What to Expect During CoolSculpting and Afterwards: my Honest, Detailed and Impartial Account. - Santa Barbara, CA

I lost 100 lbs about 15 years ago. For the past...

I lost 100 lbs about 15 years ago. For the past two years I've been on a health kick: weightlifting, aerobic exercise, and a diet of 1,500-2,000 calories per day. (I'm a male with a muscular frame, so this is a fairly strict diet.)

My health kick has given me more muscular definition, made me stronger, and given me the ability to enjoy strenuous activities more. Unfortunately, it has NOT eliminated the remnants of my old, morbidly obese self. I've still got slight man boobs, flabby arms, fat thighs, a gracious spare tire around my midriff, and a maddening amount of residual fat and loose skin around my belly. I decided to try something new and "cheat" my way to a better figure while continuing my workout routine.

After doing substantial research, CoolSculpting stood out as a relatively low risk, low cost way to get started. I consulted with a local cosmetic surgeon, brought up some of the common issues I'd heard about on RealSelf, and got satisfactory answers. I took a couple days to decide, purchased a 4-sculpt package to tackle my flanks (aka "spare tire") and abdomen. It's been two days since the procedure, so I have no idea whether it was "worth it." My goal in writing this review is to give people detailed information about the procedure itself -- how it feels, how it looks -- and to keep the review up to date with my progress over the next 8-12 weeks.

The treatment machine is basically a very large mini-fridge with an LCD touchscreen interface. The applicator resembles the head of a vacuum cleaner, only with more internal volume, a sterile plastic covering, and a comfortable silicone lining. Cold water circulates through the applicator and back into the machine to be chilled. The machine makes some noise while it's running, but in all, it's not a very intimidating device!

The nurse who was administering my treatment applied a cold, medical-grade "wet nap" and fitted the applicator over my left flank. The suction was, as everyone says, uncomfortable but not painful. That sensation lasted about a minute, fading gradually as my skin cooled. After five minutes everything was numb; I settled back and read a book.

When the applicator came off an hour later, I'll admit that I was alarmed by what I saw: a big, firm, cube-shaped mound of angry red skin, glistening with agar gel left over from the "wet nap" which had been protecting my skin from frostbite. The nurse massaged the flesh back to its normal shape -- which was ticklish and a bit painful, but only lasted 20-30 seconds. Then we set up my other flank and went through the whole procedure again.

After hour two, the nurse returned and changed the applicator to the larger size to do my abdomen. This thing was LARGE, with the volume of a loaf of bread (but narrower). I was warned to expect more discomfort since the stomach has many more nerve endings. The applicator went on and FWOOMP -- sucked my whole belly up into it! It tickled quite a bit ,causing me to laugh, which was painful. Then the sensation got more uncomfortable, almost a burning muscular pain -- like doing a continuous sit-up or Russian Twist, very disconcerting. The nurse distracted me with small talk for two minutes, and once again the discomfort began to fade as everything began to numb. After five minutes the pain had turned mostly numb with a lingering, slightly unpleasant cool sensation in my belly. I relaxed my abdominal muscles and the machine sucked up even more of my midriff.

When the applicator came off the final time, it was VERY strange to look down and see how much of ME was sitting there, frozen into a gelid lump with that same angry red appearance. The massage wasn't painful, despite being much more intensive, because everything had gone numb. As my belly began to warm I felt an intense stinging sensation throughout. This lasted for only 30 seconds, and faded into a significant abdominal ache, exactly as I would feel after an intense ab workout.

I went home and spent the afternoon taking it easy. My bright red skin had faded to a livid, dark red "flush" within an hour. I felt very little pain or discomfort; mostly, everything was numb. I skipped my workout that day, mostly to reward myself

On day two, the numb regions shrank and the aching became more pronounced, especially in my abdomen; it felt comparable to a 100-situp workout. I took some ibuprofen, which eliminated all of the discomfort.

