Since CoolSculpting Freezes Fat to Kill It, Why Not Just Repeatedly Apply Ice Bags?

I had a free consultation for Coolsculpt and have read online about the 'popsicle' studies that led researchers to exam whether freezing fat to kill the cells would be effective for spot fat reduction. This led to Coolsculpt. But if this method is effective, why couldn't one apply ice bags on fat bulges and gradually destroy the fat cells?

Doctor Answers 59

CoolSculpting does not freeze fat!

You are obviously a curious and thoughtful person, and ask a question that the original creators of the CoolSculpting device had to consider carefully.

There is a misconception that has been widely circulated, perhaps for the sake of simplicity, that Coolsculpting freezes fat. This is not actually the case. The device has been carefully and cleverly designed to extract heat from the tissues via the application to the skin of cold, but not freezing, plates.  The temperature of the skin in contact with the plates is continuously monitored throughout the entire procedure, and the temperature of the plates altered according to that feedback such that the skin and fat will never freeze but rather be chilled.  

If you were to apply something frozen to the skin, you might reach temperatures that would injure fat cells, but you would also get frostbite in the overlying skin. If you were to apply something not quite frozen to the skin, it would rapidly warm up and you would never reach a temperature cold enough in the the fat layer to injure the fat cells.

The reason the device, and only a device such as this, can injure fat cells without damaging the overlying skin, is because of a  simple but wonderful difference in a physical property of water and fat: the freezing temperature.  The temperature at which fat freezes is higher than the temperature at which water freezes.  Since skin has a lot of water and fat doesn't, you can applying below-freezing plates to the skin that are not cold enough to freeze the skin, but cold enough to chill the fat cells just enough that they are gently shifted into a process called apoptosis, or programmed cell death, and therefore die off slowly, one by one, during the months after treatment.

i hope this answers your excellent question.


New York Dermatologist
5.0 out of 5 stars 8 reviews

Controlled Cooling With CoolSculpting

The CoolSculpting device has been engineered to provide controlled and precise cooling at a consistent temperature for a period of time necessary to cause a natural death of the fat cells without damaging the surrounded skin, nerves, blood vessels, tissues, etc. This is what makes the treatment so safe. There is no way that this can be accomplished by applying ice bags. Ice bags will cause inconsistent freezing at an inconsistent temperature. This will lead to the same clinical manifestations as frost bite, with damage to the skin and surrounding tissues. Please do not try anything like that.

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 reviews

Coolsculpting is controlled cooling- its okay to eat popsicles!

The fat must be a specific temperature for a specific period  of time to trigger fat cell death. While the initial popsicle cases stimulated the idea, cool sculpting was developed through extensive scientific research that identified the precise temperature and time period needed to stimulate fat cells to die and to do this without causing skin damage. The combination of isolating the fat in the suction chamber and maintaining controlled cooling allows for safe, smooth, and reproducible results. If only ice bags would do it!

It is important to note, the children had prolonged contact with extreme cold before the cheek fat wa affected- so do not worry about eating popsicles!

Andrea Willey, MD
Sacramento Dermatologic Surgeon

Icepacks instead of Coolsculpting

This will not work and poses a danger as Coolsculpting does not freeze the skin. Coolsculpting is a cold application just above freezing. Keep in mind freezing skin will injure the skin- whereas Coolsculpting is specifically designed to apply temperatures that kill fat but do not injure skin at a temperature below freezing. Coolsculpting works excellent. .

 

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Zeltiq's CoolSculpting can not be duplicated with application of icepacks to the skin

If one were to try to freeze the fat by freezing the skin with ice long enough, the skin would die and this necrosis would heal with scarring probably.  There also can be cirulatory changes to the skin.  Zeltiq has been able to preserve the quality of the skin by localized the temperature reduction in the fatty tissues.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Can the effects of CoolSculpting be replicated by the application of ice bags

CoolSculpting is performed using a device that rather than delivering cold actually extracts energy (thereby cooling) the tissue.  The device carefully monitors this process with continual feedback so that the temperatures achieved are such that the fat will freeze but not so cold that other tissue such as skin, muscles, nerves or blood vessels will.   One could never monitor such a process with the use of an ice bag.  It is highly unlikely one could deliver cold enough temperatues to the fat with an ice bag alone and even if one were able to do so,  you will most likely freeze the overlying skin.  As a result of the freezing of the skin,  a scar will be induced.  

