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 53

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 Dermatologic Surgeon
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.

Pramit Malhotra, MD
Ann Arbor Plastic Surgeon
4.6 out of 5 stars 82 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 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
Great Neck Dermatologic Surgeon
5.0 out of 5 stars 31 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 .

Ruth L. Hillelson, MD, FACS
Richmond Plastic Surgeon
4.4 out of 5 stars 12 reviews

Long-term Effects of CoolSculpting

If you maintain a healthy diet and get regular exercise you can expect the results of CoolSculpting to last you a lifetime.  The fat cells are permanently killed with the patented controlled cooling CoolSculpting treatments for long lasting results. If the applicators are applied correctly and messaging to the area is administered the results should not come out lumpy, the results are very consistent. Thinner patients with bulges usually have great results in 1 to 2 treatment to the same area.  Patients that require more fat to be removed should consider something that removes more fat.  We would recommend  VASERlipo®, where we remove more fat in 1 treatment. 

Daniel Taheri, MD
Los Angeles Dermatologic Surgeon
3.6 out of 5 stars 11 reviews

Coolsculpting Not Damaging To the Body

It makes you wonder how does Coolsculpting just target fat and nothing else, right? That is what makes Coolsculpting such a great treatment.  The scientists who created CoolSculpting learned that the fat that does not respond to diet and exercise does not like a cold environment; it prefers the Bahamas vs Iceland. It was then tested that this fat has a different freezing point temperature. As such, it can be frozen at a lower temperature to freeze and kill it off while meanwhile bypassing the skin, nerves, muscles, organs, etc. This is why only fat is targeted. 

Many are concerned about "lumps" from the Coolsculpting treatment. This can be possible when two things happen. One, where a fat bulge is not fully targeted, leaving an area treated and the adjacent area not targeted, leaving the appearance of a lump.  Or, when a "best case scenario" is experienced and such a sort of "dent" is experienced. This typically happens when a true "bulge" was not targeted. 

This is why a consultation is always required so that one may assess which areas are best to treat, and which are best to refrain from.  

Edward Stokes, MD
West Hollywood Physician
5.0 out of 5 stars 4 reviews

Long term effects of CoolSculpting

CoolSculpting protects the skin on the surface with the gel pad so that only your fat cells are destroyed with the controlled freezing under the skin. The long term results are permanent fat reduction. We've never seen any lumpiness in over 2000 treatments given. One of the most important considerations is which hand piece to use and where it is applied for best body contouring results. Thinner patients with a bulge here and there will have great results in probably 1 treatment vs someone with more fat may need 2 treatments to the same area. For some patients with more fat to be removed we would recommend SmartLipo, where we remove more fat in 1 treatments.

Emerico Csepanyi, MD
Newport Beach Physician
4.3 out of 5 stars 6 reviews

Long Term Effects of CoolSculpting


Thanks for your question. There are no known long term negative effects of CoolSculpting. It is important to understand that CoolSculpting is not a weight loss treatment. It is for exercise and diet-resistant pockets of fat in people that are at or near their ideal weight. The cooling provided by CoolSculpting is controlled to avoid damaging other tissues.

Janet Turkle, MD
Indianapolis Plastic Surgeon
4.8 out of 5 stars 61 reviews


Coolsculpting is a safe procedure that results in a 20-25% reduction in fat with each treatment.  The way it works is that due to differences in water content fat freezes at a different temperature than skin and this device will regulate temperature during the treatment to selectively freeze fat and not skin or blood vessels.  After effect can very rarely include paradoxical hyperplasia and unevenness.  The best way to optimize your treatment is to treat with someone who has a lot of experience.  Good luck with your treatment.

Michelle Ellern, DO
Livingston Physician
5.0 out of 5 stars 3 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.