CoolSculpting by Zeltiq

What is CoolSculpting® by Zeltiq™

CoolSculpting® is a unique non-surgical treatment for removal of fat from localized pockets of excess. This non-invasive procedure represents an alternative to surgical liposuction or invasive SmartLipo™ by using a novel cooling technology that permanently removes fat cells from treated areas. Body regions that we treat most commonly include the central abdomen, waist (a.k.a. “love handles”) and back; these problem areas often remain despite exercise and diet and fat removal of 22% to 25% have consistently been observed.

Background Information on CoolSculpting

Zeltiq™, the company that manufactures the CoolSculpting device, based its technology on research performed at the same Harvard laboratories that did the ground work for other non-invasive technologies including laser hair removal, tattoo removal and Ultherapy™. Observations of permanent fat loss in children who habitually sucked on popsicles lead to the description of cryolipolyis, the specific elimination of treated fat tissue.

Is CoolSculpting approved by the FDA?

The FDA gave its final approval to CoolSculpting for fat removal from targeted fat compartments in September 2010. Patients in Europe and elsewhere in the world had the advantage of CoolSculpting way before this time. Our patients today can benefit from the vast experience gained over the years with this new treatment of non-invasive fat removal.

What is the Science behind CoolSculpting?

The procedure of CoolSculpting takes advantage of cryolipolysis which describes the targeted destruction of fat cells through cold temperatures. Fat cells experience injury through cooling leading to permanent removal of these susceptible cells. This cooling can be performed without physical skin penetration; the specific cold temperature leads to treatment of fat without causing injury to skin or other tissues.  Just like fat on a piece of meat turns from soft to very hard when put in the freezer, human fat changes from liquid to solid state at precise temperatures. This process induces apoptosis, a naturally pre-programmed progression leading eventually to complete removal of the injured fat cells.

After the treatment, apoptosis starts on a microscopic level by contraction of the fat cells. The adjacent skin, nerves, muscles and vessels are left unharmed. Fat stored within the cells loses its containment and is slowly and naturally absorbed by our body systems. CoolSculpting-induced fat removal was found to be very safe: because it happens slowly and gradually, no noticeable change on the blood’s lipid and cholesterol levels occur. As the fat cells disappear, the thickness of the fat layer is reduced.

How is the Procedure Performed?

During your consultation, the patient’s specific problem areas and candidacy for CoolSculpting are determined. Your overall body constitution, the location and amount of fat excess, patient expectations and your desires are determined. A treatment plan is developed specifically for your situation. CoolSculpting is performed without medications or anesthesia. The body area to be treated is mapped and we apply a specific gel sheet in order to protect your skin. A vacuum applicator is chosen for your particular sculpture which allows the fat pocket to be drawn away from your trunk for the treatment. Cooling panels positioned within this applicator initiate the temperature reduction of the fatty tissue. Safety is provided through sensors within the applicator that deliver feedback for proper cooling. The treatment continues for exactly one hour; mild massage of the treated fat tissue marks the end of the therapy. No other local care is necessary after the treatment.

What does CoolSculpting Feel Like?

Our patients experienced the CoolSculpting procedure with ease; partly because cold (as opposed to hot temperatures) is an effective anesthetic. During the treatment, patients read, listen to music or simply rest; even napping has occurred. For many, the application of the gel pad gives them a little shiver although these pads are stored at room temperature. The moment when the treatment area is sucked into the applicator is described by most as “interesting” or “strange”. Other patients find this uncomfortable. The cooling down phase feels similar to the use of an ice pack to this part of your body. Once the pain reducing anesthetic qualities of cold come slowly into effect, patients relax for the remainder of the 60 minutes; the CoolSculpting machine gently humming in the background.

What Can You Expect after the Zeltiq Procedure?

After removal of the cooling applicator, the treated area is still cold (although numb) and will appear prominent. As the tissue regains its normal temperature, the normal shape will return leaving just some skin pinkness behind. By the next day, many patients do not see or feel much in the treated area; others have described a slight sense of tenderness. Because of the negative suction pressure, the treated area can appear like a “hickey” with some broken capillaries or mild bruising. Total resolution of these signs usually takes a few days, but can take up to a couple of weeks.

When Will You See Results after CoolSculpting?

Because of the natural removal of fat cells, patients have to allow their body to do the work. It takes easily 3 weeks for most patients to observe a slight improvement. Complete treatment results can take 3 or 4 months during which time the body had a chance to completely remove the apoptotic fat cells necessary for the cosmetic improvement. Studies proved a 22 to 25% reduction of fat in the treated areas, enough for good candidates to see a significant improvement.

Can I Have Additional CoolSculpting Treatments?

CoolSculpting is designed to deliver results after one treatment session; it is not a mandatory treatment series.  This does not prevent further treatments, even in previously treated areas, if a patient seeks additional benefits. We recommend waiting 3 months before undergoing the second CoolSculpting session of the same regions; other regions can be treated at any time.

What are Possible Side Effects after CoolSculpting?

Zeltiq’s CoolSculpting was found to be a very safe and effective non-invasive and no-downtime procedure. You can resume your normal activities after the treatment. The most common side effects are related to the cold temperature and suction application to the skin including pinkness, pins-and-needles sensation, skin numbness, broken capillaries or bruising, tenderness and pain which may take up to a couple of weeks to resolve. The most significant side effect that has been described (approximately 1 out of 3,000 treatments) is more significant pain in the treatment area that may last a couple of weeks to resolve. This pain always resolved and it remains unclear why so very few people develop it in the first place. No long-lasting side effects have been encountered.

Could I have Liposuction or SmartLipo (a.k.a. Laser Liposuction) After CoolSculpting?

Yes, that should not be a problem. Because of the induction of natural fat cell loss, there is not scaring after CoolSculpting. In fact, the remaining tissue looks totally normal under the microscope – just with less fat. Therefore, if a patient wishes to undergo conventional liposuction or laser-assisted liposuction (SmartLipo etc.) years later, the liposuction procedure can be performed safely and effectively. The CoolSculpting-induced fat reduction will remain.

Will there be Dimples, Bumps or New Skin Wrinkles After CoolSculpting?

No, these side effects have not been reported after the Zeltiq procedure. Although a concern after surgical liposuction or SmartLipo, CoolSculpting does not appear to result in noticeable dimpling or unevenness of the treated body region. But it also has to be noted that cryolipolysis does not lead to skin tightening; therefore, skin laxity present before the procedure should be expected to be there afterwards.

How Long Will the CoolSculpting Results Last?

The procedure is based on cryolipolysis, a permanent reduction in the number of fat cells within the treated areas. The number of fat cells will not increase after they have been removed through CoolSculpting. Of course, weight gain is undesirable after CoolSculpting. In cases of weight changes, the volume of remaining fat will be effected but an advantage will continue.

Does CoolSculpting Replace Weight Loss Through Exercise or Diet?

No, it does not. In fact, CoolSculpting will be most effective for patients within 10 to 15 pounds of their ideal body weight. If you plan on losing weight in conjunction with CoolSculpting, you certainly want to do so before your Zeltiq procedure. Most people are still left with bothersome fat compartments after successful weight loss which will be amenable for CoolSculpting.

Before                                                               2 months after 1 CoolSculpting treatments

Before                                                               2 months after 2 CoolSculpting treatment

Before                                                                    2 months after 1 CoolSculpting treatment

Before                                                                   3 months after 1 CoolSculpting treatment