Why Do Some Coolsculpting Patient Report Little Pain and Others Report Severe Pain?

Is there a reason why there are such different responsed to the level of pain with coolsculpting?

Doctor Answers 28

Reactions to CoolSculpting treatment

Thank you for your question.

The CoolSculpting method is based on science performed by the Wellman Center for Photomedicine at Massachusetts General Hospital in Boston, Massachusetts. Research determined that fat cells are more vulnerable to cold temperatures and when introduced to these cold climates are effortlessly and permanently demolished. Beginning weeks after the cooling application, the cooled fat cells initiate the process of solidifying the fat cells without destroying surrounding tissues, eventually causing the cells to shrink and disappear naturally. Gradually as the cells diminish, the depth of the fat layer will be reduced.

Each patient is different with how they respond to this procedure.  Usually, patients experience more of the achy, tingly, etc when the procedure is performed on the abdomen vs. other areas. It really is patient specific.


Some CoolSculpting patients experience little-to-no pain and others more than that

It is very normal to feel tender in the area that has been treated with the CoolSculpting technology. Depending on the area, one may also experience a tingling sensation and slight numbness in the area. It is all normal. After all, we are permanently destroying fat cells by cooling them to a specific temperature. A small percentage of people experience a more intense pain and it is generally when they are treated with several "applicators" in the abdomen area. Once the patient receives the proper medications to manage the pain, it is generally not an issue. Very few of our patients state that the treatment was a 'painful' one. As we are the first in the province of Quebec and in the city of Montreal to have brought on the technology, we also have developed ways to increase post treatment comfort and minimize discomfort. It is certainly nothing compared to having to go under the knife!

Manish Khanna, MD, FRCP(C)
Montreal Dermatologic Surgeon
4.5 out of 5 stars 11 reviews

Is there pain with CoolSculpting?

In my San Antonio Plastic Surgery office I very rarely have patients complain of pain.  The few that do have pain seem to be those who have had the larger head used.  Also, those with pain may have been treated with a setting that was too high.

Suresh Koneru, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 17 reviews

CoolSculpting and pain

The CoolSculpting developed based on the research from Wellman Center for Photomedicine at Massachusetts General Hospital in Boston, Massachusetts. They confirmed fat cells are more vulnerable to cold temperatures then the surrounding supporting tissue. It is possible to cause fat to die and disappear without damaging the supporting connective tissue and overlying skin. Zeltiq has really perfected this technique with their CoolSculpting device.

Coolsculpting procedure is usually fairly pain free but there is a small percentage of clients who report moderate to significant pain when their nerves are trapped in the fatty tissue that is dying. The pain usually resolve within a few weeks with massage and analgesic. Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) can also be helpful.

My CoolSculpting nursing team at my clinic have a lot of experience with these clients and you are welcome to contact us if you have additional questions.

Colin Hong, MD
Toronto Plastic Surgeon
4.5 out of 5 stars 34 reviews

Any Pain with Coolsculpting

I would first like to say, the finesse of the technician is incredibly important in delivering an enjoyable treatment day and our patients report little to no discomfort during treatment in our CoolSpa; some even report it as the most relaxing day they have had in a while! 

Approximately 98% of our Coolsculpting patients will experience only subtle swelling and discomfort in the first 48 hours following the procedure and any soreness remaining will subside over the course of the next several days. In rare cases (approximately 2% of Coolsculpting patients) some may experience discomfort 5-7 days following treatment with varying intensity. This is due to the nerves reanimating following treatment with cold temperatures when the nerves are put "to sleep". It's important to have the procedure done under the supervision of a physician so that these rare cases can be afforded comfort with the use of a prescription nerve blocking agent. Our patients know we have a physician on call 24 hours a day, 7 days a week, to see to their needs should this issue arise albeit unlikely. Your Coolsculpting provider should always have a comfort plan for you and should be able to answer the question "What are you able to do for me should I experience discomfort in the days following my procedure?"

Many of my own staff have been treated and are more than happy to share their own experiences and before and after photos!

Coolsculpting Pain or no Pain

In our San Diego medical spa, we educate our patients about the coolsculpting procedure so they know what to expect. While pain is generally minimal, the initial vacuum sensation when the applicator is applied can cause a bit of anxiety for some patients. This is amplified somewhat with the larger CoolMax head. Once the cool is applied, our patients generally relax, watch a movie or sleep, and even enjoy a light snack. For more anxious clients, light oral sedation is also available.

Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews

It depends on the area

  • Certain areas are more sensitive then others and each patient’s sensitivity level varies. If discomfort is felt initially, patients find that as the treatment progress it becomes much more comfortable.

Sam M. Sukkar, MD
Houston Plastic Surgeon
5.0 out of 5 stars 24 reviews

Coolsculpting and Pain

You asked a very important question that I would like to answer.  Coolsculpting is a painless procedure.  The arms, abdomen, legs, flanks, and outer buttock areas only have minimal discomfort for the first few minutes until the applicator freezes the area after several minutes.  However, the abdominal area can be uncomfortable in some patients for a few days to weeks after the procedure.  This discomfort feels much like doing a "hundred sit-ups".  In a rare subset of patients they may have pain in the abdominal area afterwards since the nerves were irritated and may require analgesics.  The most important thing is to consult a board certified dermatologist with a great deal of experience with coolsculpting for the best cosmetic results.

Pain after Coolsculpting

I do find with most procedures that there is a wide variety of discomfort.  As a general rule, I have found the following:
1)  Abdominal treatments tend to have more discomfort than other body regions
2)  Those with a greater degree of tissue pull into the applicator have greater discomfort
The majority of patients return to their normal activities afterwards, and a minority may need some medication support to help with the discomfort.  I would make sure you do your treatments at a place with a lot of Coolsculpting experience and who can help manage the post-procedure concerns.


The pain depends on the size of the applicator and type of tissue treated. We have had very few patients with any sign pain after Coolsculpting, but in all those occured in patients who had the abdomen treated with the large applicator. We attribute our success to the use of percussion devices that helps distribute the temperature gradient across the tissue and reduce the chance of tissue damage and nerve irritation.

Amir Moradi, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 7 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.