CoolSculpting, or cryolipolysis, is a nonsurgical body contouring procedure. A plastic surgeon uses a device to freeze fat cells under the skin. Once the fat cells have been destroyed, they are gradually broken down and removed from the body by the liver.
Most CoolSculpting sessions take around an hour and cost about $1,000 per treatment area.
CoolSculping is a fairly new technique, only approved by the United States Food and Drug Administration (FDA) in 2012. CoolSculpting and cryolipolysis are registered trademarks of Zeltiq Aesthetics.
While the number of independent clinical research studies backing the procedure is still relatively small, Zeltiq Aesthetics claim CoolSculpting lowers the amount of fat cells in the treatment area by between 20 and 25 percent.
Most people start to notice the effects a few days after the procedure, but it often takes 1 to 4 months for the full results to show.
Although research is still limited, CoolSculpting is generally viewed as a safer, non-invasive type of fat reduction surgery than traditional procedures, such as liposuction.
Most people do not feel anything during the procedure, aside from a tugging sensation where the skin is between the device's two cooling panels.
As the procedure does not involve any cutting, tissue manipulation, or anesthesia, most people do not need any recovery time and can immediately resume normal activities.
The only noticeable side effects of the procedure tend to be minor and occur only around the area of treatment. Most minor side effects reduce or go away within a few days to weeks after the procedure.
It is normal, however, to experience numbness or loss of sensation in the treatment area for around a month.
Common immediate side effects of CoolSculpting include:
- pinching sensation
- minor swelling
- skin sensitivity
- mild to moderate pain
- muscle cramping
A person may continue to experience these side effects for a few weeks after the procedure. Other common side effects that a person may experience in the first few weeks after CoolSculpting include:
- itchiness, especially a few days after the procedure
- diarrhea, as dead fat cells are removed from the body
- a feeling of fullness in the throat after treatments involving the neck or chin region
The risk of side effects and complications often depends on the medical professional performing the procedure.
People should make sure to choose an experienced, trusted professional, such as a dermatologist or plastic surgeon. Individuals can do this by researching local options and asking questions before committing to the procedure.
CoolSculpting is relatively new, and so the full extent of risks, side effects, and complications associated with the procedure is still unknown.
A 2017 study reviewing all available research papers from two major medical research databases found only 319 studies linked to the terms cool sculpting, cryolipolysis, fat freezing, and lipocryolysis.
As it is relatively new, few medical professionals are aware of the procedure or have much experience with it
CoolSculpting is also only approved and proven effective on a limited number of body areas.
Body regions where CoolSculpting is considered safe and effective for removing minor fat deposits include:
- under the chin or upper neck
- under the armpit
- buttocks and under the buttocks
CoolSculpting is considered a safe, effective way to reduce the number of fat cells in a small target area. It is not considered a form of weight loss and not recommended for the treatment of obesity.
The procedure is designed to help dissolve stubborn fat cells that usually only shrink through diet and exercise.
People with weakened immune systems are not ideal candidates for surgeries such as CoolSculpting. People with certain conditions that weaken or change the body's ability to handle the cold can also experience serious medical complications.
Conditions that rule out the use of CoolSculpting include:
- pregnancy, attempting to become pregnant, and breast-feeding
- cryoglobulinemia, a disorder where proteins that usually only increase in response to cold are in abnormally high concentrations
- cold agglutinin disease, an autoimmune condition where temperature change kills red blood cells
- paroxysmal cold hemoglobinuria, a condition where red blood cells die in response to temperature change
- Raynaud's disease
- reduced circulation or skin sensation at the treatment area
- nerve conditions, such as diabetic neuropathy
- skin conditions related to the immune system, such as eczema and psoriasis
- inflammatory skin conditions, such as dermatitis and hives
- a recent injury to the skin area being treated, including scar tissue
- long-term use of blood thinning medications
- bleeding conditions that thin the blood
- history of a hernia or a hernia in or near the treatment area
- active, implanted medical devices, such as pacemakers
- allergy to propylene glycol or isopropyl alcohol
- chronic pain conditions
- severe anxiety disorders
In some very rare cases, fat cells respond to CoolSculpting by enlarging rather than dying. This condition is called paradoxical adipose hyperplasia (PAH).
A 2014 study reported the incidence of PAH with CoolSculpting is currently thought to be around 0.0051 percent.
Researchers are not sure why PAH occurs, but most people who develop the condition are men. While PAH does not cause any symptoms aside from changing physical appearance, only surgery can reverse it.
Additional rare complications that may occur after CoolSculpting include:
- pain that starts several days after the treatment and usually resolves when numbness goes away, or after about a month
- scarring or changes to skin color
- reduced movement or response of the tongue following procedures involving the neck or chin
- lower lip muscle weakness following procedures involving the neck or chin
- reduced saliva production and dry mouth following procedures involving the chin or neck
- frostbite, or first- and second-degree freeze burns
- dizziness, light-headedness, sweating, painting, nausea, and flushing
- hyperpigmentation, or dark skin coloration that often resolves on its own
- subcutaneous induration, a generalized hardness or specific hard nodules that develop in the treated area and can be painful
- abrupt and undesirable changes in fat layering
One benefit of CoolSculpting is that, unlike with diet and exercise, fat cells are actually destroyed and removed from the body. This means the same fat cells cannot return or enlarge with weight gain.
There are several other benefits of CoolSculpting:
- It is a low-risk procedure for most people.
- The skin barrier is not broken or compromised, removing most of the risk of complications, such as infection and scarring.
- There are few reported adverse reactions or outcomes.
- There is no need to take time off from work or everyday activities afterward.
- The results look natural, as they develop gradually in the weeks following the surgery.
- It can help people who have lost weight or at a healthy weight but still have excess fat in particular areas.
- There is less risk of regaining weight and results are long-lasting because fat cells are actually destroyed and removed from the body.
- The risk of skin dimpling or bumps is low because fat cells are destroyed evenly across a patch of skin.
Overall, the procedure can help boost self-confidence, especially when combined with weight loss achieved through a healthful diet and exercise.
There is not much independent research on CoolSculpting at present. What research exists suggests that it is a low-risk option for removing small amounts of fat that is proving difficult to remove with diet and exercise.
People who are interested in this form of treatment should discuss it first with their doctor. They can help decide whether it is the right option, or if there are more suitable ways for removing unwanted fat.