CoolSculpting for Fat Loss: Is It Safe?

Medically Reviewed by Zilpah Sheikh, MD on May 24, 2024
8 min read

CoolSculpting is the brand name for a fat-freezing method that aims to get rid of stubborn fat in certain parts of your body. The method is called cryolipolysis. The FDA approved it in 2010.

Scientists came up with the idea for cryolipolysis by studying what happens to fat during frostbite. Fat freezes at a higher temperature than skin. The cryolipolysis device cools your fat to a temperature that destroys it while leaving your skin and other tissues unharmed.

Cryolipolysis isn't surgery and doesn't use needles. The device holds the part of your body your doctor wants to target between two paddles. The paddles cool quickly and your doctor leaves them in place for about 35 minutes to 1 hour and 15 minutes. During that time, the process destroys about 20%-25% of the fat cells in the area that's targeted.

The final results may not show up for a few months, but you may start to see some changes within a few weeks. Your immune system clears out the dead fat cells slowly over this time.

CoolSculpting might be a good option if you have a fat bulge that won’t go away, even if you’ve tried exercise and diet changes. It only works on small pockets of fat, so it won’t help you lose weight. But if you want to smooth out (or “contour”) a particular part of your body, it’s a good choice.

A doctor can use cryolipolysis to kill fat cells in areas like:

  • Under the chin and jawline
  • Thighs
  • Belly
  • Back and sides
  • Under the butt
  • Along the bra line
  • Upper arm

CoolSculpting BMI requirements

The CoolSculpting website doesn’t list any BMI requirements. But it works best for people with a BMI in the normal range (i.e., between 18.5 and 25). If your BMI is between 25 and 30, you might need two or three treatment sessions. 

Does CoolSculpting help with visceral fat?

There are two types of fat: subcutaneous and visceral. Subcutaneous fat is the kind you might be more familiar with: it’s the extra pounds around your stomach, hips, and ankles, as well as other areas with visible fat.

Visceral fat is the fat that cushions your organs, so it’s deeper inside your body. You might not be able to see it, but having too much visceral fat can raise your risk for diabetes and heart disease.

CoolSculpting can freeze the subcutaneous fat near the surface of your skin. But it can’t do anything about visceral fat.

Who should avoid CoolSculpting?

Cryolipolysis isn't a way to lose weight. If you need to lose weight, talk to your doctor about changing your diet and exercise routine. If you have a lot of weight to lose, liposuction, or weight loss surgery would probably be more helpful than CoolSculpting.

You should also avoid cryolipolysis if you have:

  • Loose skin
  • Poor skin tone
  • Cryoglobulinemia (a condition where abnormal proteins in your blood thicken in cold temperatures)
  • Cold urticaria (a skin condition that causes hives when you get cold)
  • Paroxysmal cold hemoglobinuria (a type of anemia that destroys your red blood cells when you're in cold temperatures)
  • Raynaud’s phenomenon, pernio, or chilblains (conditions that affect blood flow in cold temperatures)
  • An infection
  • A hernia

You should also avoid it if you:

  • Can’t handle cold well
  • Are pregnant or nursing
  • Have obesity

Cryolipolysis should not be done on areas with:

  • Varicose veins
  • Nerve problems
  • Rashes or lesions
  • A lot of scarring
  • Poor blood flow

If you fall into any of these categories, ask your doctor about alternatives like diet, exercise, liposuction, or abdominoplasty (tummy tuck).

You can get cryolipolysis done at your doctor's office. You should be able to go back to your regular activities right away, so you don't need to schedule recovery time afterward. It's OK to drive yourself home from the appointment.

During the process, you may feel a pulling or tugging on your skin, tingling, aching, and an intense cold. These feelings might go away in a few minutes as the area becomes numb.

After the procedure, you might notice side effects like:

  • Redness
  • Swelling
  • Paleness
  • Bruising
  • Firmness
  • Tingling, stinging
  • Aching or tenderness
  • Cramps
  • Itchiness
  • Sensitive skin
  • Feeling of fullness in the back of your throat (if the procedure was done under your chin)
  • Numbness

Rarely, you might get:

  • Paradoxical hyperplasia
  • Bodywide inflammation
  • Fat embolism (fat cells entering the bloodstream)
  • Lipoma (a fatty lump)
  • Severe or delayed pain
  • Freeze burn
  • Dizziness or fainting
  • Deep thickening of the skin
  • Hyperpigmentation
  • Hernia

Sometimes your skin can look less smooth afterward. This is because the treatment destroys a small pocket of fat, but the surrounding areas still bulge. You can fix this with additional CoolSculpting sessions or liposuction. 

Paradoxical fat hyperplasia

Paradoxical fat hyperplasia, or paradoxical adipose hyperplasia (PAH), is when the number of fat cells in the treatment area go up instead of down. It can cause a large, firm, and typically painless mass under the skin in the treatment area. You might also notice a change in body weight. 

