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What is CoolSculpting?

CoolSculpting San Antonio

CoolSculpting is a breakthrough, non-surgical procedure that uses patented cooling technology to eliminate fat. This clinically proven technology selectively targets problem areas of fat resistant to diet and exercise. CoolSculpting has been FDA-approved since 2010. It can treat stubborn pockets of fat on the abdomen, thighs, arms, flanks, and back. In 2020, over 350,000 non-invasive fat-reduction procedures were performed in the United States. [1]

Also called cryolipolysis, this effective treatment slims the body’s contours and comes with the convenience of zero downtime. Because, unfortunately, stubborn pockets of fat cannot be spot reduced no matter how hard we diet, exercise, or wish them away — thank science for CoolSculpting! Patients who want to take control of their contours can take advantage of the effects of cryolipolysis and the specialized approach designed by board-certified plastic surgeon Dr. Suresh Koneru

With over 26 years of experience, Dr. Koneru draws from his love of science to provide his patients in the San Antonio, TX area with the latest cosmetic techniques and surgical procedures. In fact, he was the first board-certified plastic surgeon in all of South Texas to have this device. Dr. Koneru pays close attention to clinical studies and research when selecting non-surgical procedures, and offers innovative combination treatments to produce spectacular outcomes. 

To experience the slimming effects of CoolSculpting, call (210) 499-5900 to schedule a consultation, or fill out our contact form, and we will get back to you shortly.

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Before and After Photos

The Science Behind CoolSculpting

Believe it or not, the science behind CoolSculpting has a rather sweet beginning. Harvard scientists developed and evolved these techniques after observing that children who ate many popsicles developed dimples in their cheeks. [2] These cheek depressions, scientists realized, were from repeated exposure to cold. The term “Popsicle Panniculitis” has been used by pediatricians since the 1970s. And so, the first step in the scientific method was complete: observation, no doubt followed by a healthy dose of skepticism that the idea could lead to a body sculpting solution. After all, CoolSculpting almost sounds too good to be true, like the magic weight-loss pill mused about for decades. But the science is sound, and CoolSculpting works!

How Cold is Cool?

It stands to reason that the temperature used in CoolSculpting is colder than the popsicles that first prompted scientific observation. In fact, CoolSculpting employs a proprietary “Cooling Intensity Factor,” which injures fat cells and leads to a routine and controlled part of an organism’s growth or development called imminent apoptosis [2], i.e., cell death.

Why Doesn’t CoolSculpting Freeze the Skin?

Adipose tissue, a specialized connective tissue containing fat or lipid-rich cells called adipocytes, makes up about 20-25% of a healthy body. These adipocytes are more susceptible to cold than other cell types. [1] So while it’s not good for fat cells, it’s perfectly safe for other cells, which can withstand colder temperatures safely. There is no risk of frostbite or damage to other tissues and organs. [2] The CoolSculpting machine is designed to turn itself off if a malfunction occurs.

CoolSculpting Packages

To further increase your cosmetic results, Dr. Koneru combines CoolSculpting therapy with additional treatments to create the following packages:

CoolSculpting + ZWave

Because CoolSculpting does not affect the tightness of the skin, there can be issues with overstretched tissues being looser than most patients would prefer once the fat is gone. So, to add skin tightening and collagen regeneration, Dr. Koneru will follow your CoolSculpting session with ZWave. ZWave is a hand-held system that delivers painless high-energy radial shockwaves, scientifically proven to impact collagen structure and connective tissue, improving blood circulation. Fat reduction is enhanced in only a few treatments, as is skin firmness and elasticity, and quickly collagen begins to regenerate.

Greenlight Therapy using Rohrer Ultralight

A recent advance in cosmetic aesthetics is light emitting diodes (LEDs), also called phototherapy or photo biomodulation, which uses non-thermal, non-invasive light at different nanometer (nm) wavelengths. Phototherapy is effective in both medical and cosmetic uses. [3] Greenlight therapy (532nm), used by the Rohrer Ultralight system, further enhances the effects of CoolSculpting when performed a few weeks after the session. The greenlight wavelengths can be used for circumferential reduction for a slimmer appearance.

Radio Frequency (RF) Microneedling

The combination of RF microneedling and CoolSculpting is what Dr. Koneru calls “Fire and Ice.” This combination of non-surgical treatments targets and eliminates the dreaded double chin by tightening skin, slowing the effects of aging while addressing other skin concerns.

What are the Benefits of CoolSculpting?

