Zeltiq CoolSculpting - Pain, Bruising, Risks?

Does Zeltiq hurt? What are the risks? Does it depend on how much suction/temperature doctor uses as to if there is bruising/pain afterwards?

Can Zeltiq cause nerve damage? Cause Other problems? Can the suction pressure be controlled by the dr? Is the Bigger suction more painful than using 2 smaller suctions for the stomach? Pre/post treatment care? How long has it been being used in the states? in Europe? What are the complications?

Doctor Answers 45

Is CoolSculpting Painful?

CoolSculpting has a very high acceptance rate amongst patients and doctors.  It advantages are that it does not require any sugery, incisions, anesthesia, needles or downtime.  The risks are minimal and include some transient minor bruising. Most commonly patients may experience some mild discomfort after the procedure which generally subsides in 1-2 weeks.  Its unusual for patients to have significant pain after the procedure but in all cases to date in which it has happened the pain seems to  subside within one months time.Regarding the larger applicator,  it would seem intuitive that it would entail a larger risk of post procedural pain but a recent study I saw stated that the use of the larger applicator was not associated with greater incidence of post procedural pain.


Long Island Dermatologist
5.0 out of 5 stars 4 reviews

Coolsculpting tolerable and minimal post procedure discomfort

Coolsculpting is very well tolerated during and after the procedure. The first 10 minutes of the treatment is definitely uncomfortable and bordering unbearable for some. This sensation goes down quickly. I have found that the abdomen tends to be the the most uncomfortable both during the procedure and afterwards. The overall discomfort does depend on the amount of tissue stretch that accompanies the suction of your tissue into the Coolsculpting probe. The more tissue is pulled into the probe, the greater the overall initial discomfort and chance for post-procedural discomfort. This is one of the reasons the abdomen may be more sensitive. I have also prescribed Neurontin at times for people who have high degree of discomfort due to hypersensitivity as the nerves recover from their stretched state. This may last ~10 days give or take a few days. The other perspective that I share with patients is that the overall level of discomfort is still much less than a surgical procedure such a liposuction or a tummy tuck. Almost everyone returns to work immediately. Liposuction requires at least a few days off, and a tummy tuck can require a good week or two off of work.

Zeltiq Coolsculpting risks and side effects

Zeltiq is one of the safest procedures available, especially among fat reduction procedures.  It was FDA-approved for fat reduction in September of 2010 and has been safely used in Europe for approximately 5 years.  The reason why it is so safe is that the cold exposure is not to such an extreme that it immediately kills fat cells;  rather, the cold exposure initiates natural programmed fat cell destruction, which is why it takes 2 months to see the results.  The exposed fat cells naturally degrade and the byproducts excreted by your body.  The only contraindications to undergoing Zeltiq is if you have rare conditions of cold-intolerance. 

The procedure may be slightly uncomfortable during the first few minutes of treatment, but it is more of an odd pulling and cold discomfort than pain and gradually turns into a barely noticeable numbness.  This odd feeling is greatest with the largest treatment head/applicator, and less with the small and medium applicators.  Immediately after the procedure, the treated area may have mild to moderate tingling, numbness, and soreness.  Mild bruising is sometimes seen, but is uncommon.  The soreness may last for 2-3 days and feels like the muscle soreness you get after a round of intense exercise.  The tingling and numbness feels just like the sensation your skin has after intense cold exposure.  It lessens over time and is usually limited to 2-3 weeks.  Zeltiq does not cause long-term nerve damage.

With standard settings, there should be little if any bruising or pain.  Sometimes the vacuum settings are increased in thinner individuals to get proper exposure of the treatment area to the cold applicator.  The higher suction could increase the chance of bruising, though it is still usually minimal and limited.  The temperature is currently not altered in the current model of the Zeltiq device.

When a device like this comes along that claims to be so effective with so few risks, it is usually too good to be true, but with the Zeltiq device, it is both good and true.

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Zeltiq Coolsculpting: minor discomfort

There is usually a mild transient pain upon starting the procedure especially when suction begins.  This is short lived and most patients are relaxed and don't feel any pain the remaining portion of treatment time  Any bruising is temporary and in our experience last no more than 18-24 hours, most times there is none at all.   We have had a few patients feel some numbness for up to several weeks.  Our patients are generally very happy with this no-downtown treatment.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 15 reviews

Pain, bruising...

