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 53

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

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 43 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 100 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.

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.


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 44 reviews

CoolSculpting Is Excellent for Fat Reduction

Since I first started using CoolSculpting at my practice in Atlanta, Georgia, it quickly became one of the most popular non-surgical treatments among my patients. The majority of women and men who undergo CoolSculpting to reduce pockets of fat find the procedure comfortable and return immediately to their normal daily activities once they leave my office. Some patients describe a tugging or pulling sensation at the beginning of the procedure, and swelling, bruising, redness, and numbness are common but temporary side effects. The bottom line is CoolSculpting is cleared by the FDA, has been performed worldwide millions of times, and is considered a safe and effective procedure.

Theresa M. Jarmuz, MD
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Risks with CoolSculpting

During the initial few minutes of your CoolSculpting treatment, some pain can be expected. Our patients have rated the initial suction of the hand piece followed by a cold burning sensation as mild to moderate pain. This pain will diminish once the area is numb, normally within 6-10 minutes after the treatment has begun. After treatment, numbness, tenderness to the touch, swelling, bruising, itching and burning can be expected. These side effects are easily managed with OTC pain medications, compression garments, or ice. Occasionally, late onset pain may occur 3-5 days post treatment and subside within 5-7 days. This has been described as prickly, stabbing pain, normally in the abdomen. Ask your doctor how you can manage late onset pain.

David L. Robbins, MD, FACS
West Des Moines Plastic Surgeon
4.5 out of 5 stars 26 reviews

Coolsculpting treatment and risks

Cool sculpting isn't painful to most.  About 15% find it painful. Bruising is sporadic. If you bruise easily, you'll probably bruise. 

Complications are rare.  Much safer than surgery. It's been studied for surgery and efficacy. 

Daryl K. Hoffman, MD
San Jose Plastic Surgeon
4.6 out of 5 stars 14 reviews

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.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 98 reviews

What does CoolSculpting Feel Like?

Once the CoolSculpting applicator is applied to the area of treatment the patient will initially experience a tight pulling, pinching, tugging, and cooling sensation. After a few moments the sensation will subside and the patient will be able to take a nap, watch tv, read a book, eat lunch, or relax. Following the procedure, it is possible the patient might experience slight bruising, sensitivity to the treated area, numbness, redness, and swelling.  Not every patient experiences these side effects and the side effects are only temporary.

Mark Pinsky, MD
Palm Beach Gardens Plastic Surgeon
4.5 out of 5 stars 11 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.