Does Coolsculpting Work?

Does Coolsculpting Work? – Introduction

Cosmetic surgery and aesthetic procedures have gained popularity in the last few decades. The increase in these procedures is mainly driven by the baby boomer generation, which seeks to delay the effects of aging and achieve the best possible body contour and skin tone.

According to a survey done in 2021 by the American Society for Dermatologic Surgery, 70% of the surveyed people were planning to undergo a cosmetic procedure. The most common reasons for this were excess weight (77%), skin tone and discoloration (66%), wrinkles on the face and around the eyes (62%), and excess fat under the chin and neck (70%). Among these, most people desired to remove excess submental (under the chin) and neck fat. (1)

Many surgical procedures are traditionally used for fat removal, as many of you must have heard of liposuction surgery; it is an invasive procedure with associated risks. With the advancement in cosmetics, non-invasive procedures have emerged and gained popularity. These replace surgical procedures, as study results showed a 508% increase in non-surgical procedures since 1997. (2)

Cool sculpting, or Cryolipolysis, is one of the most popular noninvasive procedures for removing fat from different body areas, such as the submental region, neck, flanks, abdomen, thighs, bra strap region, underneath the buttocks, and upper arm.

What is Cool Sculpting?

CoolScultping (also known as cryolipolysis) is a noninvasive procedure in which intense but controlled cooling freezes the subcutaneous fat. The cooling causes the fat cells to undergo apoptosis (programmed death) and are removed from the body.

It is considered an effective alternative to invasive procedures such as liposuction due to its high patient satisfaction, effectiveness, and less associated risks. The United States Food and Drug Administration (FDA) approved CoolSculpting for treating visible fat bulges in various areas, including the thigh, abdomen, and flank, among others, starting in 2010. (3) Since then, the range of approved treatment areas has expanded, reflecting its safety and effectiveness.

Does Coolsculpting Work

Does Coolsculpting Work – What Is Cool Sculpting?

Does Coolsculpting Actually Work?

So the main question here is, “Does coolscultping work,” or is it just a trending thing with no actual results? Much research has been done, and some are still being done to find the answer. Let’s review the results of some of these studies.

Research on CoolSculpting for submental fat removal indicates high levels of patient satisfaction. One study reported that 83% of participants were satisfied with their results, with 77% observing a visible reduction in submental fat. These findings are supported by ultrasound measurements, demonstrating an average fat layer reduction. Ultrasound of the treatment area also showed an average reduction of 2.0 mm in the fat layer. Moreover, no adverse effects of the procedure were reported. (2)

Another study on abdominal and flank fat removal using CoolSculpting involving 106 participants also showed significant satisfaction of patients, as 95 of 106 participants (89.6%) were satisfied with the results. (6)

Coolsculpting for inner thighs was also evaluated by a study involving 42 patients, whose results were studied after 16 weeks of treatment. All of the patients maintained their weight within 5 lbs. of baseline. A fat reduction of 2.8 mm was also shown on ultrasound data. Moreover, it also showed an average of 0.9 cm reduction on circumferential measurements. 93% of patients were satisfied with the treatment, 91% were willing to have a second treatment session, and 84% noticed a visible fat reduction. (7)

Overall, there was a high percentage of patient satisfaction with the procedure. Cool sculpting is well suited for people wanting non-surgical and non-invasive fat reduction. It is effective in both men and women and can be done easily in a single visit.

What is The Underlying Mechanism Of Coolsculpting?

The concept of CoolSculpting originated from observations made during studies of frostbite, where researchers noted that fat cells freeze at higher temperatures than surrounding tissues. This discovery led to the development of cryolipolysis as a targeted approach to fat reduction, leveraging the vulnerability of fat cells to cold injury without damaging the skin or surrounding tissue. As a result, fat cells are broken down earlier during frostbite before any damage to the skin and other tissues, making adipocytes (fat cells) more susceptible to cooling than other tissues.

The slow, intense, and precise freezing effect produced during cool sculpting triggers the death of the adipocytes, which are engulfed and broken down by the macrophages (white blood cells). There is no immediate noticeable change in the subcutaneous fat after this procedure. An inflammatory process begins in the targeted area, involving the recruitment of more and more inflammatory cells surrounding the dying adipocytes.

