Pain?

Is there a reason why there are such different responsed to the level of pain with coolsculpting?

Doctor Answers 20

Reactions to CoolSculpting treatment

Thank you for your question.

The CoolSculpting method is based on science performed by the Wellman Center for Photomedicine at Massachusetts General Hospital in Boston, Massachusetts. Research determined that fat cells are more vulnerable to cold temperatures and when introduced to these cold climates are effortlessly and permanently demolished. Beginning weeks after the cooling application, the cooled fat cells initiate the process of solidifying the fat cells without destroying surrounding tissues, eventually causing the cells to shrink and disappear naturally. Gradually as the cells diminish, the depth of the fat layer will be reduced.

Each patient is different with how they respond to this procedure.  Usually, patients experience more of the achy, tingly, etc when the procedure is performed on the abdomen vs. other areas. It really is patient specific.


Coolsculpting and Pain

You asked a very important question that I would like to answer.  Coolsculpting is a painless procedure.  The arms, abdomen, legs, flanks, and outer buttock areas only have minimal discomfort for the first few minutes until the applicator freezes the area after several minutes.  However, the abdominal area can be uncomfortable in some patients for a few days to weeks after the procedure.  This discomfort feels much like doing a "hundred sit-ups".  In a rare subset of patients they may have pain in the abdominal area afterwards since the nerves were irritated and may require analgesics.  The most important thing is to consult a board certified dermatologist with a great deal of experience with coolsculpting for the best cosmetic results.

Pain after Coolsculpting

I do find with most procedures that there is a wide variety of discomfort.  As a general rule, I have found the following:
1)  Abdominal treatments tend to have more discomfort than other body regions
2)  Those with a greater degree of tissue pull into the applicator have greater discomfort
The majority of patients return to their normal activities afterwards, and a minority may need some medication support to help with the discomfort.  I would make sure you do your treatments at a place with a lot of Coolsculpting experience and who can help manage the post-procedure concerns.


The pain depends on the size of the applicator and type of tissue treated. We have had very few patients with any sign pain after Coolsculpting, but in all those occured in patients who had the abdomen treated with the large applicator. We attribute our success to the use of percussion devices that helps distribute the temperature gradient across the tissue and reduce the chance of tissue damage and nerve irritation.

Amir Moradi, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Discomfort is a subjective thing to describe.

There are so many things that can contribute to the way that a person describes their discomfort.  Everyone's response to pain is different and can be influenced by many factors, including the area that is treated and the way that they support their body during the healing process.  Compression garments can often help you to feel more comfortable, as can antiinflammatories and curtailing more strenuous activities if they cause significant discomfort.  Everyone structures their recovery differently and these subtle differences can impact the way that they feel as they are recovering from their treatment.

Why Do Some Coolsculpting Patient Report Little Pain and Others Report Severe Pain?

Coolsculpting is a fairly pain free procedure. Following the treatment most people continue with their normal daily routines. Over the course of a few days, some people feel mild discomfort similar to what you might feel after a workout. Compression garments can help alleviate those aches. On occasion, significant pain has been reported in less than 4% of patients and can be mitigated with compression, ice and even a doctor prescribed medication in severe cases. The patients who experience significant discomfort are usually the patients which had a treatment with a single large applicator on the lower abdomen area. The abdomen tends to be the most sensitive area to treat but also the most popular. Areas like inner and outer thighs have very few complaints of pain. Good luck.

Steven Gabel, MD, FACS
Portland Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Difference in Pain

Thank you for you question. It is common to experience a little discomfort during the initial application and especially if you were treated with the larger head piece. Once the precise cooling has been initiated the area will start to go numb within 7 to 10 minutes and the discomfort starts to dissipate. The abdomen tends to be the most sensitive of all areas that we treat.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 23 reviews

Why Do Some Coolsculpting Patient Report Little Pain and Others Report Severe Pain?

Thanks for your question. Coolsculpting is a fairly pain free procedure. Patients that report a lot of discomfort after the procedure were likely treated with the larger head piece that treats the lower abdomen. The abdomen tends to be the most sensitive area to treat but also the most popular.  Areas like inner and outer thighs have very few complaints of pain.

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 17 reviews

Cool sculpting and pain

Thanks for your question. Pain during the procedure is very unusual. When the device is initially applied, some patients describe mild discomfort or pressure at about 4 minutes which usually subsides within one minute. Make sure to see a surgeon who is certified by the American Board of Plastic Surgery for all your aesthetic concerns. Best of luck!

Richard Chaffoo, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 9 reviews

Pain Variation with CoolSculpting

Hi, thank you for your question. The first factor to consider is that every individual’s pain threshold is different. Unlike tumescent liposuction, CoolSculpting is a non-invasive treatment. It requires no incision and no intrusive vacuuming of the targeted fat. CoolSculpting works by using a two-paneled device that holds the targeted area and delivers cooling technology to freeze fat cells. The fat cells die through apoptosis and are then disposed of by the body’s natural defenses. There is no anesthesia or pain medication needed with this procedure. The severe pain reported may be due to a low pain threshold and unfamiliarity with the cold temperature on the bare skin. Rest assured that CoolSculpting will never drop to temperatures that cause frostbite. The technology simply targets fat cells while leaving all other skin, tissue and healthy cells undisturbed.

Daniel Behroozan, MD, FAAD
Los Angeles Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.