Did you know it’s impossible to “spot reduce” specific areas of the body? Diet and exercise can only take you so far before it becomes clear that particular body areas aren’t responding; this might be due to age, genetics, following childbirth, or significant weight loss. CoolSculpting is FDA-approved to treat nine areas of the body:

  • Under the jawline
  • Under the chin
  • Flanks (love handles)
  • Abdomen
  • Thighs (inner, outer, distal)
  • “Bra fat”
  • Upper arm
  • Back fat
  • Banana roll (below the buttocks)

Ideal CoolSculpting Candidates

Patients dissatisfied with their body shape due to uncompromising areas of fat will enjoy treatment results using CoolSculpting. Because CoolSculpting does not affect blood lipids or liver enzymes, treatment is safe for all ages. [2] Ideal candidates should be within five to twenty pounds of their goal weight. It is important to remember that CoolSculpting is not a weight loss procedure, and patients may not see a weight reduction. The only areas that CoolSculpting can address are those easily drawn into the applicator, so use the “grab” test to indicate possible treatment areas. Can you pinch an inch (or two)?

Additionally, CoolSculpting is ideal for patients who:

  • Are not good candidates for surgery because they smoke
  • Have a higher risk of bleeding or clotting
  • Dislike the idea of anesthesia
  • Are busy and can’t take time from their schedule

The applicator should not be applied over hernias, wounds, or other damaged areas, so if you are injured, you may need to hold off on treatment until you have healed.

Personal Consultation

Initial consultations are available at our San Antonio plastic surgery office or virtually via telemedicine. During this appointment, we will review the areas you would like to treat and whether or not you are a candidate. For example, patients with a Body Mass Index (BMI) greater than 35 are not usually candidates, but Dr. Koneru will be able to suggest a different method to meet your goals. During your consultation, you can ask questions about this or other treatments and procedures offered by Dr. Koneru. To schedule your consultation, call (210) 499-5900 or fill out our contact form, and we will be happy to call you back.

The CoolSculpting Procedure

On the day of the treatment, we recommend you eat what you usually eat for breakfast or lunch before coming in. It is crucial that you are well hydrated before the procedure. 

Before treatment begins, we will mark the areas to be treated and take clinical photos to track your progress. The procedure then progresses as follows:

  1. A gel pad is applied to the skin underneath the applicator to protect the skin and underlying tissues further.
  2. The head of the CoolSculpting device will draw your tissue up to rest against two cooling plates. Patients will feel a slight vacuum pressure and an intense cold as treatment begins. After approximately ten minutes, this area will become temporarily numb.
  3. While the CoolSculpting machine works on stubborn fat, you can catch up on reading, listen to music, watch your favorite show, or even take a nap. Patients report that the discomfort level is low and easily tolerated.
  4. Treatment can take from one to three hours. For example, if we treat your love handles, the process will take about an hour on each side. However, treating the outer thighs will require the CoolSmooth head, and each side will require two hours of treatment.
  5. When each treatment ends, we will remove the applicator(s) and gel pad; the treated area is massaged for two minutes to break up the damaged fat cells.

Recovery From CoolSculpting

After treatment, you can resume your normal activities; there are no restrictions. You may have bruising after the process, so we recommend you stop taking blood thinners at least a week before treatment. You may experience numbness and tingling, but it will dissipate shortly after the procedure.

What are the Results of CoolSculpting?

In a clinical trial, patients saw a 20-33% reduction in superficial fat. However, because of the body’s natural metabolizing rate, the effects of CoolSculpting are not visible immediately following the procedure. With help from the body’s natural immune defense, the damaged cells are metabolized through the liver within the following weeks and months; fat reduction may be observed in as little as three weeks, with optimal results appearing at around two to four months post-treatment. [2]

Another benefit of CoolSculpting is the increase in self-care following treatment. As a result, patients are often motivated to lead healthier lives to protect their investments and accelerate results.

Corresponding & Complementary Procedures


BodyTite is an advanced liposuction technique that heats tissue to melt fat and increase collagen production, tightening the skin. The BodyTite/FaceTite procedure boasts zero downtime and incredible results.


This radio frequency microneedling system can tighten and firm loose skin.


This non-invasive device uses massaging shockwave therapy to smooth contours and reduce cellulite.

Green Low Level Laser Therapy (Green LLLT)

Gentle laser energy is applied to the body for circumferential reduction and a more slender appearance. 

What is the Cost of CoolSculpting in San Antonio, TX?

The cost of your CoolSculpting session is determined by the areas treated. A treatment plan and cost analysis will be presented during your consultation, so you know what to expect. In addition, you can use this time to talk to Dr. Koneru about the other procedures and treatments he offers to find out about combining treatments. 

Call us at (210) 499-5900, so we can help you achieve your aesthetic goals!


  1. American Society of Plastic Surgeons. 2020 Plastic Surgery Statistics Report.; 2020.
  2. Gabriel M, Williams M. Cryogenic Lipolysis. Plastic Surgical Nursing. 2014;34(4):171-172. doi:10.1097/psn.0000000000000066
  3. Ablon G. Phototherapy with Light Emitting Diodes. The Journal of Clinical and Aesthetic Dermatology. 2018;11(2):21-27.