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How Risky Is CoolSculpting?

Medically reviewed by Susan Kerrigan, MD and Marianne Madsen on February 10, 2023

You’ve tried everything you can to lose weight, but you’re left with pockets of fat that won’t go away. You’re feeling discouraged in your journey toward better health–nothing you do is working on that fat. Your self-esteem and motivation are flagging. You’re looking for something to rid yourself of those stubborn problem areas. What’s out there to help you?

 

In the realm of plastic surgery, there’s a relatively new kid on the block. CoolSculpting was originally founded in 2005, and officially FDA approved as a method for removing fat in the “love-handle” area in 2010. Also known as cryolipolysis (or fat freezing), this technique was pioneered to help people who have done everything they could to lose weight but still have fatty deposits that won’t move. 

 

How does CoolSculpting work?

 

For starters, while it’s lumped into the cosmetic surgery world, CoolSculpting is in fact a non-surgical procedure–a fact that makes it even more tantalizing to someone considering it. First, the pocket to be removed is outlined using a skin marking pencil. An applicator is then used to freeze the fat cells that are located under the skin. To protect the area, a special gel pad is applied. Once those steps have been completed, the stubborn pocket is suctioned into the applicator’s opening. The eventual end goal is to cool the fat between a temperature of 30.2 and 39.2 degrees Fahrenheit. A massage may be necessary to help the fat break down even further. 

 

Effectively, the technique is based on the knowledge that fat cells in particular are more susceptible to retaining damage when they are cold. Remember that burning feeling when you ate a popsicle or simply tried eating snow as a kid? Well, this process (called cold-induced fat necrosis) was first developed after kids ate popsicles and left them on their cheeks for a few minutes (no kidding!). The founders of CoolSculpting were then able to observe the skin samples from children in this scenario and found that the fat showed signs of inflammation, but the skin remained undamaged. 

 

In 2007, they tested a device on pigs to see if they could kill specific cells. They found that yes, there was about a ½ inch reduction in the layer of fat without sustaining any damage to the skin itself. The theory is that fat cells are more susceptible to damage from the cold. The fat cells die a few days after being cooled, and then over the next several months the body uses its own natural processes to clean up the dead fat cells. 

 

Risks

 

As with all procedures, you should be aware that CoolSculpting comes with some risks. First of all, patients who are obese or very overweight are not candidates for CoolSculpting. Even with an overall positive outcome, you may be left with skin that is irregular looking or not smooth even after it’s done healing. If you need more than one treatment, you will have to wait a minimum of 6 weeks for the next one to be certain that the damaged fat cells are all gone. 

 

It is entirely possible you will gain weight instead of just losing fat–instead of just disappearing, the fat may be deposited to other parts of your body. Lastly, there is one possible but rare side effect that may happen called paradoxical adipose hyperplasia, where instead of the fat cells shrinking and disappearing, the fat cells actually grow in size after treatment. 

 

All in all, if you are an overall healthy person with a few stubborn fat pockets, you are likely to be considered a candidate for CoolSculpting. It appears that CoolSculpting is a relatively safe procedure that can drastically change someone’s outlook on their body.

 

Written by Yonah Leserowitz

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