Zeltiq CoolSculpting - Pain, Bruising, Risks?

Although Coolsculpting is a non surgical procedure, it can cause the following side effects.
1. The suction accompanied by older applicators are much higher than the new applicators . Therefore the old applicators can cause bruising, can be more painful, and the post procedure neuropathic pain symptoms such as tingling, numbness is much higher compared to Cool-advantage applicators. The degree of discomfort depends upon the area, total number of treatments and the individual pain tolerance.
2. The discomfort with large applicators are much more than smaller applicators.
3. The risk of long term nerve damage is unknown.
4. The incidence of Paradoxical Adipose Hyperplasia is extremely rare and can be treated by liposuction.

The most common side effect after a Coolsculpting procedure is mild swelling and numbness over the treated area.  This usually subsides after a few days and does not cause significant discomfort in the majority of patients.  Occasionally, a more sever type of pain can occur, which is neurogenic in nature, and can be treated with Neurontin if the pain persists.  With the introduction of the new Cool Advantage applicators we have seen much less of these type of post Coolsculpting reactions, because the new applicator works without putting as much suction on the tissue.  It does seem to occur more commonly with the larger applicator vs the smaller, but again it is very infrequent now with the new applicators.  There can also be some minimal bruising post Coolsculpting as there is suction being applied to the treatment area, but if you do not bruise easily you most probably will not bruise from a Coolscupting procedure.  Patients on Aspirin or other blood thinners would be at higher risk for bruising post Coolsculpting, so if possible it is best to stop those for a few days before getting Coolsculpting.
Thank you for the question.
Best,
Dr. Flashner