Where Did All That Frozen Fat Go?

Actual Patient. Dramatization. Photo: Allergan Aesthetics; Photo Illustration: Rebecca Hoskins

It’s not often that a buzzy treatment comes along and actually sticks around, but CoolSculpting® continues to beat the odds. While most emerge out of short-lived trends — when was the last time you heard about someone getting a vampire facial? — other treatments, albeit few, manage to stand the test of time and our short attention spans. But CoolSculpting® is part of a unique club of medical treatments that continues to be a hot topic of conversation. Since its inception, more than 13 million CoolSculpting® treatments have been performed worldwide. When it comes to reducing stubborn fat, CoolSculpting® continues to be a chosen treatment.

But its sustained relevance means a refresher is often in order. Maybe you were around in 2008 when the concept of freezing fat cells was introduced to the world, but if you weren’t, you may have some questions. Even if you were, there may be some lingering inquiries you’ve historically felt too embarrassed to ask. So we did the asking for you. From result expectations to that rumor about CoolSculpting® changing your poop, Dr. Jennifer Levine, New York plastic surgeon and CoolSculpting® expert, answers it all.

What is CoolSculpting®?
CoolSculpting® is a Food and Drug Administration-cleared treatment for the reduction of stubborn fat in nine FDA-cleared areas of the body that do not respond to diet and exercise.

How does CoolSculpting® work? 
CoolSculpting® uses cryolipolysis also known as fat freezing. Once the fat cells are frozen, the cells die off and the body naturally eliminates them in the weeks to months following the treatment.

Do I need a consultation before CoolSculpting®?
Yes, all patients require a consultation. We always meet with each patient to go over their goals, formulate a custom treatment plan, and make sure that they are an appropriate candidate for the procedure.

Who is a good candidate for CoolSculpting®? 
CoolSculpting® is indicated for patients with stubborn fat. CoolSculpting® is FDA-cleared to treat visible pockets of fat in nine different areas on the body — on the abdomen, flanks, thighs, upper arms, bra fat, back fat, and the banana roll (the area underneath the buttocks) — in patients with a BMI of less than or equal to 30. Submental (under the chin) and the submandibular (under the jawline) fat can be treated in patients with a BMI of up to 46.2. It is also FDA-cleared to affect the appearance of lax tissue in the submental area.

What are the side effects?
Side effects may include numbness, swelling, and discomfort. Some redness, tingling, or stinging may occur. A rare complication known as paradoxical hyperplasia may occur in about 1 in 3000 treatments (0.033 percent). [Ed note: These are not all the side effects of CoolSculpting®. Please see additional Important Safety Information at the end of this article.]

Is there any downtime? Are there any restrictions on activities after treatment?
CoolSculpting® has little to no downtime. There is no restriction in activities after the procedure.

Model was treated with CoolSculpting® on her abdomen. Results may vary. Photo: Allergan Aesthetics; Photo Illustration: Rebecca Hoskins

Where does the treated fat go?
Treated fat cells are frozen and then die. In the weeks to months following treatment, the body will naturally eliminate the dead fat cells.

Will it come back or migrate around the body?
No. Once fat cells die off and are eliminated, they do not come back. The process occurs slowly and there are no other depositions of fat in other parts of the body.

Does your poop change after CoolSculpting®? 
None of my CoolSculpting® patients have reported any changes to their poop.

Let’s talk aftercare. Is that two-minute massage post treatment really important? 
The massage immediately after the treatment is necessary to help break up the fat cells. It helps improve the results, which leads to greater fat reduction.

What food should I avoid after CoolSculpting®?
Patients should drink plenty of water and maintain a healthy diet. Avoiding heavily processed foods, refined sugars, and other carbohydrates are part of healthier eating.

How many CoolSculpting® treatments does someone need to achieve their desired results?
For many patients, two or more treatment sessions are needed to reach their body contouring goals.

How long will each treatment take?
Each treatment takes as little as 35 to 75 minutes, depending on the area treated. With CoolSculpting® Elite, you are able to treat two areas at the same time.

Does CoolSculpting® hurt?
CoolSculpting® typically does not hurt. For the first five to 10 minutes of the treatment, you experience a very cold sensation, but after that, the area usually goes numb for the remainder of the session.

Can I freeze my fat cells at home with an ice pack?
You cannot get the results of CoolSculpting® with an ice pack, and you could injure your skin or cause other types of injuries if you try this. CoolSculpting® has proprietary technology that allows it to freeze and eliminate stubborn fat safely and effectively.

What happens if I gain weight after CoolSculpting®? 
If you gain weight, your other fat cells increase in size, so it can negate the effects of the treatment.

What’s the difference between CoolSculpting® and CoolSculpting® Elite?
CoolSculpting® Elite has two applicators, which enables treatment of two separate areas at the same time, reducing treatment time. The applicators have a C-shaped design that allows it to fit the body’s natural curves for improved fit and comfort.

When can I expect to see results?
Results vary from patient to patient, and results can be seen after one treatment. Some patients may see some changes in four weeks, and it may take up to six months or more to see the full effect. Depending on the patient and their treatment goals, two or more treatments may be required.

What kind of results will I see? 
Patients can expect up to a 20 to 25 percent reduction in fat layer thickness after one session. For many patients, two or more treatment sessions are recommended to achieve their body contouring goals. Patients saw up to 73 percent greater fat reduction after two visits than after just one.*

Are the results permanent?
Treated fat cells are eliminated, so yes, the results from CoolSculpting® are permanent. It is still advised to maintain a healthy lifestyle, including a diet and exercise routine, after your treatment to help keep fat off.

Is CoolSculpting® covered by insurance?
No, CoolSculpting® is not covered by insurance.

How much can CoolSculpting® cost?
Prices can vary by practice or by region. A national average of CoolSculpting® practices showed a price of $3,200 for a package of eight CoolSculpting® treatments. Through May 2023, participating CoolSculpting® providers are offering a “Buy 4 Get 4” treatment package. Visit CoolSculpting.com to learn more and to locate a provider.**

*In a study, 106 patients received CoolSculpting treatments on the abdomen and/or love handles. 102 received two treatment visits and four received one treatment visit. The primary goal was to evaluate patient satisfaction. The secondary goal was to measure the change in fat volume from the start of the study to a certain timepoint after each treatment visit. Volume of fat was measured at day zero, 8 weeks after the first treatment visit and 12 weeks after the second treatment visit. After the study was completed, calculations were done using the fat volume data of the patients who received two treatment visits. Change in fat reduction was compared at each timepoint.

**At participating providers only. Check with provider to confirm participation. Must be an Allē member.

During the procedure you may experience sensations of pulling, tugging, mild pinching, intense cold, tingling, stinging, aching, and cramping at the treatment site. These sensations lessen as the area becomes numb. Following the procedure, typical side effects include temporary redness, swelling, blanching, bruising, firmness, tingling, stinging, tenderness, cramping, aching, itching, or skin sensitivity, and sensation of fullness in the back of the throat after submental or submandibular area treatment. Rare side effects may happen in 1 to 10 out of 10,000 CoolSculpting® Elite treatments (between 0.01% to 0.1%). One such rare side effect is a visible enlargement in the treated area, which may develop 2 to 5 months after treatment, will not resolve on its own, and may require surgical intervention for correction.