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CoolSculpting uses an FDA approved device to chill the skin for up to an hour<ref name="CyroMeta"/>, with a session lasting one to three hours<ref name="CSFaq"/>, producing a reduction in the fat thickness in the treated area. Animal and human studies have shown a reduction in fat thickness between 20% and 80% over 3 months following treatment<ref name="ClNelson"/>. The device sucks the skin and underlying fat into a cup<ref name="CryroNerves"/>. More than one treatment can be used, but the results of the second treatment are not as dramatic as the first<ref name="CryroChin"/>. CoolSculpting is considered an alternative to liposuction, which is the most common type of plastic surgery.
=How does CoolSculpting work?=
The device removes heat from the skin at a constant rate, rather than chilling to a particular temperature. (I suspect that simple icing is not used to ensure the technique is patentable.) While the underlying mechanism is unclear<ref name="ClNelson"/>, the current theory is that chilling fat tissues to just below freezing triggers inflammation of the fat cells ([http://en.wikipedia.org/wiki/Panniculitis Panniculitis]) and then triggers natural cell death in the fat cells ([http://en.wikipedia.org/wiki/Apoptosis apoptosis]). The inflammation starts 3 days after treatment, peaking at 30 days, with some residual inflammation seen after 90 days and the number of fat cells declining over the 90 day period<ref name="CsPig"/>. However, there is a recent study showing that as little as 30 minutes of icing can change the gene expression of fat cells to improve their fat burning capability<ref name="Kern-2014"/>. (The study also showed that in lean subjects, similar changes naturally occurred in winter, but far less change occurred in obese subjects.){| class="wikitable" |- valign="top"|[[File:CoolSculpting-Kern-2014-Icing.jpg|none|thumb|x300px|Changes in fat burning capabilities due to 30 minutes of icing<ref name="Kern-2014"/>. The markers represent each of the seven subjects. ]]|[[File:CoolSculpting-Kern-2014-Winter.jpg|none|thumb|x300px|Changes in seasonal fat burning capabilities of lean and obese subjects<ref name="Kern-2014"/>. (A BMI of 30 was used to divide subjects.)]]|}
=How much fat is lost?=
A study of CoolSculpting showed an average reduction of about 4mm after two months<ref name="CryroChin"/>. A second treatment had a lower reduction of an additional 1-2mm. There is an individual variation in response to CoolSculpting, with some practices reporting 30% of patients being 'unimpressed with the results<ref name="CSIndividuality"/>.
The research into CoolSculpting suggests that it takes 3-4 months for the full effect. Because I applied the CoolSculpting more to the left side of my abs, it is possible to see how long the effects last. I used DIY CoolSculpting in May 2012 for a period of a few weeks. In the following two years my weight fluctuated by around 15 pounds. I performed no more DIY CoolSculpting or icing of my abs during that time. Regardless of these fluctuations the slight difference in the two sides remained constant. This difference is slight, amounting to around 1-2mm, but is noticeable on inspection. This suggests that the effects of DIY CoolSculpting last for at least two years and probably much longer. Obviously DIY CoolSculpting does not prevent overall weight gain, but it's unclear if it will limit this gain in any way.
==How to perform DIY CoolSculpting==
I iced for 1-3 hours most days, which is far more than CoolSculpting which uses a single 1 hour session. I have no idea if 'more is better' or if a single hour every couple of months is optimal. None of the research I found had any indication of the dose/response relationship. The latest research suggests that 30 minutes might be enough to induce changes.
==DIY CoolSculpting Questions and Answers==
Here are some of the questions I've been asked about DIY CoolSculpting along with my answers.
<ref name="CSIndividuality">Zeltiq sometimes painful, variable results | Christopher B. Zachary FRCP http://www.drzachary.net/2010/06/20/variability-in-responses-to-cryolipolysis/ </ref>
<ref name="StevensPietrzak2013">W. G. Stevens, L. K. Pietrzak, M. A. Spring, Broad Overview of a Clinical and Commercial Experience With CoolSculpting, Aesthetic Surgery Journal, volume 33, issue 6, 2013, pages 835–846, ISSN [http://www.worldcat.org/issn/1090-820X 1090-820X], doi [http://dx.doi.org/10.1177/1090820X13494757 10.1177/1090820X13494757]</ref>
<ref name="Kern-2014">PA. Kern, BS. Finlin, B. Zhu, N. Rasouli, RE. McGehee, PM. Westgate, EE. Dupont-Versteegden, The Effects of Temperature and Seasons on Subcutaneous White Adipose Tissue in Humans: Evidence for Thermogenic Gene Induction., J Clin Endocrinol Metab, pages jc20142440, Oct 2014, doi [http://dx.doi.org/10.1210/jc.2014-2440 10.1210/jc.2014-2440], PMID [http://www.ncbi.nlm.nih.gov/pubmed/25299843 25299843]</ref>
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