You have been working hard and getting ready for your next competition. You know you are doing everything right, and you can finally see the results. You are eating clean and working out, but you still cannot lose that stubborn belly fat right above your bikini line. And your thigh gap has become more of a thigh rub. You know that if you could just get rid of that tiny bit of fat you would destroy your competition. You wish you had the time to get liposuction, but do not want to deal with the costs of recovery and surgery.
Would you believe me if I told you there was a way to freeze away your fat that does not require surgery?
CoolSculpting is a relatively new non-surgical treatment that removes stubborn fat. It is a noninvasive means of literally freezing your fat cells away. In 2010, the Food and Drug Administration approved CoolSculpting, which uses cryolipolysis to remove small collections of subcutaneous fat. Cryolipolysis is the process where fat cells are destroyed by freezing them. The device uses a vacuum applicator to deliver controlled cooling at the surface of the skin. The combination of vacuum (suction) and cold causes ice to form within the fat cells, which ultimately kills them. This innovative procedure can fix your double chin, love handles, thighs, abdomen, and flanks.
Who is a candidate for CoolSculpting?
Potentially anyone may be a candidate for CoolSculpting; it just depends on your goals. The ideal candidate for CoolSculpting is in good physical health, exhibits localized fat deposits, has minimal skin laxity, and has realistic expectations of the procedure. Those considering CoolSculpting treatment should have expectations of mild to moderate improvement and understand it is not designed for weight loss.
There are very, very few people who cannot safely undergo CoolSculpting. If you have a condition that cold weather can exacerbate, like cryoglobulinemia, cold urticaria, Raynaud’s, or paroxysmal cold hemoglobulinuria, you should not have cryolipolysis. This is because if you have a cold related condition, CoolSculpting can make it worse or trigger an outbreak because it is using cold to freeze the fat away. Also, patients with loose skin or poor tone may not be suitable candidates for the procedure.
What is a realistic change I can expect with CoolSculpting?
This device is designed to treat focal pockets of fat. If you are seeking a nonsurgical method to reduce fat in a localized area, such as in the love handles or outer thighs, CoolSculpting may be the right treatment for you. When you are undergoing a CoolSculpting procedure you can expect mild to moderate improvement in the area being treated. It is important to note that multiple treatment sessions may be necessary to achieve the best results. The number of necessary treatment cycles is dependent on the treatment area. The results of CoolSculpting are not immediately visible because your body has to remove the killed fat cells. It may take your body up to four months to complete the process of removing the destroyed fat cells. Changes in the treated area may become apparent as early as three weeks after CoolSculpting, and the most dramatic results will be seen one to three months after treatment.
You can expect a twenty percent reduction of fat in the treated area. It may take more than one treatment session to achieve this. Individual experiences vary, so you will need to discuss individual results and expectations with your plastic surgeon.
If you desire a dramatic change to your appearance and want a large area changed, you should ask your surgeon about liposuction and body contouring procedures. But remember, the alternatives to CoolScuplting are surgical and will incur more cost, risk, and a longer recovery period.
What are the surgical alternatives to CoolSculpting?
Liposuction is an extremely common plastic surgery operation. It involves, most commonly, the injection of a fluid into the space to be suctioned followed by the removal of fat with a suction device called a canula. Liposuction is best for removing excess fat from large areas like the entire back, buttocks, or abdomen for a dramatic change in your appearance. Liposuction can also be combined with fat transfer to transform an area of your body like your buttocks to give you the butt you have always wanted. Liposuction will produce immediate results.
Body contouring surgery is where the skin and fat is redistributed to create a more pleasing shape. It is most commonly done for aging women or those who have lost large amounts of weight and desire a dramatic change to their appearance. Common examples of body contouring operations are: tummy tucks/abdominoplasty, thigh lifts, and arm lifts/brachioplasty.
How does CoolSculpting work?
CoolSculpting uses a process known as cryolipolysis. It was discovered after scientists understood how frostbite damaged tissues; it freezes fat by forming ice crystals within it, leaving the overlying skin intact. A section of your skin is inserted into a freezing device for about an hour, resulting in the destruction of some fat cells.
What should I expect when I undergo CoolSculpting?
Because it is a non-surgical treatment, no anesthesia is required, and you will be awake for the entire treatment. You can expect a CoolSculpting treatment session to last about sixty minutes, but sometimes more time will be required. First, the desired area is measured and assessed to enable proper selection of the treatment applicator. The treatment area is marked for applicator placement. After this, a special gel pad will be placed on your treatment area to protect your skin. Next, the applicator is applied, and the bulge is vacuumed into the hollow of the applicator. The temperature inside the applicator drops, numbing the treatment zone. Occasionally, you may experience discomfort from the vacuum’s pull on your tissue, but this resolves within minutes, once the area is numb.
Most patients spend their treatment watching T.V., reading a magazine, or perusing their smartphone. Once the treatment is completed, the vacuum is removed and your treatment zone is massaged. Massaging the treatment area improves your result.
How much time will it take me to recover from CoolSculpting?
Because CoolSculpting is a nonsurgical procedure, it offers you a quick recovery with minimal associated discomfort and a low risk of complications. Most of the time, you will be able to resume your normal activities immediately after the procedure. You will not need to budget any downtime afterwards. Occasionally, you may have some redness, minor bruising, tingling, numbness, or discomfort in the treated area. These signs and symptoms can be expected to resolve quickly.
If you have a big event coming up, we recommend scheduling your CoolSculpting treatment about six weeks before it to ensure the results are optimized before it.
Is CoolSculpting a safe treatment?
In short, yes, it is very safe. The complication rate is low, and the satisfaction rate is extremely high. According to the American Society of Plastic Surgeons, CoolSculpting saw an unprecedented increase in popularity in 2017 of over 800 percent from 2010. In our experience, this is due to the benefits of fat removal and no down time!
However, there is a risk of surface irregularities and asymmetry. It is important to remember that any body contouring procedure, including CoolSculpting, may result in an asymmetry. We believe it is important to note that there has been no reported complications that required hospitalization or revisional surgery in the eight years CoolSculpting has been used in the United States of America. The key to being happy with your result is understanding what can be realistically achieved with CoolSculpting, because it may require multiple sessions to get the result you have been hoping for. Rarely, in less than 1 percent of cases, patients may have paradoxical fat hyperplasia, which is an unexpected increase in the number of fat cells. Paradoxical fat hyperplasia is three times more likely in men than in women and is seen more commonly in those of Hispanic or Latino descent.
I can truly say that after almost 40 years of practice and having done thousands of body contouring surgeries like liposuction and CoolSculpting, nearly all patients were thrilled and told me they would do it again. In the pageantry world, it is a popular cosmetic procedure,
and it can clearly make a huge difference in your
final outcome.
The decision to undergo any procedure is not a question I can answer for you. I can help you make an informed decision, but getting CoolSculpting is an individual choice. It is important not to have unrealistic expectations and make sure that this is something that is right for you. Most women who chose to undergo CoolSculpting after a long and thoughtful process truly enjoy their new appearance. More information is always available through our office and at the FDA website at M

Dr. Bergman is a board-certified plastic surgeon practicing in Des Moines, Iowa. He has 25 years of experience and specializes in breast enhancement surgery. For examples of Dr. Bergman’s work, log on to