Hair-growth vitamins, cellulite creams, skincare products that shrink your pores—most things that sound too good to be true in the beauty and wellness industry usually are. And if you, like me, have been burned one too many times by false promises, you’ve likely become somewhat of a skeptic who trusts nothing and no one. So when CoolSculpting, a noninvasive, fat-freezing treatment, became the topic of conversation after the FDA approved it in 2010, you can guess how I felt about it: skeptical.
But here we are, almost a decade and a half later, and people are still talking about the procedure. In fact, it’s been a hot topic of conversation in recent months due to publicized reports of a rare side effect causing adverse effects. So I decided to do a little digging: Does CoolSculpting work? And more importantly, is CoolSculpting safe? Slimming Body Machine
To answer my many fat-freezing questions, I tapped board-certified plastic surgeons and dermatologists—Ramtin Kassir, MD; Chris Funderburk, MD; Ira Savetsky, MD; and Paul Jarrod Frank, MD—and also spoke with licensed estheticians Marisa and Adriana Martino about how much CoolSculpting costs, how it works, and more. Let’s get into it.
“CoolSculpting is a non-surgical cosmetic procedure that helps reduce stubborn fat in certain areas of the body,” says plastic surgeon Ramtin Kassir, MD. CoolSculpting is the brand name for cryolipolysis, a process that uses extreme cold to freeze fat cells, causing them to gradually break down until they’re naturally eliminated by your body over time.
In more scientific terms, Dr. Kassir says that the fat cells that have been frozen undergo a natural cell death—over time, your body’s immune system clears away these damaged fat cells, resulting in a reduction of fat in the treated area. “The elimination of these fat cells occurs gradually over several weeks to months,” says plastic surgeon Ira Savetsky, MD.
Whether or not CoolSculpting actually works depends on what you would consider “effective.” Will it tone your body and replace a healthy lifestyle with regular exercise? Definitely not—and it also won’t give you the results of liposuction or invasive surgical procedures. What CoolSculpting can do, however, is help to reduce small amounts of fat in certain areas.
But is CoolSculpting effective on everyone? The answer is no. “CoolSculpting works best on someone with small amounts of pinchable, plump fat,” says dermatologist Paul Frank, MD. “So someone who has three pounds of pinchable fat to remove in one area will have better success with CoolSculpting than someone who has an excess of 10 pounds.” And even then, it’s not a guarantee that CoolSculpting will give the same results—or dissolve the same amount of fat—in every person.
According to Dr. Savetsky, you can treat a number of areas on your body with CoolSculpting—if, of course, your doctor deems that you are a good candidate for treatment. Here’s a quick breakdown of potential areas:
According to licensed esthetician Adriana Martino, most patients will typically get one to two areas treated at once—usually the abdomen and flanks—but she notes that every person and clinic is different, which is why your CoolSculpting specialist will require you to come in for a consultation first to customize your treatment plan.
“There are only a few combinations that have to be done separately due to patient positioning, like the banana roll and the abdomen,” she says. So the number of areas you can treat at once will depend on which body parts you’re hoping to work on.
During your first CoolSculpting appointment—if you haven’t already had a consultation—your practitioner will assess and evaluate the treatment area, looking at your skin, the fat underneath, and its potential muscle contribution to determine if you’re a good candidate for CoolSculpting. “If you’re looking to treat an area of fat that’s distinct and there’s not a lot of skin or muscle, you’re a good candidate,” says Dr. Kassir.
At this point, your specialist will have a better estimate on how many sessions you’ll need for your desired results (typically, at least two), and which type of applicator is appropriate for your treatment plan.
Before starting treatment, your specialist will apply a protective gel pad that will act as a buffer between your skin and the CoolSculpting applicator. Then they’ll ask you to either lie down (if they’re treating an area on your body) or sit upright (if they’re treating your chin). Once they place the applicator in its correct position, it will tightly suction to your skin, similarly to a strong vacuum.
After the applicator forms a tight suction, the freezing will begin. Typically, you’ll start to go numb after five minutes and won’t be able to feel the treatment happening. You’ll then chill for the rest of your treatment—i.e., queue up your fave Netflix show on your phone—until it’s time to take the applicators off (typically after 30 to 60 minutes, depending on the location and your specialist’s assessment).
Now for the most painful part: the massage. After the applicators are removed, the treatment area will be left with a frozen lump of fat in the shape of the applicator that needs to be massaged for a few minutes to help it “thaw” (yes, really). This tends to be the most painful part of the entire CoolSculpting treatment, but again, it only lasts a few minutes.
Afterward, you’ll feel burning or stinging for up to 15 minutes (kind of like an ice burn in the winter), and you may experience a bit of bruising, swelling, and numbness for a few days afterward, although this isn’t a guarantee.
The results from CoolSculpting will last forever, because the specific fat cells that have been treated and destroyed will exit the body (meaning they’re gone for good, just like with liposuction or other fat-removal treatments). However, CoolSculpting can’t and won’t prevent new fat cells from forming in their place, so you will need to keep a stable weight in order for the results to truly last.
