Maximizing Coolsculpting Results with CoolAdvantage and Zimmer Z Wave

Coolsculpting has established itself as the worlds #1 noninvasive fat reduction treatment. It has over 3 million treatments worldwide and has been found to be a safe, well tolerated, and reliable procedure. It was FDA approved to cool skin to allow for anesthesia in 2009 and later in 2010, it was given the permanent fat reduction approval.

Coolsculpting treatments involve attaching a handpiece to the area of desired fat removal. There are various sizes of handpieces to assist in reaching all the different areas of the body where there is excessive fat. Most of these handpieces use a suction to pull/draw the tissue and fat into the handpiece, so a requirement (except for the outer thigh where a flat handpiece is used) is that there is “pinchable” fat. These handpieces gradually cool the area treated to the optimal temperature where the fat is killed but the surrounding tissues (skin, blood vessels, nerves) are kept safe. The attachment duration has been 1 hour until recently. It has been proven that about 25% of the fat treated will be removed during this process. It has also been shown that massaging the area treated immediately after handpiece removal improved the outcomes too. There was more fat loss and less post procedure discomfort.

There was a study last year that showed the Zimmer Z Wave treatment, done in place of the massage, lead to a 65-100% improvement in outcomes. In large volume practices, including Dr. Weiner’s office, this is now routinely performed on all Coolsculpting patients immediately when the handpieces are removed. The Z Wave uses radio pulsed technology that send shock waves through the tissues. When these waves bump against newly frozen fat cells, the already compromised cell is further damaged. This increases the amount of fat cell death from the Coolsculpting treatment. Another way to explain how it works is that with Coolsculpting, there are cells that are killed, cells that aren’t, and cells that are undecided. The Z Wave pushes some of these undecided cells to the point that they will die.

A recent advancement in the handpiece technology has been developed. This is the found in the CoolAdvantage and CoolMini handpiece. The changes consist of a more uniform cooling of the area treated. Older handpieces had cooling elements only on the sides of the handpiece cup but the newer has cooling throughout. What does this do to change the treatments? It lowers the treatment time from 1 hour to 35 minutes (45 min with the CoolMini). The newer handpieces have less depth, so more fibrous, less flexible skin areas can now be treated. This also translate into a much more comfortable treatment because there is less pulling in of the tissues. It has been found that post treatment discomfort is also less. There are reports that these handpieces are more effective because there are no longer fat pockets that might not get to the critical temperature need for death.

With the addition of CoolAdvantage technology and the Zimmer Z Wave, Coolsculpting treatment times are almost cut in half, treatments are more comfortable (during and after), and most importantly, the procedure is significantly more efficacious. When researching providers, make sure they use these new technologies.


  1. Dan

    I’m curious about CoolSculpting….on RealSelf there are many testimonies of the recovery being *far* from painless, yet it seems every provider of the service claims that there is no downtime and it’s pain-free. Seems like a disconnect, here?

    Mostly, though, I’m curious about the risks of hyperplasia. I understand it is very rare, but if one is concerned about it, would doing a small test area reveal whether the patient is prone to reacting this way?


    • Hyperplasia is about 1:10,000 risk. It is impossible to do a test area. You could treat one area and see how it goes. The discomfort some patients get is only for the abdominal handpieces and should be less with use of the Cooladvantage and Zimmer Z wave. It can usually be controlled with topical lidocaine patches.


      • Dan

        Thanks for the quick reply!

        Aesthetically speaking, in terms of recovery, what has your experience been with the length of time before a patient is no longer showing bruising or redness (ie, photoshoot or beach ready). Specifically on the abdominal region (I assume everyone is different, but in general?)

        Thank you for your very informative blog.


      • In general, a couple days. If bruising is significant, about 10 days, but that is extremely rare.


  2. jacky

    Its clear that More and more Doctors are recommending a compression garment after coolsculpting. 10’years back 10/10 Doctors said “no, a compression garment is not needed” . We started to see a change in opinion particularly after 2014 . why are Doctors now opening up to the benefits of a compression garment?



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