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

Assuming you have an expert provider in both solutions, I would say that Smartlipo or even traditional liposuction can outperform Coolsculpting.  As the first plastic surgeon in Houston to adopt Coolsculpting, I am very familiar with the capabilities of what Coolsculpting can do.  I do get very nice results for my patients, but I do know that I get even stronger results using Slimlipo, Vaser lipo, or traditional liposuction.

CoolSculpting has become quite well known as an effective fighter of "spare tire." The condition you are describing is exactly what we look for in a good CoolSculpting candidate. A person who is fairly fit and in good health who has stubborn areas of fat that don't respond to diet or exercise is typically a great candidate for CoolSculpting. The best way to know for sure is to have a consultation with a highly experienced CoolSculpting specialist who can evaluate you in person.

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.

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.

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.

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.

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.

It sounds like you might be a good candidate for either procedure.  SmartLipo is going to give you much more dramatic results more quickly because more fat can be removed at one time.  CoolSculpting treats about 20-25% of the fat cells in the specific treatment area and takes about 3 months to show full results.  SmartLipo has minimal downtime and costs more.   CoolSculpting is less expensive, and offers zero downtime.  Some people do not want surgery and CoolSculpting offers a nice alternative with realistic expectations.  We offer both procedures and have patients who may be candidates for either procedure but personal preference dictates which option they choose.  SmartLipo results will be highly dependent on the skills of your plastic surgeon. Be sure to look for a board-certified plastic surgeon if you decide to opt for liposuction.  

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

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