Is CoolSculpting painful and are there any major risks?

I want to get rid of fat in my stomach area, and I don’t want surgery. CoolSculpting seems like it’s my best option. Is it painful, and are there risks I should be worried about? I got a small tattoo on my foot when I was 19. It was uncomfortable but not overly painful. Is it sort of like that?

EllaofLight

F, 34, New York

Only roughly 10% of CoolSculpting patients report postoperative pain, but it’s still probably wise to expect some discomfort just in case you are one of these people. Some patients feel no discomfort whatsoever while others experience minor pain for a few days or weeks.

For pain relief, your doctor will likely recommend you take an anti-inflammatory medication like Advil (ibuprofen) three times a day. If the pain is significant, prescription medication may be required. For many patients, medical compression garments or Spanx are recommended for the first two weeks following treatment. Acquiring these items before the procedure to have on hand for the recovery period would be pragmatic and helpful.

As for major risks, the only one documented to date is a very rare condition called paradoxical adipose hyperplasia, which occurs in the treated area when fat cells actually become larger instead of atrophying. Experts have yet to determine why this happens or why it’s more common with male patients. Paradoxical adipose hyperplasia isn’t dangerous but can be unsightly and won’t go away on its own.

Some less serious but more common side effects of CoolSculpting include pain, aching or stinging, a tugging sensation and temporary swelling, bruising, redness and sensitivity in the treated area.

Researchers believe this discomfort is likely caused by skin/tissue exposure to extreme cold during the procedure. These effects usually begin shortly after the treatment and, research has shown, can last from 3 to 11 days before disappearing on their own.

The tugging sensation, should you experience it, is caused by the two cooling panels placed at the treatment site during the CoolSculpting procedure. The sensation can last for the duration of the treatment (1-2 hours).

Swelling, bruising, redness and skin sensitivity are also the result of exposure to the cold temperatures during the CoolSculpting treatment. An ice pack can be used to reduce the swelling. Overall, these effects typically disappear on their own after a few weeks.

Not everyone is a good candidate for CoolSculpting. While it is a safe and effective treatment for fat reduction for most people, some with certain conditions (e.g., cold agglutinin disease, cryoglobulinemia and paroxysmal cold hemoglobinuria) should avoid the procedure, as it could possibly  cause serious complications. If you have one of these conditions, it’s imperative that you discuss the risks with your primary care provider before seeking the services of a plastic surgeon.

It is also important to understand that CoolSculpting is only meant as a fat freezing procedure to address small areas of stubborn fat, like love handles. It is not a weight loss procedure.

With earlier versions of CoolSculpting most of my patients reported no pain or mild discomfort during the procedure. A small number of patients reported moderate pain or “pinching” for a short period, followed by a numb sensation.

More than half of the patients who underwent one of the earlier CoolSculpting treatments stated that the recovery process was quite easy and over 20% of these patients said they found the recovery to be average with minor discomfort. More than three-fourths of these patients were able to return to their daily activities immediately after treatment. Others experienced bruising, tingling, redness and numbness.

However, a small but not insignificant number of patients found the recovery process to be quite difficult. Most of these patients rated their post-treatment pain as being moderate. However, a small fraction reported severe pain which lasted between one and two weeks but was somewhat assuaged with pain medication.

It’s worth noting that patients who received the treatment on their lower abdomen were most likely to develop pain during the recovery process.

All of this changed with the advent of CoolAdvantage, an updated version of CoolSculpting. CoolAdvantage is quicker, more effective and causes less discomfort than earlier versions. Now, the procedure can be performed in as little as 35 minutes, with an easier recovery period characterized by less discomfort, pain and bruising.

Dr. Landon Pryor has 1 CoolSculpting before & after:

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We are very experienced with Coolsculpting and also have their most recent technology ( Cool Advantage) which makes the process shorter and more comfortable.  You are a good candidate based on the fact that you already know you don't want surgery.   The cost depends on how many treatments you need, which is different for everyone as it depends on how much fat you have.  

We assess patients with a full consultation the give you a plan and cost.   If there is pain it is sometimes nerve stimulation pain and is treated with that in mind.

We are a CoolSculpting office in San Antonio, Texas, located in a plastic surgery office where we often consult about traditional Liposuction vs. CoolSculpting. Many of our patients are good candidates for CoolSculpting and abdomen is one of the most popular areas of treatment. With the latest 2017 CoolSculpting technology there is less discomfort for patients from previous models that many physicians still use. The older technology did cause soreness that lasted days, and the treatment itself was considered painful to most. However, the new technology has totally redesigned the suction/cooling heads. Most patients find that the area being treated goes numb after 3-5 minutes and from that point there is no discomfort. For 1-3 days afterwards, many patients report feeling anything from a tingling feeling, itchy sensation or mild to moderate soreness, but nothing that caused them to request pain medication. It seems you described the discomfort well with, "it was uncomfortable but not overly painful." Our patients are overwhelmingly pleased with the results they've achieved and many have returned for treatment in new areas.

As long as treatment protocols are followed by the technician delivering the CoolSculpting treatment there should not be any major risk involved with the procedure, but it is always a good idea to ask questions of your physician and have them cover possible risks as it relates to you. Good luck in exploring CoolSculpting!

Dr. Robert N. Young has 1 CoolSculpting before & after:

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most patient have some soreness in the treated area for a few days after CoolSculpting.  in my experience there's little difficulty for the vast majority, but some do end up taking pain medications.