Can the coolsmooth applicator be use effectively on pinchable fat area like lower ab to avoid delayed nerve pain?

Question

Can coolsmooth applicator use on pinchable fat area lower ab to avoid delay nerve pain? had extreme delay nerve pain for 3 weeks on my lower ab from using traditional suction applicator(1 hr). All the pain was coming from the belly button area. I had coolsmooth applicator done to upper abdomen & no delay nerve pain. I believe the suction from applicators causes delay nerve pain. I understand the new suction applicator (35 minutes) have less pain but I rather not take a chance.

Ramandeep Sidhu, MD · Answer

Great question. First of all I am sorry to hear that you are having nerve issues but it should get better over time. As far as the applicators are concerned the flat applicator without suction can be used but it will be hard to get full contact and you will have below average results. If the fat is pinchable the standard applicators are preferred. Now the new advantage applicators have less incidence of all the side effects so might be worth trying so that at least you get good cryolipolysis.

Edward Stokes, MD · Answer

Thanks for your question.  I would not recommend using the CoolSmooth Plus applicator on the lower abdomen.  That applicator is specifically designed for areas that are not pinchable. But, I can tell you that we have treated thousands of lower abdomens with the newer CoolAdvantage (35 min) applicators, and have not had even one patient complain of late onset pain. You will see that the entire experience is completely different and so much more comfortable using the Advantage applicators.  I think you will get much better results using the applicator that is designed for the lower abdomen.  Good luck with your CoolSculpting journey!

Marcia Fleming, MD · Answer

Coolsmooth applicators can be used on areas other than the outer thighs but this does not mean you will not receive any nerve pain in the treatment area.  More importantly, the outer thighs applicator is not usually the right shape for areas like lower abs.  A better treatment with pinchable stomach fat is to use the new Cooladvantage series of applicators which were designed to be faster, more comfortable and product less side effects/downtime.  Since we started using these applicators over year ago, we have not seen any incidences of nerve related issues and our clients continually report that they are way more comfortable than the original series!

Michelle Ellern, DO · Answer

Each person and each treatment in the same person can have a different response with regards to nerve pain.  If you have this issue please speak with your treating physician about it and have them start you on medication to ease this discomfort.  There does seem to be a reduced incidence with never pain with the new applicator. Good luck with your transformation.

J.D. McCoy, NMD · Answer

There is still similar post treatment numbness and tenderness post cool smooth.  The newer applicators have less incidence of post treatment nerve pain, however the addition of acoustic wave massage (Z-wave or Cellutone) after any coolscuplting treatment has the most dramatic reduction of ALL post treatment issues.  From my experience, the most important thing with the CoolSmooth applicator is it typically requires two treatments to get the best result (I set that expectation with patients so that we shoot for the best result possible).  Single treatments with the non-smooth applicators can be enough for many patients, but the smooth requires a double treatment 90% of the time.  Cheers!

Vinay Aggarwal, MD · Answer

The CoolSculpting applicator has seen fantastic results on the abs, including the pesky fat on the lower side of the belly. There shouldn't be any sort of nerve pain, and the general numbness of it all will subside within a couple of weeks at most. I would consult with your physician if the "nerve" pain continues.

Warren B. Seiler III, MD · Answer

This is a great question, people
who have experienced the delayed nerve pain typically do not want this feeling
again. If you have fatty tissue that you can pinch, you want to use a suction
applicator for optimal results. This allows the tissue to be pulled away from
nerves and muscles to get optimized cooling.  You are right in that the newest CoolSculpting technology uses "cups" instead of "parallel plates" and the risk of nerve pain after the procedure is extremely low.  
The smooth plate was designed for
outer thigh and areas where you have fatty tissue that can not be
pinched.  I have experience with both suction applicators, and I have
not had anyone experience the delayed nerve pain with the newer applicator
(35min). It is more comfortable during the treatment and after.  I would
suggest pursuing treatment on the lower abdomen with the new CoolAdvantage
Applicator for best results. 
Hope this helps!

Vincent A Marino, MD · Answer

Thank you for asking this question. Delayed onset nerve pain has to do with how the nerves regenerate after being exposed to the cold. Each patient reacts differently, even from body area to body area. We've treated patients in the same area with the same applicators a second or third time who have had different sensations from treatment to treatment. If the nerve pain is keeping you from your daily activities the physician where you were treated should be able to provide you with Gabapentin or other nerve medication.
 The applicator placement is based on which applicator is the best fit for the tissue in that area, and so the CoolSmooth applicator is used rarely on the abdomen, if at all. The newer CoolAdvantage applicators have the benefits of a more effective treatment and shorter exposure time to the cold, which has shown more positive patient experiences overall with regards to numbness and nerve pain post treatment. Depending on how your body responds to this first round of treatment, another assessment may be necessary around your 90 day mark to see which applicator would be best for you going forward.
I hope this helps, best of luck!

Alain Michon, MD · Answer

Thank you for your question. CoolSculpting is great at removing pinchable fat. Your CoolSculpting provider will choose the applicator that has the best fit for the treated area. The new Advantage applicators are more comfortable, quicker and treat slightly a bigger surface area than the older applicators. However, delayed nerve pain may still happen with the Advantage applicators. Also, on occasions we choose the older applicators instead of the Advantage as they offer a better fit for some patients. I hope this help. Please see a Cool certified practice. All the best, Dr. Michon

Nicholas Tarola, MD · Answer

Thank you for your question.  The delayed nerve pain should have nothing to do with the type of applicator used.  The choice of applicator is based on which applicator provides the best "fit" for the area to be treated.  You would not want to use an applicator that does not appropriately fit.  There are certain medications that can be used following the treatment to help with nerve pain.  Discuss with your practitioner.  Best wishes!

Can the coolsmooth applicator be use effectively on pinchable fat area like lower ab to avoid delayed nerve pain?

Answers (12)

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