Expert Doctor


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Karen Horton, MD

San Francisco, CA


The CoolSculpting applicator cools the treated area to a temperature level that makes the fat cells crystalize and die. The treatment targets problem areas such as:

  • Arm fat
  • Love handles
  • Waist
  • Neck
  • Inner and Outer Thighs
  • Hips
  • Abdomen

CoolSculpting is not a treatment to help a person achieve large amounts of weight loss. Researchers have found that the body’s fat cells are very unhappy at a narrow range of lower temperatures. If doctors treat an area of stubborn fat in that narrow temperature range for one hour, 25% of the fat cells will die. The body will naturally clear them so it is a way to reduce an area of stubborn fat in the body.

Am I a Good Candidate for CoolSculpting?

Patients are a GOOD CANDIDATE for CoolSculpting if:

  • They want to target localized deposits of fat
  • They have good skin elasticity and skin tone
  • He or she is in overall good health

On the other hand, a patient is NOT A GOOD CANDIDATE for CoolSculpting if:

  • They are obese
  • They want to target large, or widespread, areas of fat
  • They have poor skin elasticity or skin tone
  • They have large amounts of scarring in the area to be treated
  • They do not have realistic expectations about what CoolSculpting can accomplish

How is CoolSculpting Performed?

CoolSculpting is performed using a machine that freezes fat tissue. The fat is frozen by a device that is applied to the skin in order to facilitate the removal of the fat. Two rolls of fat are placed between two cooling panels. The device creates a suctioning movement that removes the fat once the fat cells are damaged by the freezing sensation. The coldness damages the cells of fat so they can be suctioned out as well as causing some of them to die. Then, the body absorbs the dead fat cells. Although CoolSculpting can treat a number of areas on the body, it is most commonly performed on the abdomen, the love handles and the flanks.

In general, the entire procedure takes about an hour depending on how much fat is being frozen on the patient. Since it is a non-invasive fat removal, it does not require the use of anesthetics as the cold temperature itself serves as the numbing agent. CoolSculpting may produce some discomfort that is felt as a pulling sensation but there is very little pain. 

CoolSculpting creates a permanent fat reduction. People are born with a certain number of fat cells and they can no longer multiply after the age of 14 (or so). When the fat cells are removed by injuring them with the cold, the body clears them naturally. Fat cells that have been removed, or have died, are not coming back. Genetically, each person is predisposed to put on fat in certain areas. If a patient puts on additional fat after a fat-reduction procedure, theoretically, they could store fat in those same areas where they are genetically predisposed to put fat on.


Lipo is a popular alternative treatment for patients who want more dramatic results. This is a surgical treatment that breaks up fat and removes it from the body by using a cannula.  CoolSculpting provides more subtle results while liposuction gives an 80-90% reduction of fat in patients. Lipo is a very precise body contouring procedure that allows surgeons to treat several areas in about an hour. However, there is bruising and swelling along with little surgical incisions so the healing process is longer after liposuction. On the other hand, CoolSculpting allows a patient to get rid of fat without the need for surgery or any of the recovery and downtime associated with a surgical procedure.

Other Alternatives:

There are a number of alternative treatments to CoolSculpting that patients can use to remove fat and some of them include:

  • Elixis (uses external radiofrequencies and ultrasound)
  • ThermiTight (uses internal radiofrequencies)
  • VASER (uses ultrasound)

The use of CoolSculpting, or these alternative methods, depends on the final results desired by the patient. A person should consult with a board-certified doctor to determine which method will best help him, or her, achieve the desired results.

What is the Cost of CoolSculpting?

The cost of CoolSculpting depends on the number of areas being treated and any fees charged by the doctor or the facility where the treatment is performed. The cost of CoolSculpting is normally in the range of $1500-$4500.

Recovery and Downtime

One of the things patients love most about CoolSculpting is that there is little to no RECOVERY time. There might be a little bit of discomfort but patients can go about their normal activities immediately after the treatment. There are no compression garments or bandages necessary. Depending on the amount of discomfort felt by the patient, he or she might want to limit their workout activities for a few days.


Patients can expect to see some of the results after two or three weeks. The final results will not be apparent for three or four months. If a patient has had a noticeable result that looks great, he or she will probably not need to treat any further areas. Some patients that see improvements want to treat the areas again. They can expect another 25% reduction of whatever is left at that time so the results can be cumulative.

Sometimes patients feel that they have not seen any significant results after their procedure. Once they are shown photos of how they looked before the treatment, they realize they have good results. It is such a gradual and subtle result that it takes a little while to see it.

Limitations and Risks of CoolSculpting

The main LIMITATION of CoolSculpting is the amount of fat it can treat and the results it can provide. As mentioned earlier, this treatment is best used on targeted areas of fat. It is not as effective in treating wider areas of fat and will not provide the same dramatic results as liposuction.

Some commons RISKS of CoolSculpting:

  • Tugging or pulling sensation at the site of the treatment during the procedure
  • Pain or stinging at the treatment site
  • Redness
  • Swelling
  • Bruising
  • Skin sensitivity
  • Numbness

Don’t Simply Trust the Brand Name

Patients have to do proper research and find a board-certified doctor because each individual case is different. It is a matter of finding the best fit for every patient on an individual basis. Even though a person does not have to be a physician to run the CoolSculpting machine, it is best to have an assessment by a board-certified plastic surgeon in order to get a medical and surgical opinion as opposed to just trusting the brand name of the machine. The doctor needs to explain the risks and benefits of each procedure option and make the decision based on the results desired by the patient.


Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Karen Horton, MD in San Francisco, CA