PAH usually happens about 2 to 5 months after treatment. It can occur wherever you were treated. It’s not clear why it happens, but some doctors think that it has to do with equipment malfunctions or provider mistakes. This could lead to the fat cells being cooled enough to spur growth, but not enough to destroy them.

This is a rare side effect, occurring in less than 1% of cases. It’s more likely to happen if:

  • You’re male
  • You're of Hispanic descent
  • A large handpiece was used during treatment
  • The procedure was done on your abdominal (or belly) region

Genetic factors may also play a role.

PAH won’t go away on its own. You may need:

  • Liposuction, a surgery that takes out fat from specific parts of your body
  • Abdominoplasty or tummy tuck, a procedure that removes extra skin and fat from your stomach
  • An injection of deoxychalic acid, which also can help remove fat

CoolSculpting bruising

Up to 10% of people get bruises from CoolSculpting, possibly because of the suction from the vacuum. These bruises go away within 2 weeks.

Studies show that cryolipolysis is safe and effective. The risks are few and rare. There's no damage to your liver. Side effects are mild, too, and go away after a short time. On average, it lessens the amount of fat in targeted areas by 10%-25%.

CoolSculpting can help you get rid of stubborn patches of fat. But it won’t help you lose weight, and you can still gain weight after the procedure. So it’s important to follow up with a healthy diet and exercise routine.

If you do gain weight, the extra pounds will probably be spread evenly throughout your body.

After your CoolSculpting session, you should be able to get back to regular activities almost immediately. Don’t forget to schedule a follow-up appointment.

You’ll probably notice side effects like redness, numbness, bruising, and swelling. These tend to go away within a week or two. But for some people, numbness from CoolSculpting can last for several weeks.

You probably won’t notice results right away. That’s because your body needs time to get rid of the destroyed fat cells. 

According to the CoolSculpting website, you should start seeing results after about 6 weeks, with full results by 12 weeks. 

Other research suggests that full results take a little longer, about 3-6 months after treatment. Some studies add that the treatment could also help with skin tightening.

After the procedure, it’s important to follow up with healthy habits. You can still gain weight after CoolSculpting. If you gain weight, it will probably be distributed evenly throughout your body. Talk to your doctor about finding a diet and exercise routine that’s right for you.

How to speed up CoolSculpting results

There’s no research on ways to speed up CoolSculpting results. But there are some studies being done on how providers can improve your results. For example, the provider can massage the area immediately after treatment. 

Other studies are looking at whether the number of CoolSculpting sessions, the use of heat, and combined therapy with deoxycholic acid or electromagnetic radiation could improve results. But more research may need to be done before providers start using these strategies.

Cryolipolysis is considered a cosmetic treatment. That means insurance won’t cover it.

How much you’ll pay for cryolipolysis depends on several things: 

  • The body part you want to treat (smaller areas cost less) 
  • How many sessions you have
  • Who does your procedure
  • Your location 

Cryolipolysis for the arms, for example, may take only one session per arm and would cost less per session than larger areas, such as your stomach or hips. According to the CoolSculpting website, a personalized treatment plan typically costs between $2,000 and $4,000.

Other procedures to remove, shrink, or break down fat include:

  • Liposuction, a type of plastic surgery that removes fat deposits
  • Heat treatments (SculpSure) that use lasers to remove fat
  • Deoxycholic acid injection (Kybella), which breaks down fat cells (used only for the chin area)
  • A radiofrequency procedure (truSculpt, Vanquish) that kills fat cells with heat 
  • A cold laser treatment (Zerona) that shrinks fat cells 
  • Electromagnetic treatment (Emsculpt), a procedure to break down fat cells and tighten muscles.

Talk to your doctor before having any cosmetic procedure.

CoolSculpting could be a good option if you’ve tried diet and exercise but still can’t get rid of a stubborn fat bulge. The provider will use a tool to freeze fat cells in a certain part of your body, destroying them. It can be done in a doctor’s office, doesn’t require anesthesia, and is generally considered safe. But it won’t help you lose weight and can cause some side effects. Ask your doctor if CoolSculpting is right for you.

Does CoolSculpting actually work?

CoolSculpting won’t help you lose weight, but it will get rid of stubborn pockets of fat. Each procedure destroys about 10%-25% of fat in the treated area.

How long does CoolSculpting last?

CoolSculpting doesn’t stop you from gaining weight. But if you do gain weight, it will probably be spread evenly throughout your body.

What is the downside of CoolSculpting?

CoolSculpting can help you get rid of small pockets of fat, but it won’t help you lose weight.

Does CoolSculpting work on belly fat?

CoolSculpting can help with visible belly fat, but it won’t get rid of the visceral fat deeper inside your abdomen.