Does CoolSculpting Really Work To Freeze Off Fat, And Is It Safe?

If you’ve heard about people literally freezing off their fat through a noninvasive procedure called CoolSculpting, it’s only natural that you might be skeptical. A host of concerns comes to mind: Is it safe? Does it actually work? Is it expensive? If you can freeze off your fat with cold, why don’t we all just take long trips to Antarctica?

Celebrities like Kris Jenner, Khloé Kardashian, Molly Sims and Malin Akerman (see below) have touted CoolSculpting as a way to quickly and easily eliminate fat without diet or exercise, claiming the procedure requires no downtime or restrictions afterwards. But can we really trust these celebrity claims?

With the return of social gatherings and events — hello, weddings postponed from 2020! — and the arrival of swimsuit season, people may start to desire a quick fix like CoolSculpting, which claims to eliminate 25% of fat in the targeted area (which can be anywhere from the thighs, the lower belly and even arms). So HuffPost spoke with experts to get the lowdown on whether CoolSculpting is really worth all the hype.

TL;DR: The experts HuffPost spoke to agreed that CoolSculpting can be effective, but only for the right candidate, so anyone considering the procedure should receive a thorough consultation from a reliable professional beforehand.

“It’s going to work great for the right people; It’s not going to work for the wrong person,” Hao Feng, assistant professor of dermatology in the University of Connecticut Health’s department of dermatology, told HuffPost. “You definitely want to make sure you’re an ideal candidate for this treatment before you take the plunge.”

What Goes Down During A CoolSculpting Session

The technology behind CoolSculpting came from researchers at Harvard Medical School and Massachusetts General Hospital, who observed that when kids sucked on popsicles, the inside of their cheeks would develop a small dimple because of the cold selectively targeting the fat cells in that area. They realized that criolipolisis — the process of using cold temperature to break down fat cells — could be implemented in a controlled setting to achieve fat loss, and thus created CoolSculpting.

First, you need to decide which area of your body you’d like to be treated. The FDA has cleared CoolSculpting for treatment of visible fat bulges under the chin and jawline, as well as the thighs, abdomen, flank, upper arms, under the buttocks and along the back and bra line.

Providers typically use large applicators on the lower body, like the sides of the hips or flank area, as well as the abdomen. Small applicators will usually be used on the upper body and the smallest CoolSculpting applicator, the CoolMini, targets chin, armpit and bra line fat reduction. More than one applicator may be used during treatment; For example, two large applicators might be utilized on the lower stomach region. The exact size of applicator and the number of used per treatment area, though, depends on the patient’s the dimensions and desired outcome.

The overall cost of the procedure will vary based on which areas you have treated and how many rounds of treatment you undergo, but CoolSculpting estimates that “a personalized treatment plan” will ring in anywhere between $2,000 and $4,000.

Your provider (often either a dermatologist or a technician at a medi-spa) will start by applying a layer of protective gel to the treatable tissue in the desired area, and then attached the applicator to the area. Then comes the cooling action.

University of Rochester Medical Center dermatologist Mara Weinstein Velez explained that the applicator selectively targets fat cells by cooling to around -11 degrees Celsius and does not affect blood vessels or the overlying skin. While “some people feel absolutely nothing,” Denise Kayler, CEO of Synergy Spa of The Guyer Institute, which offers CoolSculpting, said, “about half of the people that we’ve done feel like it’s pulling and tugging when it first goes on.” She likened the sensation to a stinging, “almost like if you went outside and your fingers got really, really cold and then you came back [inside].”

CoolSculpting sessions last around 35 to 45 minutes, depending on the size of the area being worked on, and fat will be flushed out through the lymphatic system to the liver and eliminated via stools. “A lot of people are like, ‘Well, do I pee more? Do I poop more?’” Kayler said. “No, none of that’s affected. It’s definitely through the lymphatic system.”

How You’ll Feel After CoolSculpting

Afterwards, “the area is going to feel kind of weird because it feels like a cold stick of butter,” Feng warned. “It has to be massaged either manually or there are devices that can automate a little bit. That can be a little painful, but it helps with the results.” Just a two-minute massage on the affected area helps reduce any potential swelling and/or bruising and can accelerate the process of eliminating fat cells.

