CoolSculpting Vs. Zerona

Zeltiq CoolSculpting and Zerona were both FDA-approved at the same time, and both involve non-invasive fat removal. Is it fair to lump the two procedures together and compare them? Are good candidates for one treatment necessarily good candidates for the other?

--Sharon, RealSelf.com blogger

Doctor Answers 23

CoolSculpting vs Zerona

CoolSculpting has much better studies and science behind it than Zerona. We were prepared to offer both CoolSculpting and Zerona to our clients. But, we were unable to find real evidence that Zerona is effective. Howver, after considerable research with CoolSculpting, we have two systems and we have been very pleased with the safety and efficacy of this treatment.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 50 reviews

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CoolSculpting is better than Zerona

Things to consider:

• CoolSculpting is the first  device cleared for the fat reduction!
– Zerona is cleared for non-invasive body contouring (circumferential reduction) and NOT for fat reduction. 
• CoolSculpting selectively & reliably eliminates fat in TARGETED problem areas
– Zerona cannot target where the reduction will occur.  It can only claim total contouring & circumference reduction (no telling where the 3.5 inches will come from)
• CoolSculpting KILLS the targeted fat cells
– Zerona cannot claim fat-cell elimination. The fat cells are diminished in size but do remain in place. In fact, their own study claims that this change may be temporary and more studies are necessary. In fact, what you see 2 weeks post treatment in their study are test patients starting to gain their fat back!
• CoolSculpting has no post treatment requirements, diet or exercise regiments.  CoolSculpting kills the fat cell!
-Zerona requires patients must be willing to maintain regular diet & exercise during treatment
-Zerona  Patients must give up caffeine & alcohol for 1 month & must exercise
– 2 weeks before treatment & 2 weeks during treatment
– Exercise 30 minutes a day
– Drink 8 to 10 glasses of water each day

Charles Crutchfield, MD
Minneapolis Dermatologic Surgeon
4.0 out of 5 stars 11 reviews

CoolSculpting Vs. Zerona

Thanks for your question. CoolSculpting has proven results with scientific data to back it. We do numerous of treatments everyday in our clinic with amazing results. Hope this helps. 

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 16 reviews

CoolSculpting vs. Zerona: How Do They Compare?

Though CoolSculpting by Zeltiq and Zerona may sound somewhat similar and are often confused for one another, they are very different in the way that they work and their results. CoolSculpting is the only FDA approved treatment that kills the fat cells by freezing them to the point of elimination. These fat cells are killed permanently and do not return. There are no dietary restrictions or exercise programs that are indicated with CoolSculpting, however, those people who maintain a healthy diet and an active lifestyle will get the best out of their results.

Zerona, on the other hand, uses cold laser to disrupt fat cells. The content of the fat cells leak out, but the fat cell remains alive and is not killed. So, the fat cells treated with Zerona can always grow back to their original size after the treatment. That's why it is recommended to be used in conjunction with a regular diet and exercise regimen. While Zerona is FDA approved, this approval is for non-invasive body contouring and not for fat reduction.

We chose CoolSculpting over Zerona as there was overwhelming evidence that CoolSculpting is effective with long-lasting results. The same could not be said for Zerona. In our practice we have used CoolSculpting to treat many patients who previously had Zerona and did not see any results. They have all been very please with their results after just one CoolSculpting treatment!

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 5 reviews

Coolsculpting is much more effective!

The main difference is the removal of fat cells. The Zerona perforates fat cells and the cells begin to leak. The lipids released from the cells are eliminated through the lymphatic system. The gradual leaking of the cells leads to fat cell shrinkage but the fat cells will remain active in the body. Coolsculpting freezes and destroys fat cells. Fat cells treated with Coolsculpting die off completely. The body gradually eliminates the cells. Once those fat cells have been removed, they are gone permanently.

Coolsculpting versus Zerona

Fat reduction or contouring is a sought after procedure and there are several options available.  Both technologies have been FDA approved but for different reasons and with different indications.

Coolsculpting uses cold to produce cryolipolysis of the fat cells in specific areas of the body.  It is a permanent reduction of the fat cells but it is limited to certain areas of the body.  The handpiece has to be able to grab onto the tissue and pull it into the handpiece to cool it between two plates.  The device works well for areas of the body that have some laxity and can fit into the handpiece to cool.

Zerona was approved for non-invasive body contouring and works to change the membrane of the fat cell to shrink it.  Combined with diet and exercise there can be a contouring effect over the body.  

Michelle J. Place, MD
Danville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Coolsculpting By Zeltiq is Effective Fat Elimination

Sharon Coolsculpting has many clinical studies and happy patients ( including my staff) proving its efficacy in the real world. There is no doubt that I can make more of a change with Aqualipo or Smartlipo but many patients prefer not to go to the operating room or to have down time. Coolsculpting can eliminate targeted fat by greater than 20%. the procedure takes one hour per targeted area. There are no post operative protocols to follow for diet and exercise. the best candidates are one within 20 pounds of their BMI

Zerona cannot target exact areas. It does not eliminate but shrink cells. It relies on diet and exercise.

Mark Berkowitz, MD
Sterling Heights Oculoplastic Surgeon
5.0 out of 5 stars 21 reviews

Coolsculpting and Zerona are different

Thank you for your question. Coolsculpting and Zerona are very different technologies, with different goals and indications. Coolsculpting uses cryolipolysis, with a specific cold temperature used to trigger elimination of fat cells. This reduces fat in targeted areas, and permanently removes the treated fat cells. Coolsculpting has predictable and lasting results.

Zerona is used by some for reduction of body circumference. It is combined with diet modification, and does not target specific areas. In addition, since the fat cells are shrunk and not eliminated, the results may not be permanent.

So the two treatments are not interchangable. They work differently, and should be used differently. In my Albany, NY practice, I favor Coolsculpting, as I have been consistently impressed with the results in properly selected patients.

Jeff Rockmore

CoolSculpting vs Zerona

I am a skeptic who generally does not buy into the hype of noninvasive fat reduction technology.  However, there has been enough compelling evidence that CoolSculpting actually does work and I looked into it.  

I was a tough sell and required the Zeltiq rep to bring the machine to my office and treat my body on one upper hip only.  

Within 3-4 weeks I was blown away by the results.  Not what I could have done with liposuction, but a huge change.  The lack of downtime and ease of recovery were similarly impressive.  

I treated the other side within 2 months as I was tired of being asymmetric.  The results I have seen on myself (now at 6 months) and the dozens of patients we have treated to this point have been impressive. 

I don't own Zerona, and never will.  The evidence does not support significant results and from what I can tell, any results achieved are temporary.  

York Jay Yates, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 76 reviews

Coolsculpting and Zerona comparison

Although both modalities reduce volume, the methods are completely different. Coolsculpting permanently destroys fat cells. This means you no longer have the same amount of fat cells in a treated area. Zerona draws the energy out of the fat cell, in other words it shrinks the fat cells. Many Zerona practitioners advise patients to follow specific dietary guidelines in order to maintain their results otherwise the effected fat cells can swell again. Zerona does not offer a permanent means of eliminating fat from the body.

Pamela Gallagher, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.