Zeltiq CoolSculpting - Pain, Bruising, Risks?

Does Zeltiq hurt? What are the risks? Does it depend on how much suction/temperature doctor uses as to if there is bruising/pain afterwards?

Can Zeltiq cause nerve damage? Cause Other problems? Can the suction pressure be controlled by the dr? Is the Bigger suction more painful than using 2 smaller suctions for the stomach? Pre/post treatment care? How long has it been being used in the states? in Europe? What are the complications?

Doctor Answers 56

Pain Bruising and Risks associated with CoolSculpting

We have been using CoolSculpting here in the office for about a year and have used about 400 treatment cycles. Given the patient population that we have treated so far we have seen a range of feedback with regard to pain associated with the procedure. Some patients seem to handle the procedures much easier than others. What I have seen is that of the patients who express any concern about pain it is generally more associated with the days after treatment than the day of treatment itself and the sensation that I most often hear patients complain of is a pins and needles kind of sensation or a burning sensation under the skin in the treated area(s). It seems that most complaints come from the treatment of the lower abdomen. I have had the procedure done on myself on my flanks and abdomen and found that the most discomfort that I had personally was in the lower abdomen where my belt rides. The discomfort that I experienced lasted a few weeks post treatment but I have already seen a significant reduction in the fat layer where I was treated and I couldnt be happier with my result.


Houston Plastic Surgeon
4.8 out of 5 stars 104 reviews

What to Expect

Coolsculpting is very well tolerated by most of my patients. Most patients experience an intense suctioning feel in the treatment area accompanied by moderate discomfort and a burning/stinging sensation as the applicator begins to get colder. After about the first ten minutes, the discomfort subsides and my patients are able to relax for the remainder of the treatment hour. The suction pressure is controlled by the Coolsculpting technician, but there is minimum suction necessary for each of the different applicators. My patients do seem a bit more uncomfortable with the larger applicator opposed to the two smaller, so I typically use the two smaller in succession. Aftercare is comprised of massaging the area, wearing good compression garments, and being patient! Most patients will experience some nerve discomfort in the remaining weeks including tenderness, numbness, tingling, and possibly some sharp/shooting pains. These are all temporary and typically indicate a successful treatment.

Michael E. Ciaravino, MD
Houston Plastic Surgeon
4.8 out of 5 stars 115 reviews

Zeltiq Coolsculpting risks and side effects

Zeltiq is one of the safest procedures available, especially among fat reduction procedures.  It was FDA-approved for fat reduction in September of 2010 and has been safely used in Europe for approximately 5 years.  The reason why it is so safe is that the cold exposure is not to such an extreme that it immediately kills fat cells;  rather, the cold exposure initiates natural programmed fat cell destruction, which is why it takes 2 months to see the results.  The exposed fat cells naturally degrade and the byproducts excreted by your body.  The only contraindications to undergoing Zeltiq is if you have rare conditions of cold-intolerance. 

The procedure may be slightly uncomfortable during the first few minutes of treatment, but it is more of an odd pulling and cold discomfort than pain and gradually turns into a barely noticeable numbness.  This odd feeling is greatest with the largest treatment head/applicator, and less with the small and medium applicators.  Immediately after the procedure, the treated area may have mild to moderate tingling, numbness, and soreness.  Mild bruising is sometimes seen, but is uncommon.  The soreness may last for 2-3 days and feels like the muscle soreness you get after a round of intense exercise.  The tingling and numbness feels just like the sensation your skin has after intense cold exposure.  It lessens over time and is usually limited to 2-3 weeks.  Zeltiq does not cause long-term nerve damage.

With standard settings, there should be little if any bruising or pain.  Sometimes the vacuum settings are increased in thinner individuals to get proper exposure of the treatment area to the cold applicator.  The higher suction could increase the chance of bruising, though it is still usually minimal and limited.  The temperature is currently not altered in the current model of the Zeltiq device.

When a device like this comes along that claims to be so effective with so few risks, it is usually too good to be true, but with the Zeltiq device, it is both good and true.

