Long-term Effects of Coolsculpting?

I'm seriously considering getting Coolsculpting done on my love handles and stomach. I've read up on it, but can someone explain to me why it only damages the fat cells and nothing else? And also, does it ever come out "lumpy?" I'm worried about long-term side effects. Also, are the results more dramatic or thinner people or those with more weight to remove? Thanks :)

Doctor Answers 41

Long Term Effects of CoolSculpting?

To date there are no long term negative effects of CoolSculpting.The reason it only damages fat cells is that fat cells will freeze at higher temperature than other tissues. The reason the other tissues such as skin, nerves and blood vessels are not frozen at these same temperatures are that they are water based.   The device carefully controls the cooling process so that the temperatures achieved are such that the only the fat will freeze but are above the freezing point of other tissues inside the applicator. Regarding your second question, CoolSculpting gives a very NATURAL looking reduction without issues of lumpiness nor hanging excess skin. Finally, the ideal patient is the one who is close to their ideal weight with moderate to small bulges.  However, that is not to say that the procedure does not work in larger individuals.  As with all procedures proper expectations are critical.  I have treated individuals who are less than ideal and they have been extemely gratified by their results.  One does have to ensure that they understand that complete elimination of their bulge will not happen and if desired multiple procedures can be performed for additional fat reduction.  Having accepted this, they are more than thrilled to produce undeniable results with one treatment that does not require any surgery, needles, anesthesia nor downtime!  

Long Island Dermatologist
5.0 out of 5 stars 4 reviews

Slight depression in the tissue with Coolsculpting

Coolsculpting does not typically leave lumpy areas although that is why massage is important after the procedure.

There can be a small shallow indentation where the device was applied, and for that reason when the device is applied it should be placed where this would be to the patients/ advantage.  Meaning a slight indentation would improve the overall results.

Coolsculpting targets fat cells.

As many have said, Coolsculpting really targets fat cells, there is no other tissue damage from this treatment. The results are very consistent, and if applied correctly for each patient the results should be very smooth. I have not seen any patients with any lumpiness. For best results 2 sessions are usually recommended and people who are in "good shape", and are candidates for Coolsculpting will have the most impressive results.
- Dr. P.

Kaleroy Papantoniou, MD, FAAD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 24 reviews

The freezing temperature of a fat cell is why coolsculpt only affects fat cells.

The freezing temperature of a fat cell is why coolsculpt only affects fat cells. The gel pad placed prior to the handpiece application protects the skin from freezing.  I have not personally seen irregularity after treatment. And I have done many ! Liposuction and some laser Lipo methods can result In irregularity and in skin laxity over time. Coolsculpt does not do this when applied correctly and with an aesthetic eye. The results are more dramatic for localized fat. The patients who are best candidates are not badly overweight. So all body types can have nice responses and the drama depends upon the localization of the fat .

Fat Cells Freeze at a Safe Temperature

Thanks for your thoughtful question. CoolSculpting works because fat cells freeze at higher temperatures than other tissues. The device operates at a temperature that is low enough to trigger the breakdown of fat cells — but not skin, muscle, and other cells. This is why it's so important to visit a qualified practitioner who uses a genuine CoolSculpting device, rather than any other off-brand "fat freezing" machine. CoolSculpting has been thoroughly studied, and lumpy, uneven results are uncommon. Keep in mind also that it's not ideal for large-volume fat reduction. Instead, it's meant for small areas of unwanted fat on people who are otherwise in good shape. I hope this helped answer your questions.

Mark E. Freeman, MD
Idaho Falls Plastic Surgeon
4.8 out of 5 stars 8 reviews


Coolsculpting is best when performed on an area that has an excess number of fat cells.  For example, women say, "When I gain weight, it goes straight to my belly."  That means that you were born with more fat cells in your abdominal area.  It would be great to perform coolsculpting in that area to reduce the number of fat cells there and make that are more proportional with the rest of your body.  Then, if you gain weight, it will be more evenly distributed over your body.  It won't just "go straight" to one area.

We have our patients wait 2 months before re-treating the same area.  This allows enough time for the cells to be
cleared out.  Because we have so much experience with Coolsculpting, we can tell you before we treat how many times you can expect to have the treatment performed.  The fat loss is permanent after Coolsculpting.  You typically lose 20-25% of the fat in the area treated, each time you treat it.  I have done it to myself and my staff.  It is truly effective and has no down time

All the best,

Sheila Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 44 reviews

Coolsculpting affects only the Fat, not the Skin

The reason that it does not affect the skin, is that fat cells are much more susceptible to cold than the skin. The Coolsculpting technology applies just enough cool to affect the fat, but not enough to affect the skin. Typically, the fat loss is smooth in the area treated. The only way that you may get uneven loss or what appears to be lumps is by improper placement. The key is to look for a Certified Coolscupting practice. This ensures that you have technicians that have been properly trained in the technique.

Maiysha Clairborne, MD
Atlanta Family Physician
5.0 out of 5 stars 2 reviews

CoolSculpting Has Few Side Effects and Excellent Long-Term Results

CoolSculpting is an excellent choice to target resistant fat areas, such as the “love handles” and stomach. The reason it targets fat cells without affecting other tissue is that it uses a patented method called cryolipolysis(TM), which sufficiently lowers the temperature on the area being treated to freeze fat cells and kill them, but does not lower it enough to freeze the water present in other cells. At the same time, the device is applied with a cool gel pad to protect the skin while freezing the fat as an added safety measure. Therefore, there are few if any side effects from CoolSculpting, and only very rare long-term adverse results have been reported. If the device is applied properly, and the fatty bulges marked carefully, there should be no “lumps and bumps”. After the device is removed, we apply the Zwave device to further break up the frozen cells.  This helps to get smoother results and even more loss of fat.  You are correct in intuiting that CoolSculpting works best on people who are already fairly near their ideal weight and simply would like to remove stubborn areas of fat to which they may be genetically predisposed. Schedule a consultation with a board-certified dermatologist and find out how CoolSculpting can help you.

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 15 reviews

Long term effects of coolsculpting

CoolSculpting is a very safe procedure with few long term effects. The main one would be paradoxical fat cell hyperplasia which is a rare complication that can lead to increase in fat. Also improper application can result in debts and lumpy appearance. In our practice the ideal candidate is within 15 pounds of their ideal body weight. Someone who is obese is not a candidate for the CoolSculpting procedure. It is best to consult with an expert to determine if CoolSculpting is right for you

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 20 reviews


CoolSculpting is a FDA approved, non-invasive way to use controlled cooling to target and kill only fat cells. Many patients are satisfied with their result after just one treatment.  Some patients return to have the same area treated a second time for more noticeable results.  CoolSculpting is safe and currently, no information on negative long term effects is available.  A consultation should provide you with answers to all of your questions.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 45 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.