CoolSculpting before and after photo courtesy of Dr. Chase Lay, board-certified facial plastic surgeon in San Jose, California. Results may vary.
CoolSculpting before and after photo courtesy of Dr. Chase Lay, board-certified facial plastic surgeon in San Jose, California. Results may vary.
CoolSculpting before and after photo courtesy of Dr. Chase Lay, board-certified facial plastic surgeon in San Jose, California. Results may vary.
CoolSculpting before and after photo courtesy of Dr. Chase Lay, board-certified facial plastic surgeon in San Jose, California. Results may vary.
CoolSculpting before and after photo courtesy of Dr. Chase Lay, board-certified facial plastic surgeon in San Jose, California. Results may vary.
CoolSculpting before and after photo courtesy of Dr. Chase Lay, board-certified facial plastic surgeon in San Jose, California. Results may vary.
CoolSculpting is a nonsurgical body contouring treatment that uses cryolipolysis (the medical term for fat freezing) to target and reduce stubborn areas of fat that have resisted diet and exercise.
First cleared by the FDA in 2010, this fat reduction procedure has become so popular because it freezes and destroys fat cells without harming the surrounding tissues, so it carries a low risk of serious side effects and comes with no downtime.
Over several weeks following the treatment, the body naturally metabolizes and permanently eliminates the fat cells.
CoolSculpting is FDA-cleared for treating stubborn pockets of fat on several areas of the body, including:
It's also FDA cleared to treat submental fat (commonly known as a double chin) and submandibular fat (under the jawline) with a smaller applicator called the CoolMini.Â
Providers commonly use CoolSculpting off-label (beyond its FDA approval) to tone knees, hips, and other stubborn fat bulges, like the mons pubis.Â
Dr. Jason Emer, a board-certified dermatologic surgeon in West Hollywood, California, uses this body sculpting treatment on its own, and to enhance the results of surgical fat removal procedures. âIt can be used as a spot treatment after liposuction or surgical contouring, to fine-tune or improve upon more dramatic surgical outcomes,â he explains.
âHaving a consultation with an experienced provider whoâs well-versed in fat reduction treatments is the best way to find out if this is the right choice for you,â says Dr. Lorrie Klein, a board-certified dermatologic surgeon in Laguna Niguel, California.
Pros
Cons
Your cost will depend on the details of your treatment plan, your providerâs credentials, their location, and a few other key factors. Most providers accept financing options like CareCredit.
As you're choosing your provider, look for CoolSculpting pictures with similar lighting, angles, and proportions. Pay special attention to patients with similar body types and areas of concern to your own, and note whether their results show smooth, natural-looking contours and a significant amount of fat reduction.Â
The CoolSculpting before and after pictures in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
Ideal candidates for CoolSculpting are healthy adults within 20 pounds of their ideal weight, with good skin elasticity (so it can bounce back once the fat is removed) and a body mass index (BMI) of 30 or less. Another requirement is having at least â of an inch of pinchable fat, to fit into the CoolSculpting applicator.Â
âThe best candidate is one that is already fit with small problem areas that are resistant to diet and exercise,â explains Dr. Emer. âThe bigger someone is, the more treatments needed to see an outcome, and the less substantial the results will be.â
Women who are pregnant or breastfeeding, or people with poor circulation, neuropathy, a pacemaker, or a defibrillator should avoid CoolSculpting treatment. You should also avoid this treatment if youâve been diagnosed with cryoglobulinemia, paroxysmal cold hemoglobinuria, or cold agglutinin disease.
If you have open or infected cuts or wounds, eczema, dermatitis, or a rash in the treatment area, you wonât be able to have this treatment until those conditions are resolved.
RealSelf Tip: A study published in the Aesthetic Surgery Journal in 2020, which summarized clinical best practices based on the experience of eight plastic surgeons with extensive CoolSculpting experience, notes that âthe authors prefer liposuction over cryolipolysis for patients who require significant debulking or who have a desire for immediate results.â Lipo is also preferred if the treatment plan involves fat transfer to add volume to another body area, such as the breasts or butt.
Related: Who Is a Good Candidate for CoolSculptingâand Who Isn't
CoolSculpting isnât a weight-loss solution: itâs a nonsurgical fat-reduction treatment thatâs intended for body sculpting.
As we mentioned above, itâs best for relatively fit people who are already close to their ideal weight and want to target specific areas of unwanted fat.
CoolSculpting takes 35 to 60 minutes, depending on the size and number of areas being treated. Some doctors offer âDualSculptingâ or CoolSculpting Elite, to target multiple treatment areas simultaneously and reduce treatment time.Â
Hereâs what to expect.