This is day three; there is still a pronounced numbness in my belly and flanks, but the aching and tenderness are starting to fade. No painkillers today. The bruising is more pronounced, especially along my flanks. I noticed in the shower this morning that my belly is quite swollen, as if I'd put on 20 pounds overnight.

I haven't yet felt any shooting pains, seen any lumps or bumps form, or experienced anything that I would classify as more than moderate discomfort. I'm going to resume my workout routine today. So far, it's gone better than I was expecting! I'll keep updating this review every few days with information about the healing process and the results (which I don't expect to be noticeable for at least 4 weeks).

Day 5: getting back to normal

After weightlifting, sit-ups and bicycling on, my abs were the worse for wear -- at least in the portions that weren't numb. My belly had also swollen significantly more. I decided to cut my workout frequency in half and to be very gentle with abdominal exercises until I get a good handle on how much discomfort is in store for me.

On days three and four (switching to the RealSelf way of numbering them), my abdominal swelling began to subside. The numbness also started to fade and was replaced with a dull ache -- nothing intolerable, but it was certainly uncomfortable. By the evening, I had occasional shooting pains around my belly button, and odd twinges -- not quite pain, more like a prickling sensation -- from my flanks. I popped some ibuprofen and had a good night's sleep.

The trend has continued: much of the sensation has returned to my belly, and I'm experiencing a persistent dull ache, plus frequent but mild twinges of pain. I've been wearing low-cut pants to work and changing into sweatpants when I get home; this helps significantly. I take ibuprofen twice daily which lets me ignore the pain for most of the work day and the evening. Still no complaints from my flanks, other than the occasional non-painful twinge and an overall feeling of numbness.

There is still a numb spot at the center of my belly, so more pain may be in store, but I can't say that my daily routine is seriously impacted. I'm accustomed to being sore after workouts, especially in the abs; this might be influencing my perception. Or, perhaps I'm just lucky and CoolSculpting agrees with me. In any case I almost feel wrong using the word "pain" to describe what I feel -- but "discomfort" takes too long to type.

I suspect that this trend will continue: less swelling, less numbness, more aching, more shooting pains. I'll update if anything changes significantly or when the pain is on the downswing -- whichever comes first. I'll also get my "before" pictures from the doctor's office to help provide some context.

What a difference a day makes!

When I woke up on the morning of day 6, the swelling, pain and numbness in my abdomen were all substantially better than they'd been the previous day! I was a bit skeptical that so much could have changed overnight and decided to wait a few days to post an update.

The aching and itching did come and go over the next few days, but the numbness steadily decreased, as did the severity of the other symptoms. By day 10 I was wearing high-cut pants and using a belt without discomfort; this morning I felt basically normal, with occasional bouts of mild itching and a lingering soreness that feels no worse than I'd get after my standard ab workout.

When I apply pressure to my abdomen I can still a numb and tender spot centered on my belly button, but it's nothing that I notice during normal activity. My flanks are no longer numb and they only complain when I apply pressure. (To be honest, my flanks have barely bothered me during the entire recovery period; even when they were very sore, the discomfort was never intense enough to bother me.)

I have a few ideas as to why CoolSculpting has been so easy on me, whereas numerous other reviewers have mentioned severe pain. In part, I'm probably just lucky: fewer nerve endings or higher pain tolerance or whatever. My frame of mind may have been helpful, being prepared for the worst after reading so many reviews. Also a benefit was the fact that I exercise my abdominal muscles on a regular basis and I'm used to soreness and pain. Gut pain can be unnerving if you're not used to it -- a terrible combination of nausea and having the wind knocked out of you. It feels WRONG, but as long as you understand why it's happening, it's easier to bear.

To recap some things that helped minimize my discomfort: low-cut pants; ibuprofen, small meals, hot baths, suspending my abdominal workout routine until I felt "normal" again, and keeping a positive attitude.

