Would a lidocaine patch be a possible treatment option for late onset CoolSculpting pain?

Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding CoolSculpting

Q. The pain is bad. It’s causing me to not be able to sleep. I whimper when I move. It’s so bad that had I known it would be like this there is no way I ever would have gotten this procedure. It has brought me to tears!

A. So sorry to hear of your discomfort!! Hyperaesthesia and pain are very rare concerns with CoolSculpting (CS) but obviously can happen. I believe that the sensory nerves within the CS treated areas are temporarily injured during the cooling process but not permanently injured. It will improve.

Based on a single patient who had this problem among over a 1000 of our CoolSculpted patients, I have come up with a pain assistance protocol. It includes different levels of care based on the amount of discomfort and includes:

Mild to Moderate Pain (with a pain level of 1-4 on a scale of 10):

  1. Tylenol 500 mg orally every 4 to 6 hours as needed. Maximum dose is 4000 mg per day.
  2. Ibuprofen OR Aleve (24 or more hours following CS). May be used in combination with Tylenol.
  3. Topical Corticosteroid (hydrocortisone) or antihistamine (Benadryl) cream up to 4 times daily
  4. Topical lidocaine or LidoDerm
  5. Allegra, Claritin (Loratidine), Zyrtec (Certidine) twice daily
  6. Cool compress or heating pad.
  7. Compression garment.
  8. Medrol Dose pack as prescribed

Moderate to Severe Pain (with a pain level of 5-8 on a scale of10):

  1. In addition to the above,
  2. Norco 7.5 mg hydrocodone/325 mg Tylenol every 4 to 6 hours.
  3. Must account for total Tylenol usage.
  4. May cause constipation; add stool softener.
  5. May NOT drive or make critical decisions

Extensive and Unrelieved pain (with a pain level of 5-8 on a scale of10), inability to sleep, shooting spasms, unable to interact socially:

  1. Gabapentin (Neurontin) 300 mg 2 to 3 times daily as prescribed by MD.
  2. Neurology consultation prn.
  3. Valium 10 mg as needed to sleep, assist in pain and anxiety control.

Please review this list with your CoolSculpting Specialist to see what is appropriate and helpful to you.

I wish you the best!

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

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