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 30

Reactions to CoolSculpting treatment

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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

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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
4.6 out of 5 stars 27 reviews

CoolSculpting and pain

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During the CoolSculpting procedure, there will be intense cooling for a few minutes. Some people find this uncomfortable, but the area soon becomes numb and people can relax and feel quite comfortable during a treatment. Following the treatment most people continue with their day normally with little to no discomfort. Over the course of a few days, some people feel mild discomfort similar to the feeling one might have after a workout. On occasion, significant discomfort has been reported. The patients who experience significant discomfort are almost always patients who have had treatment with a single large applicator administered to the lower abdomen area.  In my practice, we offer compression garments like the ones we use for patients following tummy tucks or liposuction. This has seemed to provide additional comfort and support to patients. On occasion, a patient might find relief with a non-narcotic pain medication called Neurontin.  This can be prescribed by the doctor or the physician assistants and nurse practitioners in the practice. However, most patients do not require medication following a CoolSculpting procedure.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Pain Tolerance in CoolSculpting Varies

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Each patient has a different pain threshold that may affect how he or she responds to any procedure, including CoolSculpting. Generally, patients may feel a sensation of cold or tingling when the applicator is first applied. This subsides after a few moments and the rest of the procedure tends to be pain free. The area that seems to be most susceptible to pain sensations is the lower abdomen. If you know you have a low pain threshold, you can request a non-narcotic pain reliever to handle tenderness after the procedure. However, most patients do not need it and are able to return to their normal routines immediately with mild soreness for a week or two. There is a rare pain syndrome that occurs three to four days after the procedure in which pain increases. This is highly unusual, but if it happens, there is a medication to reduce discomfort.  We’ve also found that wearing a Spanx or other shapewear for three to four days after the procedure helps to minimize discomfort. Please see a board-certified dermatologist to find out how to get rid of your stubborn fat.

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 20 reviews

Coolsculpting Provides Improvement in Body Contour That lasts!

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Thank you for your question. It is not uncommon to have delayed onset of pain around 5 days after Coolsculpting.  The discomfort is due to inflammation of the tissue. Nor everyone has pain or numbness The intermittent discomfort tends to subside within a week. It generally takes about 1 to 2  weeks for the swelling  subside. I do recommend compression for 3 weeks to help with these symptoms.  We utilize the new Cool Advantage applicators which are much more comfortable and reduce treatment time to 35 minutes.  We currently have 4 Coolsculpting machines and can offer "Dual Sculpting" which further reduces the treatment time.  I recommend keeping in touch with the office of your treating provider and regular follow-up.  Best wishes.

Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 65 reviews

Is there pain with CoolSculpting?

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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
4.4 out of 5 stars 18 reviews

CoolSculpting and pain

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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
4.6 out of 5 stars 40 reviews

Any Pain with Coolsculpting

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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

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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

It depends on the area

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  • 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
4.6 out of 5 stars 40 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.