CoolSculpting Guide: Top Questions and Answers

Approved by the FDA in 2010, CoolSculpting has quickly become a popular treatment for non-surgical fat reduction. The procedure freezes fat cells by applying the device to the area of stubborn pockets being treated.  

If you’re considering CoolSculpting, you probably have a lot of questions. We’ve drawn on the expertise of RealSelf doctors to bring you answers to the most commonly asked ones.

In this overview:

What is CoolSculpting?
Is it right for me?
How much does it cost?
How do I choose a doctor?
What happens during the procedure?
How much fat can I lose?
What happens to the fat?
How long do the results last?
What are the possible side effects?
What else do I need to know?

What is CoolSculpting?

CoolSculpting is an FDA-approved, non-surgical procedure that uses a handheld device to precisely freeze and destroy fat below the surface of the skin. The treatment is not intended for significant weight loss, but for treating stubborn areas of fat resistant to diet and exercise. Common treatment areas include abs, love handles, back, arms, and under the chin.

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Is CoolSculpting right for me?

Good candidates are men and women who exercise, have a healthy diet, and are within 20 pounds of their ideal weight. For those who are overweight or obese, Dr. Sheila Nazarian, a Beverly Hills plastic surgeon, offers this advice in a RealSelf Q&A: “Take the cash [you’d spend on CoolSculpting] and get yourself a good trainer for now!”

Since CoolSculpting uses intensely cold temperatures to crystallize and kill fat cells, you should not undergo the procedure if you suffer from cryoglobulinemia, paroxysmal cold hemoglobinuria, or cold agglutinin disease. Consult with a board-certified plastic surgeon or dermatologic surgeon to determine if CoolSculpting is right for you.

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How much does CoolSculpting cost?

While the average cost of CoolSculpting is listed around $2,000 on RealSelf, the price can vary widely depending on factors like the number of treatments needed and the geographic location where the procedure is performed.

Other factors that impact cost are the type of applicator used and the area being treated. There are multiple CoolSculpting applicators that come in various sizes, designed to treat different parts of the body. If you’re looking to target more than one area, ask your plastic surgeon if he or she offers a discount for a combination procedure.

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How do I choose a doctor for CoolSculpting?

Zeltiq, CoolSculpting's parent company, will only sell machines to medical professionals who have undergone specific training. That said, a physician is not the only one who can perform CoolSculpting. Nurses, nurse practitioners, and physician assistants may all manage a CoolSculpting treatment, with the appropriate training and under the supervision of a physician.

Zeltiq also offers special certification for practices that have gone through advanced training sessions. These CoolSculpting Certified Practices can be found on the company’s website.

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What happens during a CoolSculpting procedure?

When you arrive for your procedure, a medical professional will review and mark the area(s) being treated. A protective gel pad is then placed on the surface of the skin and excess fat will be pinched into the CoolSculpting applicator. You should not feel pain, only some pressure and suction for the first few minutes of the treatment. After that, the target area will become numb to the cold. The treatment will last roughly 60 minutes, during which you can read, check email, watch a movie, or even nap.

After the procedure is over, the treated area will be red and may appear as if there’s a “stick of butter” underneath the skin. This is the fat that’s been sucked up by the applicator. Your provider will massage the site, and the lump should quickly disappear. As this is a no-downtime procedure, you’ll be free to continue with your regular activities right away.

Below, a RealSelf community member describes her experience with CoolSculpting:

*Treatment results may vary

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How much fat can I lose after CoolSculpting?

In general, you can expect to gradually lose 20% to 30% of fat in the treated areas after one session. “Most patients see noticeable results within three months, but some may see results in as early as a few weeks,” says Dr. John Zavell, a Toledo, Ohio, plastic surgeon. “There is one major exception: Those who gain weight during the course of treatment. If you are serious about body contouring, you must avoid weight gain during treatment or your results will be poor.”

