Does CoolSculpting Actually Work?
Key takeaways:
CoolSculpting is a treatment that uses cryolipolysis — a process that freezes fat cells. It’s designed to change the shape of certain areas in the body.
CoolSculpting is FDA approved to treat nine areas of the body. People use it to target belly fat, love handles, the upper arms, and more.
CoolSculpting isn't intended to be a weight-loss treatment. It’s just meant to spot reduce fat in specific areas.
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There are many types of treatments that can help with weight-loss goals. But they don't help you spot reduce fat. So, people who want to get rid of fat in specific areas of their body are turning to something called CoolSculpting.
CoolSculpting is the brand name for cryolipolysis, or fat freezing. It's a noninvasive, body-contouring treatment, meaning that it shapes your body. It works by freezing fat cells to reduce fat in specific areas of the body.
Here, we review the benefits and risks of CoolSculpting so you can decide if it's the right treatment for you.
How does CoolSculpting work?
CoolSculpting uses a suction device that's placed on the area you want to reduce fat. The device freezes the fat cells in that area over the course of 35 to 75 minutes. The duration depends on the area.
The localized cold temperature causes the fat to crystallize. And when it crystallizes, it injures the wall of the fat cell. "The body recognizes that injury and then eliminates the fat cell," said Terrence Keaney, a board-certified cosmetic dermatologist who offers CoolSculpting treatments in his office.
Fat cells are more sensitive to the cold than other types of cells are. So the cold destroys the fat cells without harming the surrounding skin or muscles.
What is fat freezing? CoolSculpting is cryolipolysis, which is also called fat freezing. Our experts go over some basic facts about the process.
What does liposuction feel like? One woman describes her experience with the procedure and its recovery.
How much does CoolSculting cost? Since the procedure isn’t covered by insurance, it helps to know the typical cost beforehand.
CoolSculpting is FDA approved to treat the following areas of the body:
Abdomen
Flanks (love handles)
Thighs
Under the jawline
Under the chin
Under the buttocks (banana roll)
Upper arms
Back fat
Bra fat
The CoolSculpting machine has one applicator to treat one area at a time. The CoolSculpting Elite machine has two applicators to treat two areas at once. It comes with more targeted applicators for a better fit.
Each session may be a little different, based on the machine and the body area that’s being treated. But in general, here's a step-by-step of a typical CoolSculpting treatment:
First, you start with a consultation. You and the healthcare professional will discuss what you're looking for, and if you're a good candidate for the treatment.
The treatment area is marked with a pencil. Then, a gel pad is applied to the area to protect the skin.
A suction applicator is applied to the skin over the gel pad. It gently pulls the fat into the device and starts the freezing process.
You'll feel a light vacuum pressure and an intense cold. After about 10 minutes, the treated area will become temporarily numb. This part lasts around 35 to 75 minutes.
The applicator and gel pads are removed. Immediately after, the area is vigorously massaged for 2 minutes. This helps break down the frozen fat cells.
How long does CoolSculpting last?
CoolSculpting permanently kills fat cells. Once the fat cells die off, they can't grow back.
The body doesn’t create new fat cells. "So, if you gain weight, that fat will be more evenly distributed across the body,” Dr. Keaney said. “It won't necessarily accumulate where those previous fat cells were."
That means the results are permanent.
But CoolSculpting doesn't kill all the fat cells in a specific area. The remaining fat cells in the treated area still exist. And they can grow in size if you gain weight, which can affect your overall results.
What are the benefits of CoolSculpting?
CoolSculpting is a non-invasive treatment that contours the body with permanent results. It can target many areas of the body, especially those where you might not see much improvement with weight loss.
Research suggests that CoolSculpting is an effective treatment. One review reports that it can reduce fat underneath the skin by 10% to 25% after one treatment. The areas it seems to work best on are the abdomen, back, and flanks.
Typically, it takes 1 to 3 months to see results after a treatment. Full results can take 6 months or more.
