Is Any Damage Done to the Skin During the Fat Freezing Process?

With the freezing technique, if the fat is frozen, what's happening to the skin? Isn't the skin frozen? Damaged? Why doesn't the skin die?

Doctor Answers 16

The key to CoolSculpting is that fat freezes at a higher temperature than water.

The key to CoolSculpting is that fat freezes at a higher temperature than water. Because the skin has a high percentage of water, it doesn’t freeze as readily as the fat does. When the CoolSculpting applicator is placed on the area, the underlying fat freezes but the skin is just cold, not frozen. This is why this procedure is so successful. No other tissues are damaged, just the fat cells.

San Francisco Dermatologist
5.0 out of 5 stars 2 reviews

CoolSculpting Only Freezes Fat

CoolSculpting by Zeltiq uses a patented process called cryolipolysis(TM) to lower the temperature of fat cells sufficiently to freeze them, triggering apoptosis (cell death). However, the temperature is not sufficiently low to freeze water, skin, or other tissue. The skin may be numbed from the cooling process and will probably redden slightly for a short time, but the effect is not permanent. There is a gel pad placed between the skin and the application to further protect the skin. In some delicate areas, an anti-freeze wipe is also rubbed on the skin.  Don’t worry, you won’t get frostbite from CoolSculpting! Any side effects, such as redness, soreness, bruising, or tingling, usually resolve within hours to days. Please see a board-certified dermatologist to find out how CoolSculpting can help you.

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 17 reviews


Coolsculpting is an excellent form of non-invasive  fat reduction for the right patient. Some applicators take 1 or 2 hours but the new advantage applicators take only 35 minutes and have significantly less risk for delayed onset pain (especially in the abdomen). Results are seen at 2 months and typically 1-3 treatments will be necessary on each area to achieve ideal results. The number of treatments depends on the amount of fat there and the patient's goals.  There is not downtime and the results can be impressive in the right patient.  We also use the Zimmer Z-wave for improved patient comfort and added results. The best candidates are those who are in pretty good shape with areas of stubborn fat that won't go away no matter what. The skin is well protected during the treatment.

My best,

Sheila Nazarian, MD, MMM

Beverly Hills, Board Certified Plastic Surgeon

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Is There damage to the skin during Coolsculpting?


Zeltiq, the manufacturers of Coolsculpting designed a feedback from the measurement of the skin temperature back to the machine.  This is a safety feedback so the machine will not run if the skin temperature appears to be dropping too low.  This is to avoid any cold burn of the skin.  An error message will show up on the machine and the machine will stop.  So no, because the machine is intelligently designed, there is no damage to the skin!


Dr. Liu

Grace Liu, MD
Newport Beach Dermatologic Surgeon
4.9 out of 5 stars 50 reviews

CoolSculpting Will Not Damage Skin

CoolSculpting doesn’t burn, shatter or extract any cells. Developed by Harvard scientists, the procedure uses a targeted cooling process that kills the fat cells underneath the skin, literally freezing them to the point of elimination. Only fat cells are frozen. Your healthy skin cells will remain unharmed. 

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

CoolSculpting and your skin

Your skin stays protected by a gel pad that is placed between your skin and the machine. The temperature that the machine cools down to only affects the fat cells, which in turn keeps the skin from getting frost bite.

                                                                                                   All the best "Dr. Joe" Gryskiewicz

Joe Gryskiewicz, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 269 reviews

Cool sculpting and Skin Damage?

Thank you for the question.The cool sculpting device  is able to “target” the adipose cells because the skin is protected (with gel pads)  during the procedure. Freezing of the skin cells requires a lower temperature than does adipose cells.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

CoolSculpting freezes and kills the fat cells not skin

The scientists of Zeltiq worked out the temperature sensitivities and determined at what temperature the fat cells would perish before the epdiermal cells. It is a selective process and the skin is preserved.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Coolsculpting procedure done properly protects the skin from freezing.

The coolsculpting device requires that gel pads are placed on the skin to protect it during the procedure. The skin does not freeze because it is protected.

Laurie A. Casas, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 90 reviews

Coolsculpting and the skin

Coolsculpting is a very controlled and sophisticated piece of equipment that applies a temperature that is specific for killing fat cells and is not low enough to damage epidermal (skin) cells.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 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.