Coolsculpting by Zeltiq: Does It Really Freeze Off Fat? Reviews, Cost, and Before and After Photos

Skin Care
Coolsculpting by Zeltiq

Coolsculpting by Zeltiq: Does it really make you this thin in an hour? Photo source:

No matter how much you eat and live right, some of us just cannot get rid of those few pesky pounds here and there. Many methods are available for that purpose, from liposuction to lipolysis. Whether liposuction or lipolysis by laser, ultrasound or radiofrequency assistance, each has various degrees of invasion, efficiency and risk factors.(1) But today we explore a unique, new, FDA cleared advancement that will revolutionize the way we think about body contouring: CoolSculpting™.

CoolSculpting™ by Zeltiq®

Coolsculpting by Zeltiq

Coolsculpting by Zeltiq – Before and After. Photo courtesy

Zeltiq® was founded in 2005. The technique was developed by dermatologists Drs. Dieter Manstein, MD, PhD, and R. Rox Anderson, MD, at the Wellman Center at Massachusetts General Hospital in Boston, a teaching affiliate for Harvard Medical School.

The Science

Popsicle panniculitis

Popsicle panniculitis

The word cryolipolysis is broken down into three parts: “cryo”, Greek for icy cold; “lipo”, Greek for fat; and “lysis”, Greek for to break down. The idea actually came from the effect of cold on children’s fat: When they eat too many popsicles, they develop cheek dimpling. Interestingly enough, this dimpling has a clinical term: popsicle panniculitis! It was also noted newborns with hypothermia develop panniculitis (fat inflammation). (1)

How Fat Cells are Different From Other Cells


Apoptosis is a complex process of programmable cell death. All you need to know is that Coolsculpting causes apoptosis in your fat cells; dead fat cells are then flushed out by the lymphatic system. Image source: Wikipedia

Basically, fat cells are more sensitive to cooling than other cells surrounding them (skin, muscle, and nerve cells).(1) Cooling breaks them down in a process known as apoptosis, meaning cell death. Apoptosis in turn leads to the release of inflammatory mediators and the attraction of inflammatory cells.

These inflammatory cells help the body clean up dead fat cells. The lipids once contained inside the cells are eliminated through the lymphatic system.(1) This happens gradually over the course of the two to four months following the procedure, leading to decreased thickness of the fat layer. Because the process is slow, there is no risk of a sudden increase in blood lipid levels or affection of liver function.(4)

How Cold is Coolsculpting?

Studies by Zeltiq® tested temperatures as low as – 7° Celsius (19.4° Fahrenheit).

But more important than the temperature reached is how fast it’s reached. The people at Zeltiq® use the term Cooling Intensity Factor, or CIF, a numerical value which measures the rate at which heat is drawn away from the treated area. The heat is drawn away from the area in a controlled manner that ensures only fat cells are affected, which creators termed “selective lipolysis”.(3)

The Procedure

After your dermatologist declares you are a suitable candidate for the procedure and obtains consent, the following happens:

  • Documentation is taken for before and after comparisons. This documentation includes photography, body weight, and circumference of the area to be treated.
  • Afterward, you lie down in preparation for the procedure. Bring something to keep you busy, such as a book or an iPad. Or you can ask for the lights to be dimmed and use the time for a mid-day nap!
  • A very thin pad is placed on the skin on the targeted area. It’s soaked in “coupling gel.” This is to ensure constant contact between the skin and the applicator during the procedure.
  • The device’s cup-shaped “applicator” is applied on top of the pad, and a vacuum is turned on to suck in the targeted area. A C-shaped pillow may be put around the applicator to support it.
  • The applicator has two cooling panels on either side of the pinched skin, which start bringing down the temperature of the targeted area. Temperature sensors, also in the applicator, monitor the entire process and give feedback through the device’s display.

The Experience

  • The pad that is applied is soaked in a gel so you will initially feel it cool and wet on your skin.
  • The suction and cooling sensations are not at all uncomfortable.
  • After the applicator is removed, the area treated will feel very cold and a tad bit hard, as one delightful patient described it, “it feels like a chicken just out of the freezer!” Don’t panic! This is the desired end result and it will fade away within the next couple of hours.

