What to Know If You're Considering CoolSculpting

Woman in bra and panties

 Getty/Klaus Vedfelt

Unless you're one of the select few humans genetically predisposed with the physique of a Victoria's Secret model, you probably have to accept a certain amount of body fat. But there are some areas, especially for women, that can be particularly stubborn. Women are more inclined to store fat than men, for example—especially as we age—and we also tend to carry more fat in our hips and thighs (you know, because of that whole childbirth thing).

So while a certain percentage of body fat is totally healthy and normal, it can be particularly frustrating for women who are trying to displace any excess. Diet and exercise can only do so much, and for a long time, the only real solution for getting rid of excess fat was surgical—that is, until a very buzzy noninvasive procedure called CoolSculpting emerged on the scene. By literally freezing away the tissue, it promises to effectively stimulate fat loss—with absolutely no downtime.

Intrigued by the idea of "lunchtime lipo," we pressed nurse practitioner Cristina Shallenberger for all of the details. 

What is Coolsculpting?

CoolSculpting is not your standard body contouring procedure. Most cosmetic procedures to remove fat require lasers or surgery, which can leave the surrounding healthy tissue damaged, causing bruising or bleeding. The results are great, but traditional procedures have considerable drawbacks. So naturally, a team of Harvard scientists came up with a new solution for fat elimination. "CoolSculpting is a technique that uses cryolipolysis [controlled cooling] to freeze body fat on the abdomen, flanks, back/bra fat, upper arms, and inner or outer thighs," says Dr. Frankel.

"Immediately after a CoolSculpting treatment, the adipose [fat] tissue begins the process of crystallization, where tiny crystals form within the adipose cells and result in cellular death," he continues. This process continues over the next 12 weeks, while the dead fat cells are broken down, dissolved by your body, and eliminated through the lymph system, all of which occurs unbeknownst to the recipient, without any diet or exercise changes. How exactly does all that happen without you feeling a thing? Science. It works because fat cells freeze at a higher temperature than other types of cells.

How the Procedure Works

Got an hour? That's all you need. Dr. Frankel says there's no downtime involved, so after your lunch-hour fat-freezing session, you can go right back to work. If you're doing multiple areas, it could take more than an hour, but Dr. Frankel uses two machines simultaneously on his patients, so you can treat both thighs in the same one-hour session.

The device feels cool on your skin for the first few moments when it's activated, but after a few minutes, you won't feel anything. Once the machine has done its job, the practitioner will massage the treated areas to break up the crystallized fat cells. At first you'll be able to see where the device was working because that area will be raised, but after the massage, you won't see a thing. 

CoolSculpting vs. Comparable Procedures

For decades, the only way to quickly get rid of excess fat on the body (aside from diet and exercise) was liposuction. According to 2018 statistics from the American Society of Plastic Surgeons, the surgical procedure averages $3518, making it more costly than CoolSculpting, which averages between $2000 and $4000 per session. Liposuction is much more invasive, though, requiring weeks of recovery time and often an overnight stay in a hospital.

Another FDA-approved treatment to destroy fat cells, the injectable Kybella, costs on average $1200-$1800 per treatment, but is for now only approved for use on submental fat beneath the chin.

How to Prepare for a CoolSculpting Treatment

Some physicians will advise patients to avoid taking anti-inflammatories such as aspirin before a CoolSculpting procedure (this could help reduce bruising). Many will also suggest that beverages and caffeine be limited before, but a light meal can be eaten.

The Results

You'll start to see changes in your figure within four to eight weeks, with full results by week 12. If it's determined that you need a second treatment, you can come back in as early as eight weeks. Now here's the best part: "It's the only nonsurgical treatment on the market that permanently gets rid of fat," Dr. Frankel says. Once those fat cells are destroyed, they're gone for good. If you do gain weight at some point down the road, it will distribute evenly, just not in the places you targeted.

Side Effects

Swelling, bruising and skin sensitivity at the treatment site are common side effects of CoolSculpting. The procedure does freeze fat, though there's no risk of frostbite. One very serious, but rare side effect is paradoxical adipose hyperplasia. According to a study published in the journal JAMA, this can cause a gradual enlargement of the treatment area (in other words, the fat in the treatment area becomes hardened rather than dissolving over time). The good news: In the cases studied, PAH was successfully treated.

The Final Takeaway

Dr. Frankel says CoolSculpting is ideal for adults with stubborn pockets of fat that have been resistant to healthy diet and exercise. While it is cheaper than the other permanent solution, liposuction, the costs can add up depending on the number of areas treated.

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