Now it's a matter of sitting back and waiting for those precious results! I'm tempted to take daily measurements or photographs, but a watched pot belly never melts; I'll temper my anxiety and go about my life. I'll post an update at the end of month one.

"Before" Photos

Another "Before" Photo

Subtle but encouraging changes!

This procedure definitely works! The change hasn't happened overnight; it sort of snuck up on me, but especially over the past week, there are undeniably good things happening!

The first thing I noticed, at about the two-week mark, was that my stomach felt smaller, less bulky. Initially I thought it might be the feeling of returning to normal after all of the swelling subsided, but it lasted. Then I began to notice CLEAR improvements. For instance: I'm used to sucking in my belly all day to make it look smaller and give my stomach a flatter contour and improve the way my shirt hangs off me. When I "suck it in" now, my belly is actually quite concave; shirts that were previously tight around the abdomen and fitted when I sucked it in, are now normal and they become slightly LOOSE when I suck in my belly. There's a dramatic improvement here. Time to go shirt shopping!

Last week I was lying on my side and I twisted my torso, stretching my arm out to reach for a glass of water. Normally this would cause the skin on my sides to crease slightly, creating a kind of fold as long as I remained stretched out. No more! My flanks remain flat no matter how I twist. The profile of my sides isn't visibly less slender, but there's clearly less bulk on my sides.

Over the past three days my belly has gotten noticeably FLAT, and I can see some definition now in my abs! Don't get me wrong; I haven't developed a six pack overnight -- but I can very clearly see the outline of my abdominal muscles when I stand and flex my abs.

I've had three comments from close friends in the past two weeks about how good I'm looking, how well my workout routine has been paying off, and so forth. None of them know that I've had CoolSculpting done, so it's clear that I'm not imagining any of these changes.

With the good comes the bad: the skin of my belly is obviously more slack than it was before; it wrinkles and folds in new ways when I sit down. When standing, the skin below my belly button pooches out in a way that it didn't before. There's a lot more loose skin down there!

I'm happy with the results so far and giddy about the possibility that even MORE improvement might be on the way! Four more weeks until my follow-up appointment with the doctor and a set of "after" photos to share with everyone.

I've had a bad cold for the past five days, so my workout routine is on hold. As soon as I'm recovered, I'm going straight back to weightlifting with a better motivation than ever: to fill out all of this loose skin with some muscle mass!

Some "after" photos for comparison

As I've mentioned before, the changes to my body are subtle and the photos don't fully do them justice. If you look carefully, however, you can see that my gut has more definition and its side profile is more slender.

Judging from the photos alone, I see no visible difference in my flanks -- and it's true that the changes there are very subtle indeed. The taper of my waist seems more pronounced, and it's certainly easier to fit into the fitted shirts that I enjoy wearing.

It's worth keeping in mind that I've also been aggressively dieting and working out in the weeks since CoolSculpting. Focusing on core strength -- planks, Russian twists, crunches and reverse crunches -- has probably helped bring out even more definition in my abdominals. My 1,700-calorie diet doesn't hurt either; I've lost 10 pounds since the day of the procedure.

Normally, fat cells never die during person's lifetime; they can become slack and empty if all their stored lipids are depleted, but once the body makes new fat cells, they hang around for good. CoolSculpting kills fat cells, leading to the unfortunate side effect of wrinkly skin, but accomplishing a reduction in bulk that normal dieting can't always achieve. I'm happy with my results, and

Am I done with self improvement? Not by a long shot! I'm going to keep dieting until I hit my goal wait (only five pounds to go!); I'm going to keep working out in order to fill out this saggy skin with more muscle. I'll probably have a mini abdominoplasty to remove some of the loose skin. I'm glad I started with CoolSculpting; it was a good way to get my feet wet and it complements my exercise and diet regimen well.
Santa Barbara Plastic Surgeon

Dr. Lowenstein is courteous, honest and professional; his staff are friendly, efficient, and very accommodating. I felt at ease from the moment I walked into the office for my first consultation. Both the doctor and his on-staff nurse answered all of my medical questions honestly and without condescension. The front-office staff explained their prices and billing policies in a very straightforward manner, and worked with me to find appointment times that would fit into my busy and shifting schedule. I'm happy I chose Dr. Lowenstein's team to perform my CoolSculpting procedure!