The End Result

Coolsculpting Before and After

Coolsculpting Before and After. Photo Courtesy

  • Over the course of two to four months, you will notice a gradual reduction in the circumference of the treated area and a visible sculpting or contouring that looks very natural.(2)
  • Reduction has been reported to be anywhere between 1 – 5 cm (0.5 to 2 inches). Patients reported going down a dress size.
  • If desired, the procedure can be repeated after two to four months.
  • According to the site, results have been shown to be persistent for over six months post procedure. More long term studies are yet to be conducted.

The Cost

Depending on the target area, prices are anywhere between $600 and $2,000 per area.


  • Non invasive: no hospitalization, no anesthesia, no surgery, no stitches, no pain!
  • Zero down time: You finish the procedure, and go back to work or get ready for that dinner date!
  • Excellent for fit, healthy people or have a fat bulge here or there.


No real disadvantages, just some points:

  • The treated area becomes red; this usually disappears by the end of the day.(1,2)
  • There’s swelling or bruising due to the vacuum; this disappears within the first week.(2)
  • Twenty percent of patients reported temporary numbness in the area treated (dysthesia); this normalizes in one to eight weeks. There have been no reports of lasting numbness, but the sensation can be pretty irritating.(2)
  • This procedure is not suitable for patients who are overweight or have considerable skin laxity. (2)
  • A single session lasts from one to three hours.
  • The device has only one applicator, so if you are targeting two areas (e.g. both love handles) you will need to be there for double the time, as one area is treated at a time.
  • Expectations have to be realistic; it’s crucial to understand that the results are not as drastic as a liposuction.
  • The CoolSculpting™ makers do not recommend that the procedure be used as a treatment for cellulite.
  • As one study points out, the effect of cooling must be evaluated in patients suffering from diseases that are aggravated by the cold, such as cold urticaria or cryoglobulinema.(1)Always tell your doctor of any pre-existing conditions.

Bottom Line

Cryolipolysis is still in its early stages, and more studies are needed to fully understand the procedure and its long term effects. Nevertheless, there is no arguing this procedure is a breakthrough in the world of body contouring! Whether it is for you really depends; some would prefer an invasive, more drastic liposuction, some would prefer a non invasive, lunch time or weekend CoolSculpting™ session with more subtle effects.

Also, it is important to keep in mind that “do-it-yourself” cooling techniques, such as applying ice for a long time on your skin, can be damaging.(1) This is because CoolSculpting™ is designed to treat the skin in a controlled, regulated manner.

Thanks for reading! Remember, stop by my blog,, or tell your friends if interested in reading about skin care in Arabic!


1-     B. Zelickson et al. Cryolipolysis for Non Invasive Fat Cell Destruction: Initial Results from a Pig Model. Dermatologic Surgery 2009; 35 (10): 1462-70.

2-     A. Nelson et al. Cryolipolysis for Reduction of Excess Adipose Tissue. Seminars in Cutaneous Medicine and Surgery 2009; 28 (4): 244-9.

3-     L. Brightman et al. Can Second Treatment Enhance Clinical Result in Cryolipolysis? A Case Report. Cosmetic Dermatology 2011; 24 (2): 85-8.

4-     B. Kenneth et al. Non Invasive Cryolipolysis For Subcutaneous Fat Reduction does not Serum Lipid Levels or Liver Function Tests. Lasers in Surgery and Medicine 2009; 41 (10): 785-90.

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15 thoughts on “Coolsculpting by Zeltiq: Does It Really Freeze Off Fat? Reviews, Cost, and Before and After Photos

  1. rubab says:

    Pls can you write in detail about EMS electomagnetic stimulation and muscle building,does it really tone especially tummy area the body or not weightloss and how many treatment for how many min a day could show results.

    • Dr. Hanan Taha, M.D. says:

      Coolsculpting should not be a problem for a person with diabetes. Many diabetics have already had the procedure done, and its definitely better in terms of being non surgical. As always diabetes should be well controlled and the doctor should be made aware of any other existing medical conditions.
      Thank you for your question.

    • Dr. Hanan Taha, M.D. says:

      Hello @Mary.
      If you’re in Kuwait, there is non other than Dr. Sahar Ghannam. Not only is she a brilliant dermatologist, she is also very invested in patient education. She will give you all the time you need to discuss your concerns with you. She has great integrity, so you can feel safe with her. Plus she has a fantastic personality.
      Say hi for me!
      Thank you for stopping by!