RealSelf Tip: Avoid alcohol for 24 hours prior to your treatment, to mitigate bruising.
Clinical evidence shows that CoolSculpting does work to reduce fat:Â
âCoolsculpting works, and impressively so,â says Dr. Cameron Chesnut, a dermatological surgeon in Spokane, Washington. âLike many things, it is all about patient selection and expectations.âÂ
How well it works for you will also depend on your provider, according to Dr. Chesnut. âIt is incredibly important that you pay attention to who you are seeing for this procedure, as it is really about the planning and assessment, not just putting the device on.âÂ
This isnât designed to be a cellulite treatment, but it may improve the look of cellulite in some patients by reducing stubborn fat that can bulge and dimple.
Itâs also not intended to tighten loose skin, but Dr. Emer says that âthere is some degree of skin tightening seen after each CoolSculpting treatment.â This claim is supported by a study published in the Aesthetic Surgery Journal in 2021, which found a significant increase in type I collagen in skin after cryolipolysis treatment. New collagen production can mildly firm skin over time, but anyone looking for dramatic tightening should talk with their provider about add-on treatment options.
The intense cold and pressure during the first few minutes of a CoolSculpting treatment can be uncomfortable and even painful for some people. The device's manufacturer says that âyou may experience sensations of pulling, tugging, mild pinching, intense cold, tingling, stinging, aching, and cramping at the treatment site.â
As the area becomes numb, these symptoms should subside. Some RealSelf members say they felt comfortable enough during their treatment to read, watch TV, or nap.
Applicator updates in recent years have made the treatment more comfortable and effective. âThe original applicators required significant suction to get each bulge of fat positioned between two cold panels,â explains Dr. Heidi Waldorf, a dermatologist in Nanuet, New York.
âTheyâve been replaced by the CoolAdvantage applicators, which provide full-surface cooling and, therefore, less suction. The positioning of the applicators on the patient is critical, to provide full contact. In fact, the applicators are set up to trigger an alarm and stop working if there is a âpop offââif the skin is not in full, direct contact with the applicator panelsâto avoid moisture accumulation and frostbite.â
According to Allergan, the device manufacturer, about 1 out of 6,000 treatments (0.017%) results in severe pain, which can develop âseveral days after a treatmentâ and resolve in âseveral weeks.â
CoolSculpting is FDA cleared and widely considered to be a safe cosmetic treatment option for good candidates.
Knockoff machines sold around the world sometimes find their way into stateside medspas and other practices, so make sure youâre getting the real thing. âThe concern with these devices is the lack of regulation and paucity of studies proving their exact technologyâincluding rate of cooling, max temps, standardizations, and safety precautions and triggers,â says Dr. Waldorf.Â
Dr. Emer underscores this concern. âI have seen numerous patients who were treated with knock-off devices that caused burns and irregularities, so beware.â
Read on to learn about the potential risks and side effects of fat freezing.
CoolSculpting side effects are usually mild and resolve on their own, but you and your provider should still discuss them prior to your treatment.
CoolSculpting also carries a risk of paradoxical adipose hyperplasia (PAH), an increase in fatty tissue at the treatment site. PAH happens when fat cells expand in reaction to extreme cold.
In reported cases, PAH occurred two to five months post-procedure, after an initial fat reduction.Â
The manufacturer says PAH has been estimated to occur in 1 out of every 3,000 treatment cycles (an incidence of 0.033%). However, a study reported in the 2018 issue of Plastic and Reconstructive Surgery suggests that it might have an incidence as high as 0.72%, or 1 out of every 138 cryolipolysis treatments.
âIâve never seen it, but I do discuss it as part of informed consent,â says Dr. Waldorf, and your doctor should too.
Dr. Klein agrees that itâs extremely rare. âWe have four CoolSculpting devices and have been using [the technology] for over 15 years. Weâve done thousands of cycles and I have seen only one case of PAH.â
Based on what heâs seen, Dr. Emer believes PAH is more of a risk when applicators have been used in areas that donât align with their FDA clearance.
The excess fat from PAH can be treated with liposuction, and Allergan will cover at least a portion of the cost of liposuction to treat confirmed cases of PAH.Â
Patients have to wait several months for the fat to soften, to reduce the risk of recurrence. Some patients even need two rounds of liposuction, as well as additional procedures, potentially at their own expense.
