You’ve spent hours running on, climbing up, or lifting weights on your gym’s massive machines, only to find that the stubborn fat you’ve worked tirelessly to get rid of just won’t go away. Have you ever considered that you might simply be using the wrong type of machine for the fat reduction you’re seeking? Enter: CoolSculpting and Emsculpt. You’ve seen those bulky devices at your doctor’s office, but might have no idea what they do, how they work, or what kind of results you’ll get.
To help you decide whether CoolSculpting or Emsculpt is better and to understand the difference between the two, we tapped Spring, Texas, plastic surgeon Dr. Young Cho and Charleston, South Carolina, dermatologist Dr. Marguerite Germain for their advice on choosing the best fat-reducing treatment for you.
What does CoolSculpting do?
While the process for CoolSculpting and Emsculpt are very different, the purpose of each is generally the same: to help contour your body. CoolSculpting is a noninvasive fat reduction treatment that uses cryolipolysis—or freezing of fat—to target and eliminate diet- and exercise-resistant pockets of fat in the body. According to the brand, a single CoolSculpting treatment results in an average of 20–25% reduction in fat. “By maintaining a constant [low] temperature throughout treatment, it begins to extract heat from fat cells, inducing cell death,” explains Dr. Germain. “These fat cells are then eliminated via the body’s natural metabolic process. Dead fat cells are engulfed by macrophages [the trash men of the body], and these macrophages are then carried via the lymphatic system, filtered through the liver, and excreted as waste.”
What does Emsculpt do?
Emsculpt, on the other hand, relies on high-intensity focused electromagnetic (HIFEM) fields to stimulate supramaximal contractions of the muscle. “These contractions are more intense than what your body can produce with voluntary contractions, and Emsculpt helps to build new muscle fibers [muscle hyperplasia] as well as to bulk up your existing muscle fibers [muscle hypertrophy],” says Dr. Cho.
Does CoolSculpting or Emsculpt hurt?
Of course, another factor to consider when choosing any medical treatment is how much pain you’ll endure during the process. Dr. Cho argues that CoolSculpting results in more discomfort initially and during the recovery phase, with some patients feeling hypersensitive in treated areas. Emsculpt results might make patients feel like they just had an intense workout. “Both [treatments] can cause very different sensations, because they use completely different modalities—each may have its moments of discomfort based on individual sensitivity levels,” says Dr. Germain. But rest assured, neither procedure precludes patients from returning to normal activities.
How long does CoolSculpting or Emsculpt take?
The number of treatments recommended within a certain time frame for Emsculpt vs. CoolSculpting is drastically different. Emsculpt is more demanding than CoolSculpting in that it’s recommended to do four 30-minute treatments, two to three days apart. So make sure you have enough time within a two-week span to dedicate to this muscle-building procedure. Additionally, since muscle is something that you can continue to build, it follows the “use it or lose it” notion, meaning that patients may continue to do the Emsculpt treatment throughout the year, to maintain results.
CoolSculpting usually takes up to an hour, and depending on the area being treated, you need just a few treatments to see results. “Ideal candidates for CoolSculpting will need [one or two] treatments in each area that is treated,” says Dr. Cho.
CoolSculpting and Emsculpt results
Although both CoolSculpting and Emsculpt result in a more contoured physique, “CoolSculpting targets [only] fat, while Emsculpt targets muscle with a small fat reduction component,” says Dr. Germain. “Maintenance treatments are needed with Emsculpt, to sustain the muscle tone, while CoolSculpting results are permanent, if there is no weight gain.”
If your weight and lifestyle remain stable after either treatment, the Emsculpt results and CoolSculpting results will be long-lasting. “For the Emsculpt treatment, you are building muscle—and you may need to maintain a steady exercise regimen or repeat Emsculpt, once a quarter or every six months, to maintain the muscle gain,” says Dr. Cho. Results from Emsculpt will generally last about nine months, while CoolSculpting results are permanent.
It’s important to note that while Emsculpt does help reduce fat cells, that won’t be the case for every area of the body that’s treated. “In areas like the abdomen, specific parameters are used that do result in permanent fat loss,” explains Dr. Germain. “For the buttocks, however, the focus is on building muscle rather than fat reduction, and the treatment parameters are designed to maximize muscle growth while minimizing fat loss.”
If you’re really looking to splurge on yourself, Dr. Cho notes that the CoolSculpting and Emsculpt are two great technologies that can work synergistically, to help achieve a patient’s aesthetic body goal. So perhaps there doesn’t have to be an either-or situation.
Which is more expensive: CoolSculpting or Emsculpt?