CoolSculpting may also provide a second benefit: skin tightening. When CoolSculpting first came out, there were concerns about whether it could cause loose skin. "It's almost like deflating a balloon," said Dr. Keaney. "But research shows it can actually improve skin tightening."
CoolSculpting has a few other benefits compared to treatments like liposuction:
It doesn't use any needles or require anesthesia.
Research shows cryolipolysis is also safer than liposuction and associated with fewer risks.
Since there’s no recovery time, you can go about your day after getting treated.
What are the risks of CoolSculpting?
Even though CoolSculpting has fewer risks than invasive treatments, it still has some risks.
A review looked at about 1,500 people who had cryolipolysis. And it found complications in less than 1% of cases. The most common side effect was numbness in the treatment area that lasted more than 4 weeks. Other side effects included:
Pain
Redness
Bruising
Itch
The biggest risk of CoolSculpting is something called paradoxical adipose hyperplasia (PAH). This happens when treated areas experience an increase in fat. PAH is very rare. It affected less than 0.5% of people in a study of over 8,600 treatments.
Experts don't know yet why PAH occurs. But Dr. Keaney said it may be associated with older applicators that are no longer used. The treatment for PAH is liposuction.
Who shouldn’t try CoolSculpting?
CoolSculpting is generally safe — but it's not for everyone.
First, it's not a weight-loss treatment. It works best for people who are close to their ideal weight and want to spot reduce specific areas. So CoolSculpting isn't done on people with a body mass index (BMI) over 25.
Second, CoolSculpting shouldn’t be done in areas where there’s significant scarring or previous surgery. In addition, people with cold sensitivity disorders shouldn't do CoolSculpting.
Finally, people with the following rare conditions can't be treated with CoolSculpting:
Cryoglobulinemia
Cold agglutinin disease
Paroxysmal cold hemoglobinuria
Also, people with Raynaud's phenomenon, which usually affects the extremities, should speak to their rheumatologist before considering CoolSculpting.
And if you’re pregnant or have ongoing medical conditions, it’s a good idea to talk to your primary care provider before you consider CoolSculpting. They’ll want to review your history of:
Surgery
Pre-existing hernias
Any known sensitivities or allergies
These may reveal other things that could make CoolSculpting riskier for you.
Frequently asked questions
The average cost of a treatment plan is about $3,200. This plan can include multiple sessions. Most patients find that they need two or more treatments. You can download the Allē app for rewards and offers that may help lower the cost of your treatment.
The most painful part of CoolSculpting is most likely the massage at the end of the treatment. It also depends on the part of the body being treated. Some areas are more sensitive than others.
Right after removing the applicator, you may notice the fat under is a bit firm and red in the shape of the applicator. The blood flow returns fairly quickly. So the redness subsides pretty quickly too, Dr. Keaney said.
The bottom line
CoolSculpting is safe and effective for spot reducing fat. But it isn’t intended to be a weight-loss treatment. It’s best for those near their ideal weight who want to contour their shape without surgery. Just note that you might need more than one session. And your full results take months to see.
Why trust our experts?
References
CoolSculpting. (n.d.). How CoolSculpting works.
Derrick, C. D., et al. (2015). The safety and efficacy of cryolipolysis: A systematic review of available literature. Aesthetic Surgery Journal.
Jewell, M. L., et al. (2011). Noninvasive body sculpting technologies with an emphasis on high-intensity focused ultrasound. Aesthetic Plastic Surgery.
Kania, B., et al. (2023). Cryolipolysis: A promising nonsurgical technique for localized fat reduction. Journal of Cosmetic Dermatology.
Krueger, N., et al. (2014). Cryolipolysis for noninvasive body contouring: Clinical efficacy and patient satisfaction. Clinical, Cosmetic and Investigational Dermatology.
Nikolis, A., et al. (2021). A multicenter evaluation of paradoxical adipose hyperplasia following cryolipolysis for fat reduction and body contouring: A review of 8658 cycles in 2114 patients. Aesthetic Surgery Journal.
