CoolSculpting Guide: Top Questions and Answers

Reviewed for medical accuracy by Dr. Sheila Nazarian in April 2016

CoolSculpting in ActionApproved by the FDA in 2010, CoolSculpting has quickly become a popular treatment for non-invasive fat reduction. The technology behind the procedure arose from the study of the effects of freezing temperatures on the body. Perhaps the most popular example is known as “popsicle panniculitis.” When a popsicle was placed between the cheek and the gums, scientists noted that the cold caused swelling, firmness, and inflammation. When the swelling would go down, the cheek would be thinner — often producing a dimple in response to the death of fat cells in the cheek. Using this research, the Zeltiq company created CoolSculpting in order to achieve similar results on other areas of the body.

If you’re considering CoolSculpting for fat reduction, 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 questions.

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 that are resistant to diet and exercise. Common treatment locations include the abs, love handles, back, arms, and underneath the chin. Back to top

Is CoolSculpting Right For Me?

CoolSculpting is intended for body contouring, not major weight loss. Ideal candidates are men and women who exercise, eat a healthy diet, and are within 20 pounds of their ideal weight. For those who are overweight or obese, Beverly Hills plastic surgeon Dr. Sheila Nazarian offers this piece of advice: “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. Back to top

How Much Does CoolSculpting Cost?

While the average cost of CoolSculpting is listed at 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.

Perhaps the biggest factor in the cost of CoolSculpting is the size of the applicator that’s needed to treat the desired area. As of now, CoolSculpting applicators come in three sizes: mini, medium, and large. “The mini is typically $750 to $900 per applicator,” explains Dr. Nazarian. “The medium applicator costs $600 to $800, and the large typically costs $1,200 to $1,500.”

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. Back to top

How Do I Choose a Doctor for CoolSculpting?

Zeltiq, the company who manufactures CoolSculpting, will only sell their machines to physicians 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, so long as they’ve also had training and are 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. Back to top

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 will then be 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 on your device, or even take a nap.

After the procedure is over, the treated area will be red, and for many, look 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 dissipate quickly. As this is a no-downtime procedure, you’ll be free to continue with your regular activities right away. Back to top

How Much Fat Can I Lose After CoolSculpting?

In general, you can expect to gradually lose 20 to 30% of fat in the treated area after just one session. “Most patients see noticeable results within three months, but some may see results in as early as a few weeks,” says Toledo plastic surgeon Dr. John Zavell. “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 kind of results you can expect, below are three of the most viewed before and after photos on RealSelf. Back to top

CoolSculpting 1Photo courtesy of Beverly Hills plastic surgeon Dr. Sheila Nazarian

CoolSculpting 2Photo courtesy of Raleigh plastic surgeon Dr. Michael Law

CoolSculpting 3Photo courtesy of Marina del Rey plastic surgeon Dr. Grant Stevens

What Happens to the Fat After CoolSculpting?

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. Sheila Nazarian. “We have ‘janitor’ cells called macrophages that find the damaged cells,” she adds. “[The fat] eventually gets excreted through your urine.” Back to top

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. Back to top

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 on their own.

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,” explains Dr. Sheila Nazarian. “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.” Back to top

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 unique situation and desired results.

“CoolSculpting is one the best options for non-surgical fat reduction,” says San Diego dermatologist Dr. William Groff. “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,” assures San Diego plastic surgeon Dr. Richard Chaffoo. “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 With Ice at Home?
While placing a bag of ice on your stomach might seem like it would produce the same result, Dr. John Zavell warns 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.”

Have a question we didn't answer in this guide? Ask an expert plastic surgeon.

More to Explore:
See more before and after photos
Read reviews from real patients
Find plastic surgeons offering this treatment in your area

The RealSelf Guide to CoolSculpting has been medically reviewed for accuracy by Beverly Hills plastic surgeon Dr. Sheila Nazarian. Dr. Nazarian is certified by the American Board of Plastic Surgery and trained in cosmetic, plastic, and reconstructive surgery. She completed undergrad at Columbia University and holds a medical degree from Yeshiva University. She spent her plastic surgery residency at USC, where she continues to serve as an assistant professor. Learn more on her RealSelf profile.

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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