Are Coolsculpting results TRULY permanent? Also, are repeated treatments safe?

Dear kk94309:
CoolSculpting chills fat cells in the area(s) being treated to the point at which they enter programmed cell death, and they are slowly eliminated from the body. If you have a treatment that eliminates fat cells, those cells will die and not return. When you gain weight, all the fat cells of your body get larger because they need to store more fat, and when you lose weight, they all get smaller. Without any treatment, you have a given number of fat cells at birth, and that number does not change throughout your lifetime (with the exception of someone who is severely obese, in which case the cells can increase in number), but with treatment, the number of cells in the treated area is permanently reduced. Those cells will not be replaced with new cells, and you will reduce the volume of fat in the area you treat. And you will put less fat on in the treated area with weight gain than you would have had you never had the treatment. Relative to the rest of your body, you will always have less fat in the treated area than you did before. 
The reduction in fat is visible and I have found the treatment to be reliable and reproducible, in that every patient has the same response. 
Now, it can appear that some of the fat has returned even when it hasn't, since there are factors that influence the amount of fat that will be stored in the fat cells in different areas of the body. For example, cortisol and insulin allow more fat to be stored in the fat cells deep inside the belly. So if you are severely stressed chronically, and/or eat foods that are digested very quickly often (foods with a high glycemic index, such as sugary desserts, white bread, rice, and potatoes), over time more fat may be stored around the organs in your midsection (visceral fat). If this happens, even though the layer of subcutaneous fat (under your skin) has fewer cells and less fat because of CoolSculpting, your tummy can protrude from deposition of fat much deeper, within the abdominal cavity.
But the area that has been treated with CoolSculpting will permanently have fewer fat cells, and there will therefore be less fat deposited under the skin in the treated area(s). This is true sculpting of the distribution of fat in your body.
Repeated treatments are safe, just as safe as the first treatment. Pregnancy has no effect and there are no long term side effects on the fat or the body, such as increased risk for cancer or long term fat damage. Programmed cell death is the end stage of every cell in the body, and our cells are constantly turning over  is this mechanism and being replaced. In this case, they die slowly and in a way that is natural to the body, but they are not replaced. I do hope this answers your questions.
All the best, 
Dr. Clark 

Thank you for your question.  Coolsculpting is a great way to shape the body from unwanted pockets of fat.  If done in an artistic fashion, it can help to dramatically shape the body.  Regarding longevity.... Coolsculpting works by permanently destroying fat cells, and as an adult, our bodies do not normally generate new fat cells.  However, any remaining fat cells can either store more energy (i.e. get larger) or release energy (i.e. get smaller).  Thus fluctuations in weight can influence your results.  The most important thing is to find a trusted provider who can determine if you are a candidate for Coolsculpting or if different options can provide better results.  I would visit with a board certified plastic surgeon who specializes in non-invasive, minimally invasive and surgical options for your concerns.