Does Coolsculpting Work? – Introduction
Cosmetic surgery and aesthetic procedures have been gaining popularity in the last few decades. The increase in these procedures is mainly driven by the baby boomer generation seeking to delay the effects of aging and trying to get 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 of the people showed a desire to remove excess submental (under the chin) and neck fat. (1)
Traditionally, many surgical procedures are used for fat removal, as many of you must have heard of liposuction surgery; it is an invasive procedure and has 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 non-invasive procedures which is being used to remove 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 non-invasive procedure in which intense but controlled cooling is used to freeze the subcutaneous fat. As a result of the cooling, the fat cells 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) marked Coolsculpting safe and approved it in 2010. (3)
Does Coolsculpting Actually Work?
So the main question here is, “Does coolscultping actually work,” or is it just a trending thing with no actual results? There has been a lot of research done, and some are still going on to find the answer. Let’s review the results of some of these studies.
A study on coolsculpting for submental fat removal was done, and feedback from patients was taken through questionnaires. The results revealed patient satisfaction of 83%, and 77% of patients reported visible change in submental fat. 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)
Using 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. The procedure of 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 idea of cool sculpting was first given by scientists while studying the effects of frostbite on tissue. During the study, scientists observed that fat freezes at a higher temperature compared to the skin. 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, and they 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 a decrease in 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)
The procedure of cool sculpting does not involve any needles, blade incisions, or blood, as it is not an invasive or surgical procedure. It is a procedure in which a device with its two paddles is used to cool 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. The selected temperature is achieved by thermoelectric parts of the device, and the heat flux of the underlying tissue is monitored by attached sensors. The doctor leaves the device in place for almost 35 to 75 minutes (average 45 minutes), followed by a two-minute massage upon completion in order 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 is allowed to 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 sessions of therapy. 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
- Swelling of the treatment area
- Skin sensitivity
Paradoxical adipose hyperplasia (PAH) is a late and moderate to severe complication of cool sculpting. It is the paradoxical and delayed increase in the adipose (fat) tissue at the treatment region. This is a rare complication and occurs in less than 1% of cases. This may not pose any health risk as it is benign in nature but it can lead to patient dissatisfaction. (8)
A rare case of severe frostbite complication of cryolipolysis was also reported. It was a full-thickness frostbite which 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 be aware of the risks associated with cool sculpting. Moreover, certified healthcare professionals and registered hospitals should conduct these procedures in order 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
- Skin sensitivity
- Severe Raynaud’s phenomenon
- Cold urticaria
- Paroxysmal cold hemoglobinuria
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, which ultimately leads to fat removal from the body, helping in a better body shape and contouring. Cool sculpting has gained popularity for its non-invasive method, safety, and effectiveness. Overall, there was almost a 90% patient satisfaction rate and visible fat reduction reported in research data, showing the procedure’s efficacy with minimal side effects. Due to this, FDA has also declared cool sculpting a safe and effective procedure. However, you should consult your doctor before undergoing any procedure in order to get the best results and avoid complications.