Coolsculpting with the larger applicator has a higher incidence if bruising and discomfort than the smaller applicator. In patients who are unlikely to tolerate the increased discomfort, we will opt to use the smaller applicator 2 times across the lower abdomen, which covers the same area without overlapping.
We have found that this causes less discomfort.

Pain Bruising and Risks associated with CoolSculpting

We have been using CoolSculpting here in the office for about a year and have used about 400 treatment cycles. Given the patient population that we have treated so far we have seen a range of feedback with regard to pain associated with the procedure. Some patients seem to handle the procedures much easier than others. What I have seen is that of the patients who express any concern about pain it is generally more associated with the days after treatment than the day of treatment itself and the sensation that I most often hear patients complain of is a pins and needles kind of sensation or a burning sensation under the skin in the treated area(s). It seems that most complaints come from the treatment of the lower abdomen. I have had the procedure done on myself on my flanks and abdomen and found that the most discomfort that I had personally was in the lower abdomen where my belt rides. The discomfort that I experienced lasted a few weeks post treatment but I have already seen a significant reduction in the fat layer where I was treated and I couldnt be happier with my result.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 65 reviews

Coolsculpting by Zeltiq

Some patients can experience mild discomfort during the first 5-10 minutes of the treatment – a feeling of an odd pulling sensation that will fade into a numb sensation during the course of the treatment. Few patients can experience some bruising and a little numbness in the treated area which subsides over 2-3 weeks. Best of luck.

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

What does CoolSculpting Feel Like?

Once the CoolSculpting applicator is applied to the area of treatment the patient will initially experience a tight pulling, pinching, tugging, and cooling sensation. After a few moments the sensation will subside and the patient will be able to take a nap, watch tv, read a book, eat lunch, or relax. Following the procedure, it is possible the patient might experience slight bruising, sensitivity to the treated area, numbness, redness, and swelling.  Not every patient experiences these side effects and the side effects are only temporary.

Mark Pinsky, MD
Palm Beach Gardens Plastic Surgeon
4.5 out of 5 stars 9 reviews

Zeltiq CoolSculpting - Pain, Bruising, Risks?

Cool sculpting is a non-invasive method to reduce unwanted fat . There is some initial discomfort with the application of the suction device but that disappears within about one minute after application. We have been doing cool sculpting in our practice for the past two years and have seen no significant complications from the procedure. It is approved by the FDA and has many clinical studies which demonstrate its safety and effectiveness. See a board certifed plastic surgeon for a consultation and treatment plan.

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

What to expect during & after CoolSculpting

During CoolSculpting

There is typically very little pain.  There can be some discomfort during the first 5 minutes when the applicator is placed.  Once the area is frozen there is no pain.
After the treatment is completed there is a brief massage of the area.  There can be mild discomfort for a few minutes.  Overall there is very little pain with this procedure.

After CoolSculpting

Most patients experience a mild discomfort in the treated area for a few days.  This doesn't require pain medication or a change in ones routine.  A small percentage of patients develop delayed pain around day 5 which is more nerve related.  This can be significant but is easily and quickly remedied by prescribing Neurontin for about 7 to 14 days.  This is seen mostly in the abdomen when the Cool Max (the largest applicator) is used.  It is also related to the degree of suction and how much of the tissue is drawn into the applicator.

Long Term Complications

We have not seen any long term problems after CoolSculpting.  We also offer patients Smart Lipo and I would say that by far, our highest overall patient satisfaction has been with CoolSculpting due to lack of downtime and consistent results.

Ran Y. Rubinstein, MD
200 Stony Brook Court, Newburgh, New York

Board Certified Facial Plastic Surgeon (ABFPRS)
American Society forLaser Medicine & Surgery (ASLMS)
Clinical Professor New York Presbyterian Hospital
National Education Faculty (physician trainer) for:
Allergan (Botox, Juvederm, Voluma), Galderma (Scultpra, Restylane, Silk),
Cynosure (Cellulaze, Precision Laser Lift) & Solta (Fraxel, Thermage)
Zeltiq( CoolSculpting)

Ran Y. Rubinstein, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 143 reviews

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.