As a beauty editor, I've been aware of CoolSculpting for a long time. It was approved by the FDA in 2010, but I probably didn't hear about it until somewhere circa 2015. Still, that's almost 10 years of basic knowledge. I remember being intrigued by the fact that a machine could use cold temperatures to reduce fat in certain areas of the body.
Even though I was interested in it as a concept, and I had a couple of areas I would consider getting treated—my lower stomach being one—I never went through with it. That's because, if I'm being totally honest, it sounded kind of gimmicky to me. Did it really work that well? Do the results last? I was skeptical.
Fast forward to today, and I'm actually considering it. What changed? Well, I learned new information—a lot of new information, and it converted me from a skeptic to a supporter.
Earlier this year, I was lucky enough to attend a crash course on CoolSculpting at the brand's Austin, Texas headquarters. During it, I learned everything there is to know about the treatment, including how it works on a cellular level and how it can permanently reduce fat in certain areas (yes, really!). Ahead, learn everything you need to know about this much-discussed, but rarely-understood treatment.
First, a Quick Crash Course on CoolSculpting...
What is CoolSculpting?
Dr. Terrence Keaney, MD, FAAD, is the founder of SkinDC and a board-certified dermatologist. "CoolSculpting Elite is an FDA-cleared, non-invasive procedure that uses cryolipolysis, or fat freezing, to reduce stubborn fat in nine areas."
How does it work?
CoolSculpting works via panniculitis, which is the medical term for inflammation of fat and cryolipolysis, which means fat loss due to cold. At cold enough temperatures (-11 to -13 degrees Fahrenheit), fat cells crystalize and move into a process called apoptosis. Any biology majors out there will know that means controlled cell death. The post-treatment massage, although it can be uncomfortable for some people, helps speed the process up.
What areas does it work on?
CoolSculpting only works on subcutaneous fat, meaning the fat that lies between the skin and the muscle. It doesn't work on visceral fat, meaning the fat that lies underneath the muscle. Keaney says it works on the following areas: "submental (under the chin), submandibular (under the jawline), thigh, abdomen, flank, bra fat, back fat, underneath the buttocks (also known as banana roll), and upper arm."
How long does it take to see results?
While there's often virtually zero downtime with the treatment, that doesn't mean it offers instantaneous results. "Following the procedure, the body will naturally eliminate dead fat cells over the course of one to three months," Keaney says. Often, multiple treatment sessions are necessary to achieve the desired effect.
How much does it cost?
"The price of CoolSculpting Elite varies based on a number of factors, like how many areas are being treated, how many treatment sessions are required to achieve a patient’s aesthetic goals, the location where the patient is receiving treatment, etc. At my practice, the average cost per treatment package is $3,200," he says.
Fact #1: It's Non-Invasive and Most People Don't Find It Painful
I don't know why, but I tend to assume in-office treatments are painful, invasive, and generally kind of scary. That's not always true, and it's certainly not true when it comes to CoolSculpting. Here's how it works: Assuming you've had a consultation with a certified provider, clinical photos are taken to track progress. Then, the provider will outline the areas you're treating (by the way, multiple areas can be treated at once. For example, you could treat your abdomen and arms in the same appointment). Next, they place a gel pad on your skin and put the CoolSculpting applicator over top.
When treatment begins, you'll feel a light vacuum pressure and intense cold. After a few minutes, the area will begin to feel numb. While everyone has different levels of sensitivity, most people don't find it painful. In fact, some people watch a Netflix show, open emails, or even nap until the session is over.
"CoolSculpting Elite applicators take 35 minutes to 75 minutes to complete a treatment," Keaney says. "The average treatment session involves at least four applicators, and that session may last up to two hours."
Fact #2: Results Can Be Substantial (and Permanent!)
It's important to note that CoolSculpting isn't a modality for overall weight loss. Instead, it's designed to treat individual areas of stubborn fat. For me, it's helpful to think of it as a tweak. "The ideal CoolSculpting Elite candidate is someone who practices a healthy lifestyle and is looking to reduce diet- and exercise-resistant fat," Keaney says. "CoolSculpting Elite is not a weight loss treatment, but the results can provide motivation for someone who is within 15 pounds of their goal weight. The first step on a CoolSculpting Elite journey should be a consultation with a provider who can determine candidacy for the treatment, create a custom treatment plan, and provide detailed pricing."
Okay, now that that's out of the way, we can talk about what results you can expect. Keaney says that one treatment can produce up to 20-25% reduction of stubborn fat in the treated area. And with additional treatment in the same area, even greater reduction can be achieved. "In my practice, I recommend a minimum of two treatment sessions for optimal results, and I advise my patients that it will take multiple treatment sessions to approach a surgical-like outcome. Our goal is not total fat reduction, which would look unnatural, but to put problem areas back in harmony with the rest of the body."
For some reason, I was under the impression that CoolSculpting offered temporary results. I was wrong. Take it from Keaney. "The results of CoolSculpting Elite are long-lasting. Fat cells are like storage units that expand with weight gain and contract with weight loss. Adults in a healthy weight range have a fixed number of fat cells, so when a number of those face cells are destroyed with CoolSculpting Elite, they are gone for good!"
Fact #3: Major Side-Effects Are Incredibly Rare
If you're anything like me, you're terrified of treatment side-effects. The good news is that common side-effects are minimal and often easily managed. "The common risks of CoolSculpting Elite are the things we expect to see post-treatment, which include tenderness, numbness, passing itching and tingling sensations, and mild swelling and bruising," Keaney says. "These symptoms are generally not disruptive, and patients can resume all of their normal activities immediately following a CoolSculpting Elite treatment."
There is one major side-effect that can happen, although it's incredibly rare in the 14 million CoolSculpting treatments that have been completed worldwide—it only happens about one out of every 3,000 treatments. It's called paradoxical hyperplasia (PH). Instead of fat reduction, PAH kicks off the creation of more fat cells due to abnormal tissue growth. In other words, instead of reducing fat, it can enlarge it. This is the side-effect famously suffered by '90s supermodel, Linda Evangelista after she underwent CoolSculpting treatment.
That's a terrifying prospect, but I was soothed when I found out just how rare it really is. "Paradoxical hyperplasia (PH) is a rare risk associated with CoolSculpting Elite, wherein the treated area gets bigger instead of smaller," Keaney says. "The reported incidence rate of PH is 1 in 3000 CoolSculpting treatments. PH is the only risk associated with CoolSculpting that does not resolve on its own, and the recommended treatment is liposuction."
The good news is, you wouldn't be on your own if it did happen. "In the rare event of a confirmed PH case, the patient may be eligible for financial assistance for the corrective procedure. CoolSculpting Elite, like other aesthetic treatments, is not without a risk profile. With that said, I use CoolSculpting Elite to safely produce consistent, successful outcomes in my practice."
10 Firming and Skin-Smoothing Products I'm Using While I Consider CoolSculpting
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