The skin may be numb for a few hours after the procedure and redness, swelling, numbness and minor discomfort might persist for up to a week or more, but that shouldn’t stop patients from going about their normal lives or wearing tight-fitting clothing. Weinstein Velez explained that if a patient had CoolSculpting done on their stomach, for example, “you get this sensation in the belly that you did a whole bunch of sit-ups. It’s like a muscle soreness feeling.”

Before-and-after photos on the CoolSculpting site show a patient who’s undergone two treatments on their abdomen.

People who have had CoolSculpting procedures gone wrong complain of marks left behind from the applicators and areas looking enlarged after the process, known as paradoxical adipose hyperplasia (PAH). Feng said the former can be the result of a less experienced and/or not-so detail-oriented provider. “With any medical and cosmetic procedure, experience really matters,” he said. “And how you apply the applicator, whether you’re using the right applicator and whether this is the right area to do this on, really matters. That’s where experience, knowledge, and being able to properly assess whether you’re the right candidate can go a long way.” PAH usually occurs if the wrong person opts for CoolSculpting (more on that below.) Feng said the bulging happens more in men who get CoolSculpting on the abdomen, “but it’s a very rare side effect” — with less than 1% of patients experiencing it.

Most people require multiple rounds of treatment in order to achieve one’s desired look. “You rarely need one treatment,” Weinstein Velez said. And it takes 12 weeks to see the full results, so folks hoping to have a certain appearance for a particular event should plan accordingly.

So What Makes Someone A Prime Candidate For CoolSculpting?

“It’s really ideal for people who are near their ideal body weight who have stubborn areas of fat that are resistant to dieting and exercise,” Weinstein Velez said. “Essentially, the ideal candidate is someone who is already fairly fit, already practicing good habits, but just needs a little extra help to get rid of that unwanted fat they just can’t get rid of. It’s definitely not a weight-loss procedure.”

Kayler noted that CoolSculpting “really only works on subcutaneous fat,” aka the squishy kind that sits right under the skin, as opposed to visceral fat that she equated to “a man that’s got a big belly that’s hard like a rock.”

While up to 25% of fat cells in the area targeted by CoolSculpting can be eliminated, the ones that remain can get larger should a patient gain weight in the future. In order to maintain results, “the only thing that we ask is that you don’t gain weight,” Kayler said. “If you go over your weight, you’re going to have more fat come that’s got nothing to do with your treatment.”

Feng reiterated, “If you go back to having bad habits, you’re not going to retain your results because the existing fat cells that still exist will just get bigger and bigger.”

What To Look For In A CoolSculpting Provider

First, here’s what you should know about safety. CoolSculpting received FDA approval for reduction of flank and abdominal fat in 2010, marking the first time the agency gave the OK to a noninvasive fat-reducing technology. In 2014, the FDA also cleared CoolSculpting for the treatment of subcutaneous fat in the thighs.

Anyone considering undergoing CoolSculpting should have a consultation done before signing on, because of how much the treatment is tailored to your body. “We have some people who just want to bypass that consultation and that’s probably one thing I would stress,” Kayler said. “There’s no pressure on a consultation. Make sure whoever you go to, that they’ve sat down and told you exactly what’s going to happen.”

At that time, the doctor or technician should also be honest about how many rounds of CoolSculpting you’ll likely have to undergo to achieve your desired result, and whether actually CoolSculpting makes the most sense for your situation versus another body sculpting procedure.

“At the end of the day, it’s about making sure that you’re seeing someone who really understands all the options that are available to you and making sure you see someone who has the expertise and knowledge to say, ‘Look, you may be coming in thinking about CoolSculpting, but CoolSculpting isn’t the right procedure for you’ and be able to tell you what procedure is better for your particular case,” Feng said. “You’re set up for failure in the beginning when you’re not a good candidate, when something else is better.”

Ask to see pictures of the provider’s actual work, Kayler said. “Have whoever is going to do you show photos from their facility,” she continued, “not trust what [CoolSculpting owner] ZELTIQ has put out on the internet or what they see in other places.”

Be careful of anyone looking to make a quick buck. “As much as I really believe in the technology and I think the results are good, the one issue I do have with CoolSculpting is that I think it’s a little too commoditized,” Feng said. “Physicians are doing it, medical spas, a lot of people are trying to use the device and there’s money to be made in this industry.”

Because of that, Weinstein Velez said “it’s very important to know the credentials of your provider before you seek treatment.”

“It’s very unregulated,” she continued. “And if there’s a deal that seems too good to be true, it probably is. That is not where you want to go.”

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