The inflammatory process usually begins on 3rd day and peaks approximately 14 days after the cool sculpting procedure. After 14 to 30 days of treatment, the adipocytes are digested by the macrophages and inflammatory cells. This leads to decreased fat, and the inflammatory process begins to subside. A visible decrease in fat volume can be seen in two to three months after treatment. (4)

CoolSculpting Procedure

CoolSculpting is a nonsurgical and noninvasive procedure that does not require needles, incisions, or bleeding. It is designed to reduce fat through a controlled cooling process that targets and eliminates fat cells without harming the skin or surrounding tissues. A device with two paddles cools down the treatment areas, which in turn leads to fat reduction.

The coolsculpting device has a cup-shaped applicator attached to the cooling panels. This applicator is applied to the patient’s treatment area. The tissue of this area is drawn into the applicator cup under a moderate vacuum, and the temperature is set on the device. Thermoelectric parts of the device achieve the selected temperature, and attached sensors monitor the heat flux of the underlying tissue. The doctor leaves the device in place for almost 35 to 75 minutes (average 45 minutes), followed by a two-minute massage upon completion to improve the clinical effects. This procedure destroys 20% to 25% of the adipocytes in the treated area.

The patient is usually discharged immediately after the procedure and can continue his/her daily activities without any advised bed rest. The procedure does not need any preparation and can be performed in one setting.

How many treatment sessions does a patient need to get the desired effect? This depends upon the treatment area, as flank regions respond well to single-session treatment, while the fat on the back and thighs may require more than two therapy sessions. There should be a gap of 8 weeks between repeated sessions for the inflammatory process to subside. (5)

Benefits Of CoolSculpting

CoolSculpting is an effective and safe method to remove fat and improve body contour. It also has many advantages over traditional invasive and surgical procedures, such as:

  • No incision or needle use
  • No need for anesthesia
  • No particular preparations of the patient
  • No special post-operative care or advised bed rest
  • Blood-less procedure
  • The patient is comfortable during the procedure
  • Normal daily activities can be resumed the same day after treatment
  • Effective fat removal from targeted areas
  • Safe technique
  • Patient satisfaction
  • FDA approved

Are There Any Associated Side Effects?

Yes, cool sculpting also involves some associated risks that the patient should be aware of. Most of these side effects are mild that usually improve with time, and do not need any intervention. These include:

  • Mild pain
  • Skin discoloration (that is temporary and goes away after some time)
  • Intense cold feeling during the procedure
  • Bruising
  • Swelling of the treatment area
  • Skin sensitivity

While CoolSculpting is generally safe, it is associated with a rare complication known as paradoxical adipose hyperplasia (PAH), where the treated area increases in size rather than decreases. Although this occurs in less than 1% of treatments, patients must be aware of this potential outcome. Properly conducted treatments by certified professionals in medical settings can help minimize risks. It is a paradoxical and delayed increase in the treatment region’s adipose (fat) tissue. This rare complication occurs in less than 1% of cases. This may not pose any health risk as it is benign but it can lead to patient dissatisfaction. (8)

A rare case of severe frostbite complications from cryolipolysis was also reported. It was a full-thickness frostbite that occurred following the cool sculpting procedure being done for abdominal fat at a non-medical aesthetic clinic. The patient needed hospitalization and multiple debridements of the wound. Although, it is very rare and was observed during the first decades of cool sculpting use. But, the operator and the patient should know the risks associated with cool sculpting. Moreover, certified healthcare professionals and registered hospitals should conduct these procedures to deal with the complications if present. (9)

What are the Contraindications To Coolsclutping?

You should avoid undergoing this procedure if you have any of the following underlying conditions: (10)

  • Poor skin tone
  • Pregnancy
  • Skin sensitivity
  • Severe Raynaud’s phenomenon
  • Cold urticaria
  • Paroxysmal cold hemoglobinuria
  • Cryoglobulinemia


Cool sculpting or cryolipolysis is a non-invasive procedure that removes subcutaneous fat from areas like the submental and submandibular region, flanks, abdomen, and back. It uses a cooling effect to break down adipocytes, ultimately removing fat from the body and helping to improve body shape and contouring. Cool sculpting is popular for its non-invasive method, safety, and effectiveness. Overall, almost 90% of patient satisfaction rate and visible fat reduction were reported in research data, showing the procedure’s efficacy with minimal side effects. Due to this, the FDA has also declared cool sculpting a safe and effective procedure. However, you should consult your doctor before any procedure to get the best results and avoid complications.

See Also

Is CoolSculpting Permanent?

Coolsculpting Side Effects

How Much Is Coolsculpting?

Coolsculpting vs Ultrasonic Cavitation?

What is the Safest Weight Loss Surgery?

Current Version
March 8, 2024
Medically Reviewed By
Franco Cuevas, MD
July 9, 2023
Written By
Daniyal Haider, MD
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