  2. Cynthia says:

    What did you mean by “…results have been shown to be persistent for over six months post procedure…?”

    I thought the results were permanent?

    • Dr. Hanan Taha, M.D. says:


      Well, this sentence is provided on the website by the makers of Zeltiq. Basically, what this means is that the doctors/researches followed the patients for six months after the procedure and found that the results are persistent. This is good news. And, like I mention in the very next sentence, more long term studies are needed. This holds true for any new procedure. But the results are very promising.

      It makes perfect sense to say that, if fat cells are being destroyed, then they are gone and they will not come back, UNLESS new fat cells are created by gaining weight.

      Thank you for your question!

  3. Edit says:

    Dr Hanan, I have a question. Is Zeltiq recommended on areas with surgery scars? I am tempted to have it done on my abdomen but I have a big vertical scar from a surgery done 22 years ago.

    Thank you,

    • Dr. Hanan Taha, M.D. says:

      Generally it should be OK to perform Coolscultping on a scar that old, but the doctor will take a look at it beforehand to make sure there are no excessive adhesions or herniation.

      Also, you might experience slightly more bruising and discomfort than someone who doesn’t have a scar.

      Thank you for reading and commenting!

  4. J. Turner says:

    This was the worst investment I’ve ever made. I had my treatment done in Marina Del Rey and paid about $1600 and have seen NO results in a year and a half. They told me after my first treatment that I would need to have more treatments done, which would cost and additional $1600 per treatment. I was also told that it was painless which was a complete LIE. I was sore and tender in the treatment areas for five days. The only pain I can compare to it is child birth! They also told me that if I applied for the finance option it would be 0% interest, what they failed to tell me was that it was 0% for 3 months. I felt completely taken advantage of! I have reported them to the Better Business Bureau and whenever I hear some one talking about it I speak up. I wouldn’t want any one else to go through this terrible experience.

    • Dr. Hanan Taha, M.D. says:

      @J. Turner
      I am so sorry that you’ve had such a negative experience. It is very upsetting when you go in with high expectations, and pay all that money, only to end up with a lot of pain and no pay off. It also should have been made very clear that the 0% interest was only for 3 months. That this would not be made very clear is NOT acceptable. If this is entirely their doing, then I definitely am glad you reported them.
      It is a fact that not every procedure will work 100% of the time. There are too many variables. The majority that have tried Coolsculpting do see a difference. I am sorry that you were not one of them.

  5. Nichole says:

    @ J Turner,

    I too am a victim of cool sculpting and feel the need to speak out. I can hardly believe the FDA approved this procedure. I had two sessions done on both my abdomen and flanks in December, 2012 and January 2013 (so a total of 4 procedures-2 on each site) as I was also told that I would need more than one to see any results. Well May 2013 rolled around and NOTHING. I did speak up to my plastic surgeon and they gave me 1 free procedure to my lower abdomen. Apparently they noticed a difference in my flanks, which I did not and still don’t. Had my 3rd procedure on my lower abdomen in middle June, 2013 and guess what? Well it’s mid August now and I notice zero difference! Additionally, I agree with you that this is not a painless procedure, quite the opposite! I felt like I was being stabbed for 2 weeks straight after each procedure on my abdomen. So basically, for 1 1/2 months of my life I have been in agony for nothing and it hurts. Pain killers do not work because it is nerve damage. I had to ice myself every day/night in order to sleep and take ibuprofen, even though it really didn’t do anything. I’ll be going back to my plastic surgeon again in 1 month and shockingly I doubt anything will change as this has been my 3rd time!!! Nothing but lies and I hope this company goes down in flames. The only reason I even did this is because my plastic surgeon did my breast augmentation a few days ago (way less painful then cool sculpting by the way) and and has a stellar reputation, so I’m shocked that a procedure like this was offered at his office to get no results. I won’t be going back again for any future treatments, that’s for sure! So for anyone who thinks about doing this, save your money!! I spent 4k for absolutely nothing, and it was very very painful!! and Dr. Taha, don’t lie to your patients this is an aweful procedure to have done. I really think lipo would have been the better way to go considering the amount of pain I was in anyway.

    Additionally ,I was an ideal candidate for something like this. I’m petite at 5’2 weight approximately 125 lbs and just had the little pooch that they advertise will go away. Nope!!

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