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Which Procedure Would Work Better for the "Spare Tire", Coolsculpting or Smartlipo?

Is Smartlipo a better option for someone who is fairly fit and in good health, but the "roll" sticks around even when weight is lost in other areas?

Doctor Answers (18)

Coolsculpting or Smartlipo

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While I offer both coolsculpting and smartlipo, I prefer coolsculpting for the abdomen due to it being safer and more effective.


West Palm Beach Plastic Surgeon
4.5 out of 5 stars 18 reviews

Cool Sculpting for the spare tire area

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I think I prefer cool Sculpting based on its consistency of results.  The lower abdomen can be treated with a number of applicators.

Robert Whitfield, MD, FACS
Austin Plastic Surgeon
5.0 out of 5 stars 14 reviews

CoolSculpting Vs. Smart Lipo

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Coolsculpting and Smart Lipo are both excellent therapeutic options for managing localized fat of the lower abdomen and flanks. Both procedures offer advantages and the choice of procedure depends on a variety of factors.

                  Without pictures or a physical exam it’s hard to know which option is best for any given patient. When larger amounts of fat are present, liposuction will most likely yield a superior result. Unfortunately, this procedure may be associated, with more pain and longer recoveries.

                  When smaller amounts of fat are present, excellent results can occur with coolsculpting with shorter recoveries and less pain in the post-operative period.

                  If you’re considering treatment of your “Spare tire”, consultation with a board certified plastic surgeon would be appropriate. This surgeon can advise you regarding which procedure is best for you.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 89 reviews

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Coolsculpting vs. Smartlipo

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Whether you should have Coolsculpting or Smartlipo depends on a number of factors. Do you want a non-invasive treatment with no downtime or a minimally invasive treatment with minimal downtime? Since Coolsculpting is a non-invasive treatment there are less risks and downtime. Smartlipo is more powerful but involves surgery and some downtime. 

Sanjiv Kayastha, MD
Albany Plastic Surgeon
5.0 out of 5 stars 29 reviews

Ideal candidate for Coolsculpting

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When you are fit and in good health and you have a "spare tire" or "love handles" that just will not go down, then you are best candidate for Coolsculpting.  Coolsculpting was designed for exactly this type of problem.  It melts the fat in a given area when you have lost weight everywhere else.  Find an experienced dermatologist in your area since it sounds like you are perfect candidate!

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 33 reviews

Best Procedure for "Spare Tire"

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Thank you for your question. Based on the information you shared, I believe CoolSculpting would be your best option. CoolSculpting is not a weight loss solution for people who are obese, or a substitute for surgical methods such as liposuction. Good candidates have noticeable bulges in certain areas they’d like to get rid of. Of course, your doctor will determine if treatment is right for you during a one-on-one consultation. Best of luck! 

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 100 reviews

Ideal Candidate for CoolSculpting

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It sounds like you may be an ideal candidate for CoolSculpting especially if your are fit and have stubborn areas around your waist.   SmartLipo (or "SlowLipo as I like to call it) is much more invasive and I always combine it with standard suction lipectomy.  I love SmartLipo in the area of the neck, however.  If you want to avoid downtime and time away from your job, life and the gym then I would seek out a certified CoolSculpting physician and see if CoolSculpting is right for you.

Lawrence W. Shaw, MD
Arizona Plastic Surgeon
5.0 out of 5 stars 58 reviews

Lipo vs Coolsculpting

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Think of Coolsculpting as liposuction lite.  The patient who is a good candidate for lipo will be a good candidate for Coolsculpting as well.  Any lip procedure, whether conventional, power, smart lipo, or ultrasonic will by definition be more aggressive than Coolsculpting as it is a surgical invasive procedure.  If you are comfortable with a more subtle improvement without surgery go for Coolsculpting, if you want one treatment and are ok with surgeryE dn recovery go for lipo.

Eric Chang, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 8 reviews

Coolsculpting versus liposuction for "spare tire"

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For a spare tire, liposuction or coolsculpting are both possibilities.  In terms of pure cosmetic result, liposuction is better, but it is also more expensive and requires more downtime.  Which treatment is better for you depends on your overall health, physical exam, goals, whether you are able to have downtime, and your pocketbook. 

Overall health:  Liposuction candidates are people in relatively good health without heart problems, kidney problems, bleeding problems, or a history of anesthesia-related problems.  Almost anyone can have coolsculpting, since it is noninvasive. 

Physical exam:  Liposuction can reduce soft fat as well as firmer, fibrous fat.  Coolsculpting works best for soft, pinchable fat.  Neither procedure addresses excess skin or visceral fat (fat around the internal organs).  If excess skin is an issue, a tummy tuck in combination with liposuction should be considered. 

Your goals: Liposuction can give a dramatic and "customized" result and can address the abdomen and flanks in one session.  Coolsculpting can only reduce a limited area with each session so if your spare tire extends from your abdomen to your love handles, you will require multiple coolsculpting sessions to cover all these locations.  These sessions can be done back-to-back.

Downtime: There is almost no downtime with coolsculpting.  Most patients have minimal discomfort and can resume your normal activities immediately.  With liposuction, you will have several days of downtime, bruising, and you will need to wear compression garments for at least a couple of weeks.

Pocketbook: Liposuction costs depends on the surgeon's fees, anesthesia fees, facility fees. The price of coolsculpting depends on the number of coolsculpting sessions that you would need to get your desired result.

Melissa Chiang, MD
Houston Dermatologist
5.0 out of 5 stars 4 reviews

CoolSculpting vs liposuction

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For patients who have several centimeters of fat that can be pinched between two fingers on the love handles, and exercise and diet is being followed, this is not an unusual situation that this one area is stubborn. In fact, that is an ideal patient for liposuction, regardless of it being tumescent liposuction, laser-assisted liposuction (smartLipo), power-assisted liposuction, water-jet liposuction,etc. However, some patients are not ideal candidates because they take medication or have medical conditions that add risk to the invasive procedure of liposuction, or some patients just don't want to undergo surgery.  Then, CoolSculpting by Zeltiq offers a way to reduce the fat without surgery, but it is only 20% of the fat volume after one treatment, and that can take up to four or more months to see the result. Liposuction, in such a patient as mentioned above, would obtain more removal of fat by liposuction.

There are other patients who are quite slim and one area is slightly enlarged compared with the rest. In this patient, the SmartLipo would not be indicated as the risks of skin irregularities and even burn scars would be too high. CoolSculpting can provide a non invasive method for fat reduction in such a patient with much less risk than the liposuction as it only involves freezing the fat, and no invasive procedure is necessary.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 32 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.