Yes, CoolSculpting may hurt, but the sensation is fully dependent on your personal pain tolerance. CoolSculpting is often described as feeling similar to the aching pain you get after coming inside from the cold and waiting for your numb hands to warm up. According to a former Cosmo beauty editor who tried CoolSculpting on their stomach and chin, “the suctioning portion was tolerable, but the post-treatment massage hurt so badly, I went into the bathroom and cried.”
Still, in general, CoolSculpting is well-tolerated by the vast majority of patients. And because CoolSculpting sessions typically take around 30 to 60 minutes depending on your treatment plan and the area on your body, whatever pain you experience during the process is at least short-lived.
There are many possible negative side effects of CoolSculpting, as with any medical procedure. If you’ve done your online digging—or have read any of the recent reports of uneven results or adverse reactions—you might be here with a lot of questions, which, good, you’ve done your research.
In general, the negative side effects of CoolSculpting can include persistent pain or redness at the treatment site, bruising, skin sensitivity, and tingling, says Dr. Savetsky, who notes that these typically fade within a few days of treatment. In rarer cases, it can also cause uneven fat removal—meaning the treated area may be asymmetrical which will require intervention specific to the case.
CoolSculpting also carries with it a more severe and uncommon risk known as paradoxical adipose hyperplasia (PAH), a rare condition that has made headlines recently for leaving patients with mottled, bulging skin textures. But before you freak out, let’s talk about it.
Paradoxical adipose hyperplasia, or PAH, is a condition where fat cells grow abnormally after a CoolSculpting treatment, explains plastic surgeon Chris Funderburk, MD. CoolSculpting uses a process in which fat cells are frozen and die off, but sometimes—very rarely—it can trigger PAH, which causes those cells to instead grow and become firm, leading to painful lumps of tissue, he says.
Although the exact cause of PAH is not yet fully understood, it appears to be an inflammatory response to the treatment. And as of 2023, PAH cannot be reversed through specific treatments or procedures. If PAH occurs, the affected area may require alternative approaches, such as liposuction for correction, he says. Thankfully, Dr. Kassir says PAH is estimated to occur in less than 0.005 percent of cases: “It’s important to note that PAH is extremely rare, and the majority of CoolSculpting procedures are performed without complications,” he says.
Still, because of the risk, Dr. Funderburk now advises his patients to avoid CoolSculpting for the time being and recommends waiting for more data to become available. “We need more clinical trials not funded by the device manufacturer to determine the true rate of this complication and to better understand how to prevent its development.”
CoolSculpting can cost between $1,200 to $2,500 total, “depending on how many applicators and areas you are treating,” says licensed esthetician Marisa Martino. However, this number can greatly vary depending on which applicators are used, how big the area is that is being treated, whether you live in a big or small city, and how many rounds of treatment you need (typically two to four, depending on the area).
“We perform upwards of 500 treatments per month of Coolsculpting, meaning we see between 6,000 to 7,500 clients a year,” says Marisa Martino. Dr. Kassir’s practice has seen similar numbers: “We’ve performed thousands of procedures since 2011 and have had good results overall.”
CoolSculpting can be an effective way to reduce fat pockets over time if you’re the right candidate, but you should only make a decision after doing research and consulting with your primary physician and/or a board-certified dermatologist or plastic surgeon. “The key is to offer patients all nonsurgical and surgical alternatives and see which best option is for them and what they can expect,” says Dr. Kassir.
Essentially, you want to get the full picture before deciding if CoolSculpting is worth trying, which you’re more likely to get from a plastic surgeon or dermatologist rather than a med spa. And remember: Although CoolSculpting risks are minimal, they still exist and can be severe, so pretty please promise me you’ll consider everything before making that appointment. Cool? Cool.
Siena Gagliano is the associate editor at Cosmopolitan who writes beauty and has three years of experience writing about beauty, fashion, and lifestyle news. She’s an expert at researching and writing hair stories, like the best cellulite creams and stretch mark removal treatments. She’s an authority in all beauty categories, but after speaking to—and learning from—medical professionals, she feels knowledgeable on the topic.
Brooke Shunatona was the senior beauty editor at Cosmopolitan for nearly five years and has eight years of experience writing about beauty and lifestyle across print and digital, including what exactly a lymphatic drainage massage is and skincare product testimonials, like this Curology review.
Siena Gagliano is the associate editor at Cosmopolitan, where she primarily covers beauty in the makeup, skin, and hair spaces, as well as some fashion and lifestyle. Wanna know how to get the best brows of your life? Gotchu. What about how to achieve ridiculously glowing skin, a super bouncy blowout, or exactly how to use that viral face mask? Check, check, and check. Before joining Cosmopolitan, Siena was a writer at Bustle and several other media outlets. As NYC's newest resident, she has vowed to find the best (extra) dirty martini this city has to offer—and yes, that means ~attempting~ to try every cute cocktail spot in the city (hit her up with some recs, pls). Follow Siena on Instagram where you'll see that her account is mostly dedicated to pics of her cute dog and that magazine life.
Brooke Shunatona is a contributing writer for Cosmopolitan.com.
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