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What Is CoolSculpting and How Well Does it Work?

May 5, 2022

Woman undergoing CoolSculpting treatment

Medically reviewed by: Siw Sleight

When love handles, back fat, arm fat or other bulges aren’t budging despite dieting and exercising and you don’t want to resort to surgery to shrink them, CoolSculpting offers a non-invasive alternative. It takes less time to undergo than watching an episode of your favorite Netflix show, and it has quickly become one of the most popular body contouring procedures. But exactly what is CoolSculpting, how well does Coolsculpting work, and most important, is it safe? 

Siw Sleight, a body contouring and aesthetics specialist at Water’s Edge Dermatology, answers these questions about CoolSculpting and more.  

What is CoolSculpting?

woman undergoing coolsculpting on her neck

CoolSculpting is the brand name of the only non-surgical, FDA-approved method of cryolipolysis, or fat freezing. It’s approved to reduce fat cells in these nine areas:

  • Under the chin
  • Under the jawline
  • The back
  • The area between the breast and armpit (the “bra bulge” area) 
  • The upper arm 
  • The abdomen
  • The flank (“love handles”)
  • Under the buttocks (“banana roll” fat)
  • The thigh

“Many people like CoolSculpting because it’s a great alternative to liposuction,” said Sleight. “Unlike with liposuction, no anesthesia is necessary, and patients don’t have to worry about infections, scarring or downtime. Plus, CoolSculpting is less expensive than liposuction.”

The procedure is fairly simple. After marking the area to be treated, the provider places gel pads over the skin to protect it, then uses a handheld device to suction fatty tissue into a “cooling cup.” The device is left in place for about 30 to 40 minutes. The cold temperature freezes the fat cells, which eventually destroys 20% to 25% of them. It doesn’t damage the skin or other organs, which are less sensitive to cold temperatures than fat cells. When the device is removed, the provider massages the area to soften the tissue.

Sleight recommends patients get a second treatment one month after the first for best results. Areas with larger pockets of fatty tissue may require additional sessions.

Does CoolSculpting work?

Sleight said her patients have been very happy with their CoolSculpting results. “Many of them come back to have other areas treated because they love the effects,” she noted.

Studies of CoolSculpting are limited, but according to one research review published in the Journal of Cosmetic Dermatology, most patients who underwent the treatment were highly satisfied.

You won’t see results overnight. That’s because it takes time for the fat cells to break down and be eliminated by the body. Most people will notice the improvement in two or three months, though some may notice changes in just one month, according to Sleight. Once the fat cells are eliminated from the body, they are gone forever.

Am I a good candidate for CoolSculpting?

CoolSculpting is for healthy adults who eat right and exercise but can’t get rid of stubborn bulges of fat. It’s not intended for people with a weight problem who want to lose weight.

“CoolSculpting reshapes your body, but it’s not a weight loss procedure,” Sleight explained. “You lose volume, sometimes even inches. Your pants will fit better, but you won’t see a difference on the scale.” 

To be considered a candidate for CoolSculpting, your body mass index, or BMI, must be 30 or lower. Consult a BMI chart or BMI calculator to determine your BMI. As an example, a woman who is 5’5” and weighs 175 pounds has a BMI of 29.

Depending on the area you want to treat, the procedure may not be recommended for you if you are pregnant or lactating, you have a neuropathic disorder such as post-herpetic neuralgia or diabetic neuropathy, or you have a condition that involves an unusual reaction to cold temperatures, such as cryoglobulinemia, paroxysmal cold hemoglobinuria, cold urticaria (hives that result from cold exposure) or Raynaud’s disease.

Other conditions and circumstances may also make you a poor candidate for CoolSculpting. 

Your provider will evaluate you during a consultation appointment to make sure CoolSculpting is right for you. 

Does CoolSculpting hurt?

CoolSculpting can be uncomfortable at times, but the discomfort is tolerable. You may feel a tugging or pinching sensation when the fatty tissue is suctioned into the device, and the coldness can cause tingling and aching. These effects don’t last long since the area goes numb within 10 minutes.

The most uncomfortable part is the massage, Sleight said, but it takes only two minutes, and it’s not something you want to skip. “The massage is important because it helps kill fat cells that were only partially destroyed during the treatment.” 

Is CoolSculpting safe?

CoolSculpting is generally a low risk procedure. Side effects such as redness and bruising are usually mild and temporary. In rare cases, patients have developed a complication called paradoxical adipose hyperplasia (PAH), a visible overgrowth of fatty tissue in the treated area. Liposuction is one option for correcting PAH, according to Sleight. 

How long does CoolSculpting last?

CoolSculpting results are thought to last indefinitely as long as you continue to eat right and exercise. Two case studies published in the Journal of Cosmetic Dermatology followed patients for six and nine years, respectively, after the procedure and the effects hadn’t diminished.

Written by: Jessica Brown, a health and science writer/editor based in Nanuet, New York. She has written for Prevention magazine, jnj.com, BCRF.org, and many other outlets.

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Water’s Edge Dermatology is a leading full service dermatology practice providing medical dermatology, surgical dermatology, pediatric dermatology, cosmetic dermatology, skin cancer treatment, and plastic surgery, and Vein Centers. Water’s Edge Dermatology has 37 office locations throughout Florida.

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