âIn my experience, most PAH needs at least VASER ultrasonic liposuction coupled with Renuvion or BodyTite internal heating, due to the fibrosis/scar tissueâwhich is completely unpredictable,â says Dr. Emer. âSome cases also need skin removal, to remove loose or hard skin and to surgically cut out scar tissue.â
Related: Linda Evangelista Says CoolSculpting âDeformedâ Her. Doctors Explain What Happened.
Most people donât need actual downtime after a fat freezing treatment, but there's still a recovery process that varies in intensity, depending on how your body responds and how many areas youâve had treated.
Hereâs what you can expect.
Related: What to Do During and After CoolSculpting to Get the Best Results
CoolSculpting swelling takes about two weeks to resolve, though it can linger for up to a month for some patients, according to Dr. Adam Hamawy, a plastic surgeon in Princeton, New Jersey. âI have seen patients who experience very minimal swelling for just a few days and others who feel swollen for up to four weeks. For the majority of CoolSculpting patients though, swelling has almost entirely dissipated within two weeks.â
You can minimize swelling by wearing a compression garment, drinking lots of water, and exercising.
Dr. Emer takes a more active approach with his patients. âWe find that two to three daily sessions of IV therapy with glutathione and vitamin C helps significantly decrease swelling,â he says. âOral diuretics can also be given, and hyperbaric oxygen therapy all help with healing. If you want to be aggressive with the amount of improvement, add a waist trainer daily for two to three weeks, at least overnight.â
âDoing a second treatment within 30 to 60 days can enhance your treatment results,â according to Dr. Lori Brightman, a dermatologic surgeon in New York City.Â
A study co-authored by Dr. Brightman shows that the first treatment triggers an inflammatory response around the fat cells that dissipates in 60 to 90 days. Having your second treatment within that 60-day window generates a stronger inflammatory response, leading to greater fat reduction.
You should start to see some results about 30 days post-procedure, with more significant results visible within two to three months of your final treatment.
Even after that, you may continue to see some improvement. âYour body will continue to eliminate the treated fat cells for up to six months post-treatment,â according to Mississauga, Ontario, plastic surgeon Dr. Frank Lista.
Why does the process take so long? âUnlike liposuction, where the fat is removed, CoolSculpting releases the fat to be metabolized and eliminated by your body,â explains Dr. Andrew Lyos, a plastic surgeon in Houston. The rate at which the fat is naturally eliminated depends on your own biological processes.
As weâve mentioned, you may need two or more treatments to see the results you want.
âResults are cumulativeâwe really can âsculptâ over time,â says Dr. Waldorf. âWith each subsequent treatment, you get a further reduction of the residual fat. We have a range of applicator sizes, so an area that required a larger applicator to start may be further reduced and contoured with a smaller applicator in later appointments.â
To help speed up results, doctors recommend a healthy diet and exercising at least 60 minutes a day. A 2015 study also recommends massaging the treatment area for five minutes immediately following the treatment. This can help increase fat volume reduction by up to 68%, over the next two months.
Dr. Waldorf says that metabolizing the dead fat cells âcan be expedited even more efficiently by using a radio-wave device, like the Zimmer Z-Wave Pro, to break up the crystals.âÂ
âUsing the Z-Wave reduces discomfort immediately post-procedure,â says Dr. Klein, who says itâs much more comfortable than manual massaging the treated area.
CoolSculpting results can be permanent, as long as you donât gain weight afterward. The fat cells eliminated after the treatment are permanently gone, but any remaining cells can still expand. Weight gain can even lead to contour irregularities, if more numerous fat cells in surrounding areas expand.
A healthy diet and regular exercise will help you make the most of your investment.
CoolSculpting University, Allerganâs official training program, offers training for a variety of medical professionals, including technicians, registered nurses (RNs), physician assistants (PA), and doctors. Â Dr. Klein says that some clinics even offer "Master Trained" CoolSculpting professionals, who have gone through an even more extensive CoolSculpting University training program.
When you book your treatment, ask who your provider will be and make sure youâre comfortable with their level of training and experience.
Itâs also important to ensure that a board-certified dermatologist, plastic surgeon, or another type of physician will be the one ensuring that youâre a good candidate and overseeing your treatment plan.
Emsculpt Neo is a body contouring procedure that uses high-intensity focused electromagnetic (HIFEM) technology to induce nearly 24,000 muscle contractions in one 30-minute session. Like CoolSculpting, it reduces fat, but it also offers muscle toning.
We dug into the difference between CoolSculpting and Emsculpt and found out that the two procedures can provide even better results when used together. Find out more.
Updated April 14, 2023