Both technologies melt away fat. CoolSculpting does it via cryolipolysis (freezing fat) and laser via heating the fat. SmartLipo is surgical and a one time procedure with a few days of downtime. CoolSculpting is completely non surgical but requires multiple treatment sessions which can be performed over a 1 to 2 day period broken up into a few treatment sessions. Laser liposuction will give you more skin tightening. CoolSculpting has made significant advancements over the past few years and a lot more is known about how to perform the procedure to provide near laser lipo suction results. We now treat the abdomen for example with 4 to 6 treatment cycles and can repeat treatments for even greater results a month later. This is in contrast to prior treatment modalities where only a few treatment cycles were performed- with suboptimal results. What's unique about CoolSculpting is that you can "treat to total body transformation" i.e. treat multiple areas such as the abdomen, waist, bra roll, legs and arms. This is not possible with laser liposuction unless multiple surgeries are performed. Its not possible to perform laser liposuction in one session for all those areas. There would be multiple downtimes and the cost would be far greater.In summary, we other our patients both treatment modalities. Both provide excellent results. I think that CoolSculpting is ideal if you have good skin tone (don't need skin tightening), want no downtime, looking to spend less, and are ok with results that maybe slightly less than laser liposuction. If you want to treat your entire body, again, CoolSculpting is more practical. If you want more dramatic results in targeted areas and are ok with the downtime then SmartLipo maybe a better choice. Ran Y. Rubinstein, MD 200 Stony Brook Court, Newburgh, New York Board Certified Facial Plastic Surgeon Clinical Professor New York Presbyterian Hospital National Education Faculty (physician trainer) for: Allergan (Juvederm, Voluma), Valient (Scultpra, Restylane), Cynosure (Cellulaze, Precision Laser Lift) & Solta (Fraxel, Thermage)Zeltiq( CoolSculpting)