What are the Long-term side Effects of CoolSculpting?

How long have people really been using the CoolSculpting technology? My issue is focused on what the long term side effects are. I know that people have seen success in the short term (less than 5 years). But what can we expect this type of procedure to impact long term?


F, 35, Utah

CoolSculpting is a form of noninvasive body contouring. It has been around for 10 years,  was first recognized by the FDA in 2008 and has been since been approved for use on the flanks, abdomen, arms, thighs, submental area and back.

CoolSculpting treatment uses controlled cooling to eliminate small amounts of unwanted fat from targeted areas, such as the love handles. As fat responds negatively to cold temperatures, 20 to twenty-five per cent of subcutaneous fat is reduced in the area with each treatment.

Although it is still a relatively new treatment, CoolSculpting has been linked to few serious short or long term side effects. Some patients experience slight pain, redness, bruising or swelling following their CoolSculpting session, but these are symptoms that generally resolve within a few days.

There is one highly rare delayed side effect that has been documented as a result of CoolSculpting. Paradoxical adipose hyperplasia occurs in approximately 1 out of every 20,000 patients and results in the growth of adipose tissue in the treated area 2 to 5 months after treatment. It presents itself as a hard, subcutaneous lump and appears more commonly among men than women. It can be corrected successfully with liposuction. Studies regarding this condition are ongoing.

There are also two contraindications for CoolSculpting. Patients who suffer from cryoglobulinemia and paroxysmal cold hemoglobinuria are advised to avoid the treatment because of hypersensitivity to cold temperatures, leading to thickening of the blood or red blood cell death.

The long-term benefits of CoolSculpting depend on the patient maintaining a stable weight. Once the dead fat cells in the treated area have been processed by the body, they cannot return. However, the patient’s weight must be maintained to ensure that remaining fat cells do not expand and swell with weight gain. Results are apparent at 2 months and, on average, between 1 and 3 treatments are required to achieve the best results.

Studies have been conducted to assess the effects of fat freezing on the blood levels of cholesterol and fatty acids following treatment. No significant change was detected. The increasing popularity of CoolSculpting testifies to its efficacy as a successful non-invasive procedure that encourages fat loss.

CoolSculpting was first approved for commercial use by the FDA in 2008. It has since rapidly gained popularity as a non-invasive, quick and effective method of body contouring. For individuals who do not wish to undergo liposuction, CoolSculpting offers an alternative method of fat reduction. Fat cells are permanently eliminated from stubborn areas through the process of cryolipolysis, or fat freezing.

During a CoolSculpting treatment, fat cells are frozen and undergo apoptosis, where they slowly shrink and die over a two week period. During this time the cells are broken down by the body's immune system and what remains is processed through the lymphatic system before being excreted as urine. There are no known side effects as a result of this process--cholesterol levels do not change and the dead cells will not return.

Common side effects of CoolSculpting include mild bruising, swelling and pain in the treatment area following the procedure. However, most patients do not experience any side effects at all and those who do experience them find that they subside after a day or two. CoolSculpting can also lead to irregularities of the skin as the treatment may not be equally effective in all areas.

Regarding the long-term impact of CoolSculpting, the results are permanent. Once the fat cells in the targeted area have been eliminated, they will not return. However, the patient must maintain a stable weight to retain the results -- the remaining fat cells in the treated area can swell with weight gain or shrink with weight loss.

Research regarding the long-term effects or CoolSculpting is inconclusive as the treatment is relatively new. Existing studies emphasize its safety, limited side effects and significant results when used on localized areas of adipose tissue. Some researchers are currently investigating whether multiple treatments in the same area enhance the efficacy of CoolSculpting and if post-treatment manual massage does so as well.

Cryolipolysis, or fat freezing, has been studied since 1989. So there is good long-term data that shows the result hold well.