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 49

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.

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.

Ted Brezel, MD
Long Island Dermatologist
5.0 out of 5 stars 4 reviews

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 12 reviews

Risks with CoolSculpting

During the initial few minutes of your CoolSculpting treatment, some pain can be expected. Our patients have rated the initial suction of the hand piece followed by a cold burning sensation as mild to moderate pain. This pain will diminish once the area is numb, normally within 6-10 minutes after the treatment has begun. After treatment, numbness, tenderness to the touch, swelling, bruising, itching and burning can be expected. These side effects are easily managed with OTC pain medications, compression garments, or ice. Occasionally, late onset pain may occur 3-5 days post treatment and subside within 5-7 days. This has been described as prickly, stabbing pain, normally in the abdomen. Ask your doctor how you can manage late onset pain.

David L. Robbins, MD, FACS
West Des Moines Plastic Surgeon
4.5 out of 5 stars 20 reviews

Pain from CoolSculpting

It is not uncommon to have bruising, swelling and delayed onset pain after a Coolsculpting procedure. This pain is more commonly experienced with abdominal Coolsculpting. It starts 3-5 days after the procedure and can last 10 days or so. This pain is nerve based and is best treated with Neurontin. Ask your physician to prescribe you some.
Best of luck,
Sheila Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Coolsculpting treatment and risks

Cool sculpting isn't painful to most.  About 15% find it painful. Bruising is sporadic. If you bruise easily, you'll probably bruise. 

Complications are rare.  Much safer than surgery. It's been studied for surgery and efficacy. 

Daryl K. Hoffman, MD
Los Gatos Plastic Surgeon
4.5 out of 5 stars 11 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 73 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
4.5 out of 5 stars 11 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.