To get an idea of the types of results you can expect, here are three of the most viewed before and after photos on RealSelf:

Photo courtesy of Dr. Cynthia Mizgala
Photo courtesy of Dr. William Groff
Photo courtesy of Dr. Jeremy Pyle
*Treatment results may vary

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What happens to the fat?

When the freezing technology of CoolSculpting is applied to areas of excess fat, “the treated fat cells are crystallized, turned into dead cells, and naturally processed and permanently eliminated by the body, leaving you more toned and sculpted,” says Dr. Nazarian in a RealSelf Q&A. “We have ‘janitor’ cells called macrophages that find the damaged cells,” she adds. “[The fat] eventually gets excreted through your urine.”

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How long will my CoolSculpting results last?

As adults, we don’t produce new fat cells, so the number of cells destroyed and removed from the body remains permanent. That said, when we gain weight, our fat cells expand. Gaining weight after CoolSculpting could still mean an increase in the size of the remaining fat cells. Doctors recommend you focus on maintaining your ideal weight following the procedure.

*Treatment results may vary

Dr. Garry Kim answers the question, "Are CoolSculpting results permanent?"

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What are the side effects of CoolSculpting?

When performed by a qualified provider, CoolSculpting is very safe. Typical side effects include redness, minor bruising, tingling, numbness, or discomfort in the treated area. These are temporary and should resolve quickly.

RealSelf doctors report that some patients may experience more intense pain, particularly if they were treated with the largest applicator. “It is not uncommon to have delayed onset pain after a CoolSculpting procedure,” says Dr. Nazarian in a RealSelf Q&A. “This is more commonly experienced with abdominal CoolSculpting. It starts three to five 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.”

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What else do I need to know?

What’s the difference between CoolSculpting and liposuction?

CoolSculpting and liposuction are both intended to be body contouring procedures, but the treatment that’s right for you depends on your situation and desired results.

“CoolSculpting is one the best options for non-surgical fat reduction,” says Dr. William Groff, a San Diego dermatologist, in a RealSelf Q&A. “But the results do not really compare to liposuction. Liposuction can deliver dramatic results after one treatment, whereas CoolSculpting can only deliver a 20 to 30% reduction in fat and may require multiple treatments to reach a patient’s goal. CoolSculpting is great for patients who only need a small reduction in fat or who are averse to more invasive procedures.”

What happens if I get pregnant after CoolSculpting?

“CoolSculpting will not affect any future pregnancies,” says Dr. Richard Chaffoo, a San Diego plastic surgeon, in a RealSelf Q&A. “Your reproductive system is not affected in any way, and there are no risks to your baby.”

It’s important to note, however, that every woman’s body reacts differently to pregnancy. Should you get pregnant after CoolSculpting, you may need another procedure to restore your initial results. If you’re planning on getting pregnant in the near future, you may want to hold off on having CoolSculpting until after you’ve given birth.

Couldn’t I do this at home with ice?

While placing a bag of ice on your stomach might seem like it would produce the same results,  Dr. Zavell warned against trying this uncontrolled experiment. “A bag of ice will not provide sufficient cooling [deep below the surface] to kill the fat cells. Also, without the protective gel pad, applying such cold temperatures to the skin would cause damage to the overlying surface.”

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Have a question we didn't answer in this guide? Ask a doctor.

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The RealSelf Guide to CoolSculpting has been medically reviewed for accuracy by Dr. Sheila Nazarian. A Beverly Hills plastic surgeon, Dr. Nazarian is certified by the American Board of Plastic Surgery and trained in cosmetic, plastic, and reconstructive surgery. She spent her plastic surgery residency at USC, where she still serves as an assistant professor.

Disclaimer: This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional. Your reliance on any information or content provided in the guide is solely at your own risk. You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. RealSelf does not endorse or recommend any specific content, procedure, product, opinion, healthcare professional or any other material or information in this guide or anywhere on this website.

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