5 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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Comments (24)

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That sounds about right.
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Do u mind if I ask if age?
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I'm 36.
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Just wondering, I can not eat over 1400-1500 calories a day or I gain weight.
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That sounds about right.
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Age plays a big factor, of course. I dieted at 2,000 calories in college and I didn't count calories from drinking. That stopped working about 5 years ago! Even at 1,700 calories, I only started losing substantial weight once I'd built a bunch of muscle -- it requires more energy to sustain muscle tissue, boosting the basal metabolic rate. There's also the fact that men require more calories than women. This is partly due to inherent sex traits (hormones, etc) but a large part of it is because men are more muscular. Women can build muscle effectively; there's no need to bulk up, either. Focusing on slow-twitch muscle development will leave you looking firm and toned, but not bulgy. Another interesting fact about muscle is that it's 5x as dense as fat. You can lose 5 pounds, gain a pound of muscle, and be burning more calories *and* looking 4 pounds thinner. It's not only possible to lose weight and gain muscle at once -- it's normal. You sound like you've done your research so most of this won't be news to you. Thought I'd summarize it all, since you asked about my calorie intake. Informative article about muscles & dieting: http://bit.ly/1nOa7lS -- ignore the title, the science in here applies to all people.
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Agree. Muscle does weigh more but the fat is so much easier to maintain. LOL. I have been sticking to swimming and it seems to be working for me. I have lost 15 pounds since the first of the year. Just keep on with good results. If I do it I just want to smooth one flank.
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Yea for you!
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I am so happy for u. WILL u b doing more treatments? Continued good luck with the results.
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Although I'm tempted to go for more CoolSculpting, it's too early to make that decision; I want to make sure I've seen the full benefit from the first round. Also, this procedure can only do so much -- the loose skin will probably get worse if I keep it up. I had already been considering a mini abdominoplasty to deal with the loose belly skin; after CoolSculpting, I think it will result in a dramatic improvement, and give me something that CoolSculpting can't. I'm also super self-conscious about my breasts, and they will require surgery to improve. At the moment, I think my money is better spent on those surgeries, so I'm saving. It'll be expensive (5x the cost of my CoolSculpting) and there's a lot of pain, risk and recovery time associated with invasive procedures -- but if it can deliver 5x the results in terms of improvement to my self confidence and self image, then the money is well worth it! If money were not an issue, I would go for another round of CoolSculpting on my flanks (since I'd like to see more improvement there) and maybe a small-applicator treatment on my upper abs to tone them a bit more, before proceeding to surgery. Then again, my doctor does a lot more of this stuff than I do, so I'd consult with him first to see if this was a sane treatment plan!
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Thanks for the honest appraisal of what coolsculpt can and can not do.
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I am considering this procedure and am watching yr updates with great interest. I feel it is accurate and stated well. I have high tolerance 4 pain so I feel I can relate to what u r saying. Thanks.
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You'll be excited by today's update! I'm seeing results, and I really like what I see.
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"Switching to the RealSelf way of numbering them)" I hope you don't mean icing?
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No; my original post referred to day three (day one being the day of the procedure), but it was labeled as "two days post" -- so I switched to the RealSelf 0-based numbering scheme to avoid confusion.
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:o)
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Excellent review, you're a wonderful writer! You aren't up to day 5 yet, which is when your frozen nerves defrost & many here have posted about excruciating pain at that time. I hope your Dr gave you a script for Neurontin, a nerve-blocker, just in case that is your story (wasn't mine at all). I was told to take it at the 1st tinge of pain, so I did fill the script but only took 1 pill. My only other concern would be that this additional loss of fat will only cause more loose skin & that you may need to consider some skin removal in the future. My tummy is all wrinkly now, like crepe paper, with the loose skin I have left after multiple treatments.