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

Coolsculpting is the advanced technology of gradual fat tissue cooling, not of fat freezing.

Dear writer, your question is a very important one. By answering it I hope to satisfy your curiosity and also keep your approach to fatty tissue reduction safe. Coolsculpting utilizes a very specific algorithm for gradually extracting the heat from the fatty tissue. This may be called cooling, but never freezing. This algorithm, carefully studied and designed by world renowned scientist and engineers, is what makes this technology so safe, as well as effective. Putting icepacks repeatedly over the areas of excess fatty tissue may lead to frostbite, permanent loss of skin sensation and undesired atrophy or indentation of the area (because the very carefully anatomically designed shape of the noninvasive suctioning 'cup' is not used). Lastly, patients may bring themselves to a state of low body temperature (hypothermia) that could, in some cases, caused death. Your question was a very genuine and important one. I hope I helped clarify your concerns. With regards, Dr. Leyda Bowes

CoolSculpting Avoids Frostbite

Jenny,

This is a great question and one that gets asked frequently.  The CoolSculpting handpieces are very sophisticated instruments that continuously monitor the skin's temperature.  CoolSculpting delivers a very specific temperature (somewhere above the freezing point of water) that causes damage to the fat cells, but not the skin cells. This avoids frostbite, which will happen if you apply bags of ice to the skin. The difference in temperature between fat cell injury and skin cell injury is very small.  Because of this, it's important to delivery the cold temperature in a very precise manner.  That is the beauty of Coolsculpting.  

Hope that helps.

Dr. Garry Kim 

Coolsculpting vs ice bags

Hi there,

Its a thoughtful and intelligent question.

The CS machine actually extracts heat from the tissues, has built in sensors, and maintains a certain temperature where only fat cells are being frozen, and skin and underlying tissue are not. Applying ice packs to the skin would result in frostbite, skin and underlying tissue damage. Also, the applicators on the machine have a vacuum that sucks in the treatment area for maximum effect, something that cant be done with ice packs.

Hope this clears it up!

Shamim Shakibai, MD
Los Angeles Physician
5.0 out of 5 stars 9 reviews

Ice applied to the skin is NOT the same as coolsculpting

Coolsculpting is not just the application of 'ice'.  Coolsculpting freezes the fat below the skin without damaging the skin itself.  The temperature of the fat must be reduced to a specific temperature in order to induce crystal formation and breakdown of the fat cells.  The applicators used are associated with specific treatment cycle times necessary to achieve that temperature at the required level of fat.  The combination of the special applicators used to grasp the area of fat to be treated and the temperature and contact monitoring that alerts us if the area becomes too cold or the applicator loses contact with the skin before the end of the specified cycle ensures that the cold will freeze the fat, not the skin.  

Just applying an ice bag to the skin will lower the temperature of the skin slightly - the ice will also melt as the heat of the skin warms the ice.  The cold will not reach the level of the fat.  

The difference in the 'popsicle' example is that fat necrosis (killing the fat cells) was caused by a popsicle held in the mouth of a child in one position for a long period of time (so called 'popsicle panniculitis').  The mucous membrane in the mouth does not have the thick stratum corneum of outside skin and the fat layer is very closely adherent to it.  That is very different than applying ice (or a popsicle) to the outside skin.  It is also not a common phenomenon which says the temperature and contact have to be just right to make it possible in nature.

I hope that answer helps. Best wishes.

Heidi A. Waldorf, MD
New York Dermatologist
5.0 out of 5 stars 10 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.