Yours is a very good question, and it was only after a very thorough examination of this question that I decided to offer SculpSure to my patients and forgo Coolsculpting. I feel that from a results standpoint, they are similar in that they both are noninvasive technologies that can kill fat cells and reduce your overall fat profile. Both technologies usually require multiple treatments. I have found that with SculpSure, my patients need two or three treatments to achieve the result they desire. There are better options for some patients than others: Some patients want a noninvasive treatment with no downtime, and are willing to take their time to get to the desired result. Some want a more definitive and comprehensive result that will be immediate and can accept 2-3 days of down time, and choose liposculpting. Overall, patients are very happy with the results offered by fat reduction treatments.I think the most important differences between Coolsculpting and SculpSure come when you look at the potential downsides. In my eyes, Coolsculpting has many potentially serious complications that I do not want to risk. These include Long-term nerve pain or nerve damage. I have seen many Coolsculpting patients who have had pain that has lasted for several days, weeks or even months - in some cases necessitating the use of prescription pain medication. I have seen patients with specific nerve damage: I had one patient come to my office who was treated with Coolsculpting on the arms and had injury to the ulnar nerve (the "funny bone nerve") resulting in numbness of the small finger for over a year. SculpSure is targeted only to your fat and does not interfere with anything else except the fat under your skin. Step-off / Shelf effect. Coolsculpting is performed with a suction cup that grabs all of the fat in the area of treatment. Unfortunately the cold treatment works only within that area. Any fat just outside of the suction cup will not have the cold treatment and will not be reduced. That has resulted in a step off effect where some patients can literally have a shelf or line demarcating the border of areas that were treated and those that were not. SculpSure has a diffusion effect where the laser energy has a gradient and smoothes out the boundaries of treatment, resulting in an even contour, and, often, a wider area of fat reduction. Coolsculpting can create more fat!?!? There is a complication of Coolsculpting known as paradoxical adipose hyperplasia (PAH). That means that a treatment with Coolsculpting can actually result in the development of fat rather than its removal! I have, unfortunately, treated patients with this condition after cool sculpting. The incidence of PAH has been reported at about one in 20,000 patients, but in speaking with colleagues and in some discussions that have been had at national meetings (The American Society of Aesthetic Plastic Surgeons) the consensus is that it happens much more frequently than that. This becomes a challenging situation where patients then need an invasive liposuction procedure and, possibly, skin reduction procedure to manage this complication. There is no incidence of PAH with SculpSure.Significant pain with treatment. Many of my patients who have had both Coolsculpting and sculpture note that cool sculpting is significantly more painful than SculpSure. In some cases they could not complete the Coolsculpting treatment due to the severe pain associated with the procedure. In most cases, SculpSure is very tolerable. Downtime. There is absolutely no limitation of activity after a treatment session with SculpSure. At worst, patients have a little bit of sensitivity in the area that was treated that is simply a little reminder that it was done. I have patients who go to the gym directly after the treatment session with SculpSure. Unfortunately, with Coolsculpting, I have been told that many patients were quite unable to be active for some time after the treatment. Treatment time. SculpSure takes only 25 minutes per session. Coolsculpting can be double that. This allows us to do more in less time and get our patients back to their regular lives. My answer on the difference between cool sculpting and SculpSure is that both are fairly effective noninvasive fat reduction techniques. The difference, in my mind, is that cool sculpting has a significant complication profile that I do not feel is acceptable to my patients. What is also important is that as a board certified plastic surgeon, I am able to offer the entire spectrum of fat reduction techniques to my patients. Those involve noninvasive techniques like SculpSure, injection based therapies like Kybella and more comprehensive treatments like liposculpture. My goal is to customize each treatment to the specific needs and desires of my patients. I wish you the best, Dr. Gabbay.