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Thank you for the encouraging words! There's definitely significantly more pain now, but nothing that I would describe as excruciating -- or necessarily even as pain. The nurse advised me to stick to OTC pain killers and to call the pain became unbearable, but that looks like it won't be the case. Lucky you and me! The doctor mentioned in my initial consultation that I'd likely end up with (even more) loose skin in the abdomen after CoolSculpting, but that this would also make me a much better candidate for a mini tummy tuck I figured: in the worst case, I'll look great with my shirt on; in the best case, I'll scrounge up enough money and moxie for a full-blown surgery and look good with my shirt off. Surgery has been on the table for some time; what remains of my breasts is almost entirely glandular tissue, and CoolSculpting can't do anything about that. Thanks again for your support, and for volunteering your time to moderate these forums.
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Congrats on the significant weight loss, BTW. I needed to go to Overeater's Anonymous to finally beat that devil!
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Thanks! I was fortunate enough to come across an excellent book (The Hacker's Diet) that reduces nutrition to a few simple rules that appeal to the engineer's mindset. It's not for everyone, but for those of us who overanalyze everything, it's a superb resource. Motivation is also a must-have, of course. When I got to college, I realized that I'd never find a mate if I couldn't learn to respect my body and (at the risk of sounding like a bad self-help book) love myself. So I lost the weight, bulked up the muscles, and focused on becoming a well-rounded person. After a few years I did find my dream partner; we're still together after many years, and in retrospect I've used my contentment as an excuse to take a hiatus from my journey of self-improvement. Time catches up with everyone, though; here I am in my mid 30s, having an embarrassingly cliché mid-life crisis. It can be challenging to channel that anxiety into motivation, but it's better than letting it gnaw at me! Thus I've spent the last two years back on my self-improvement kick -- much to the amusement of my partner, who's never seen anything wrong with me. What was your motivation?
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At 8 years clean in Narcotics Anonymous, I felt I might be better off dead, than giving up my beloved binge foods (mostly sugar) or have to exist in my fat body 1 more day. That really scared me.
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Wow! I'll say. I'm glad you found your way out of the food trap _and_ the body image trap.
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I'm an engineer and The Hacker's Diet really worked for me too. You weigh yourself every day and enter into the program, which does a weighted average of your weight. No matter what you think about your metabolism or whatever, if you're weight isn't going down every day then you're still consuming too many calories. I have to eat like a bird to avoid eating too many calories, and that taught me that. Now every time I gain a few pounds I start weighing and entering again. Also writing down everything you eat and how many calories it is always reduces what I eat and I start to lose weight. I have one argument with the book, which by the way is free online, and that is he thinks a calorie is a calorie. I agree to some degree, but what you eat is super important, and by eating healthy calories rather than junk calories, you can lose weight without being hungry.
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Congratulations on starting down the road of self improvement! All of your observations are true -- I'd remind you, however, not to get discouraged by the day-to-day changes in your weight. The moving average should steadily decrease, but (as you remember from The Hacker's Diet) your daily weight can bounce around by 5-7 pounds due to the contents of your gut, water retention of your tissues, even the air dissolved in your bloodstream! One additional "trick" that I applied lately is carb loading, also known as refeeding. The idea is, once or twice per week, boost your calorie intake by 20-50% and make sure the additional calories are complex carbs: whole grains, potatoes, etc. This helps replenish the glycogen supply to your muscles (if you're weight training), but more importantly, it causes your adipose tissue to release leptin, a cytokine that curbs hunger AND promotes fat burning in your body's tissues. This can help "kick start" the metabolism and get it burning calories again. If you're feeling weak and hungry all the time, then you're not losing weight as fast as you could be.
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