Speaking of splurging, you’re probably wondering about the Emsculpt vs. CoolSculpting cost difference. According to Dr. Cho, pricing will vary according to the target zone. An abdominal CoolSculpting treatment can range from $1,500 to $7,500, depending on the number of areas treated on the abdomen to achieve ideal results. A CoolSculpting treatment on the arms could be between $1,500 and $3,000 (plus more if further treatments are needed), while an Emsculpt treatment for the arms could be between $3,000 and $4,000 (plus maintenance or enhancement treatments, if desired, after the first four).
For an abdominal Emsculpt treatment, pricing may start at $3,000 but can also increase if you’re looking to build onto the results after the first four treatments. All in all, the overall pricing for Emsculpt and CoolSculpting is difficult to determine because it all depends on the individual’s specific needs and goals.
Do Coolsculpting and Emsculpt treat the same areas?
The U.S. Food and Drug Administration (FDA) has approved the use of CoolSculpting on the chin, arms, bra fat, love handles, abdomen, inner and outer thigh, knees, and banana roll (or the roll directly under the buttock). The approval of treatment by the FDA is less broad when it comes to Emsculpt, since the device treats only the abdomen, buttocks, tops of thighs, arms, and calves.
Some doctors do use these devices “off label,” meaning that the device is applied to an area that is not included on the device’s labeling as an FDA-approved indication. “I use EmSculpt for the deltoids, trapezius and lower back muscles off label,” says Dr. Cho. Although Dr. Cho tells me he uses CoolSculpting mainly on label, there are some doctors who use CoolSculpting off label. For example, some physicians treat patients with gynecomastia, a common condition characterized by excess male breast tissue, with CoolSculpting.
Related: A New Stomach-, Butt-, and Thigh-Toning Treatment Is About to Hit the Market
Does CoolSculpting or Emsculpt treat cellulite?
While consumers primarily think of CoolSculpting and Emsculpt as body sculpting treatments, many also wonder if they can reduce cellulite too. “Cellulite is often a result of multiple factors: poor blood supply, unhealthy adipose [fatty] tissue, tethering of the skin to deeper structures, increased skin laxity, etc.,” says Dr. Cho. “CoolSculpting and Emsculpt may help decrease some of the unhealthy adipose tissue, while Emsculpt may also help to increase blood supply by building more muscle.”
Dr. Cho asserts that neither of these devices is beneficial for tightening the skin. “For cellulite, these procedures are often combined with other procedures that improve blood flow, tighten the skin and release the tethering between the skin and deeper structures,” explains Dr. Cho.
Do CoolSculpting and Emsculpt have the same side effects?
While both CoolSculpting and Emsculpt have no downtime, side effects are still possible. CoolSculpting side effects may include redness, swelling, blanching, tenderness, bruising, or itching for a few days to several weeks post-treatment. For CoolSculpting performed on the chin, patients have reported feeling a fullness in the back of their throat for up to two weeks. Developing a firm area of new fat growth—called paradoxical adipose hyperplasia (PAH)— is also possible, along with lumpiness or irregular fat dissolution.
Emsculpt, on the other hand, typically results only in soreness in the treated area after the session—like you’ve just completed a particularly hard workout. Studies show that this soreness resolves in one to two days, so patients can expect the aching to subside rather soon after treatment. Since the machine is still somewhat new, the long term side effects of Emsculpt are generally unknown. However, doctors feel that it’s been shown to be a fairly safe treatment so far.
Am I a good candidate for CoolSculpting or Emsculpt?
Unfortunately, not everyone can benefit from either of these devices. To see meaningful changes, you must be close to your ideal body weight (i.e., a body mass index, or BMI, of 25 or less). “For those with a higher BMI, multiple treatments may be necessary, and other treatment options may be more impactful,” says Dr. Cho.
If you are within the ideal BMI range and still can’t decide, perhaps Dr. Germain’s description can simplify things. “CoolSculpting is designed for someone who is close to their ideal weight and maintains an overall healthy diet but has a stubborn area of fat that is not budging, despite their efforts,” she says. CoolSculpting has a 74% Worth It Rating, according to RealSelf members who have gotten it.
Emsculpt has an 81% Worth It Rating and is better for someone “who wants to enhance the definition of their muscles in certain areas,” notes Dr. Germain.
Long story short, if you’re concerned about a very specific area of excess fat that won’t budge, despite your best diet and exercise attempts, CoolSculpting may be the best option for you. (It’s FDA-approved for the chin, arms, bra fat, love handles, abdomen, inner and outer thigh, knees, and rolls directly under the buttocks). Plan on one or two hour-long treatments that deliver permanent results—so long as you don’t gain weight.
If you’re concerned about toning your abs, your butt, your calves, your arms, or the tops of your thighs, Emsculpt is likely the better choice. While it may have a minimal impact on fat for some, it works by building muscle in these areas. Just keep in mind that it requires a bit more of a commitment. An initial series consists of four 30-minute treatments over the course of two weeks; you’ll then need to maintain the results via exercise and/or repeat Emsculpt treatments every six months or so.