Pain from CoolSculpting

It is not uncommon to have bruising, swelling and delayed onset pain after a Coolsculpting procedure. This pain is more commonly experienced with abdominal Coolsculpting. It starts 3-5 days after the procedure and can last 10 days or so. This pain is nerve based and is best treated with Neurontin. Ask your physician to prescribe you some.
Best of luck,
Sheila Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 51 reviews

How Long Will Pain/Bruising Last

Bruising is patient specific and normal. It is a consequence of patient selection and is also location specific. We find that some patients bruise more than others and to a varying degree in different locations. Skin Changes--- Most patients experience transient skin changes at the treatment site after the procedure. When the applicator is removed, the tissue appears red and raised, and feels cold and firm. Transient mild bruising may occur around the edges of the site. These changes begin to resolve within a few minutes of the procedure. Mild bruising, and/or minor swelling may arise in the days following the procedure but typically resolve within a week. Occasionally, a patient may have an atypical skin reaction. For example, bruising or swelling may take longer to resolve or the site may become red, warm and tender. These atypical reactions may be due to individual characteristics that make the patient more sensitive to the procedure.

Jay Burns, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 42 reviews

Coolsculpting

Every patient is different in terms of pain response and side effects during and after.  It is not uncommon to have some bruising, swelling, and pain due to temporary nerve injury.  The pain can start several days after the treatment and continue for a number of days after that.  Medication can be used to help with the pain.  Good luck with your treatment.  

Michelle Ellern, DO
Livingston Physician

Pain, Bruising, Risks

Zeltiq does not cause permanent nerve damage usually. While some temporary nerve pain from inflammation can occur, normal sensation occurs within 2 weeks. Bruising is rare, but can occur with improper placement. Suction pressure can be controlled by the doctor but there is a standard protocol. There is no pre-treatment care, and post treatment protocols vary by area.

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

Coolsculpting Provides Improvement in Body Contour That lasts!

Hello and thank-you for your question

CoolSculpting is a great, FDA-approved treatment for fat reduction of the abdomen and flanks. Coolsculpting relies on Cryolipolysis due to the fact that fat cells are more sensitive to cold than are other tissues. We utilize the new Cool Advantage applicators which are much more comfortable and reduce treatment time to 35 minutes.  We currently have 4 Coolsculpting machines and can offer "Dual Sculpting" which further reduces the treatment time.  It can be used safely for off-label treatment of the upper arms, inner/outer thighs, bra-strap area, chin, and above the knees. The advance cooling technology selectively targets and eliminates fat cells gently and gradually without affecting the surrounding tissue. Patients in our office have seen an average fat reduction of 20-25% with each treatment. Depending on the patient's body composition and outcome goals, it generally takes more than one treatment to achieve optimal results. A second treatment is general scheduled 30 to 45 days after the initial treatment. It takes about 2-3 months to get a general idea of the final results. The results are long-lasting as long as you maintain a stable healthy lifestyle. I recommend scheduling a consultation with a Board Certified Plastic Surgeon well versed in all aspects of body contouring to determine if your an ideal candidate for CoolSculpting.


Best regards,

Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 54 reviews

CoolSculpting - How it feels before and after

When the Coolsculpting applicator is initially applied it may feel uncomfortable.  There is a tugging and pulling sensation which will lessen after the first five to ten minutes.  At that point, the area of treatment is numb and comfortable.  Following the treatment, there may be redness, bruising and swelling in the area.  This can last for up to two weeks.  Clients may also experience late onset pain 3-5 days following the procedure.  This is nerve pain and may  last  2-3 days.  It goes away as quickly as it comes.

CoolSculpting

The FDA approved procedure of CoolSculpting takes advantage of cryolipolysis which describes the targeted destruction of fat cells through cold temperatures. Fat cells experience injury through cooling leading to permanent removal of these susceptible cells. Numbness, redness, swelling and bruising are not uncommon after a treatment but resolve over short period. You should consult the Zeltiq website to find a qualified facility.

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.