Vanquish, CoolSculpting, Zerona. What's the Best?

What are the options when it comes to non-surgical fat reduction (besides not eating and working out) those are obvious and are already under way. What are the risks?

Doctor Answers 16

We have experience with Vanquish, CoolSculpting and Zerona for fat reduction.

I have experience with Vanquish, CoolSculpting and Zerona.  We have had our CoolSculpting device now for over 5 years and were the first office in Orange County to have Vanquish.  We obtained our Vanquish in January, 2014.  We have had very nice results from both of these devices.  CoolSculpting works by freezing the fat cells and causing the cells to die.  This device is ideal for localized areas of fat such as the 'love handles' and 'bra rolls'.  The downside of CoolSculpting is that it takes one hour per localized area.  Vanquish utilizes a large panel which lies very close to the skin and can cover a broad area.  Vanquish then heats up the fat cells to over 110 degrees fahrenheit to cause the fat cells to die as well.  As you can see, you can reduce fat cells by taking them to either extreme in temperature for enough time.  Both devices take some time to see the final results.  Results can be impressive in certain patients.  I don't compare the results to liposuction as I feel I can obtain better results surgically, but not everyone is interested in surgery.  It is best to obtain a consultation to see which device is best for you.  With regards to Zerona, it utilizes low level energy to supposedly cause fat cells to 'leak'.  I had the device for several results and patients seemed happy; however, I returned the device as I felt they achieved their results from the exercise, diet and supplements that were recommended with it.


Orange County Plastic Surgeon
4.9 out of 5 stars 178 reviews

Freezing and heating fat works - Zerona doesn't

Vanquish is the latest in non-invasive fat reduction. It is FDA-approved for deep tissue heating, but clinical studies demonstrate fat reduction after treatment. Vanquish heats fat using RF (radio frequency) - specially tuned electricity that in this application targets fat without injuring other tissues. Treatment consists of 4-6 weekly sessions. It does not contact the skin, and the treatment feels like sitting under a warm blanket for 30 minutes. Average loss of waist circumference after treatment of the waist and flanks was 2 1/4 inches. Vanquish has a large "spot" area that can treat the abdomen and sides of the waist simultaneously.

CoolSculpting or Zeltiq is "cryolipolysis" or freezing of the fat. A suction cup like applicator is used to freeze the fat over a 1 hour treatment time. The skin after treatment feels like a stick of butter and is massaged. Occasionally, patients have discomfort in the treatment area that requires pain management. Results take around 1 month and result in around 20-30% fat loss in the area of treatment. New treatment regimens recommend that patients have multiple applications to sculpt the area of treatment smoothly and avoid irregularities.

Zerona is a fairly obsolete technology. Although I do not have the technology myself, feedback from colleagues is that it is not very efficacious. It also requires diet and exercise recommendations in order for Zerona to work.

Melanie D. Palm, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 23 reviews

Vanquish vs Coolsculpting vs Zerona

When considering the best bodysculpting treatment, its important to consider your baseline and what you are trying to acheive.  Zerona was one of the first laser devices to be used for fat reduction several years ago.  However, the results were temporary and did not induce permanent destruction of fat cells.

If you are within 25-30 pounds of your ideal body weight and are looking to get rid of focal areas of fat, then Coolscuplting would be the best treatment.  The technology causes destruction of fat cells using cold to treat specific "bulges" that fit into specific applicators.

If you are heavier set and have larger volumes of fat that cannot be treated by Coolsculpting applicators, then I would recommend Vanquish, which uses an array of panels that emit radiofrequency energy to destroy fat cells.  This is much more effective for circumferential reduction and can create appreciable reduction in waistlines up to 4 pant sizes.

There are also differences in time required to treat and treatment discomfort.  Coolsculpting achieves treatment goals in 1-2 treatments, although there can be moderate and rarely severe discomfort associated with the treatments, sometimes lasting up to 2 weeks.  Vanquish requires more treatments: 4 to 6 treatments scheduled once a week to achieve treatment goals, although the treatments are more comfortable (akin to heat exposure from a dry sauna).

These are the primary factors I would consider in determining the best treatment for you.

I think the Vanquish combined with the Z wave gives the best non-painful, non-invasive fat reduction results available.

Vanquish is an efficient, non-painful, non-invasive fat reduction procedure.Bottom line is both Vanquish which uses RF to heat the fat and CoolSculpting, freezing the fat both work.We spent a full year talking to people that had Vanquish and/or CoolSculpting in their office (not the reps) and bought Vanquish.In my opinion, the Vanquish technology is better for my practice for a few reasons.First Vanquish is not painful.In talking to technicians who have used both, the CoolSculpting can be painful to very painful so compliance is an issue.Vanquish is relaxing and does not hurt.It may feel warn, but not painful.Also with CoolSculpting you have to treat one flank, then the other, then the abdomen or in some cases the upper abdomen and the lower abdomen.Vanquish can target all of these areas in 1 treatment.Vanquish can be more cost effective for the provider and therefore the patient as there are no disposables with the procedure.With CoolSculpting you pay for disposable equipment with each use, Vanquish there are no disposables because the machine does not touch the skin.We use the Z Wave with every Vanquish treatment.The Z Wave uses sound waves to “break up” the fat Vanquish destroyed and in my opinion it reduces any lumps and helps the body absorb the fat faster.I think the Vanquish combined with the Z wave gives the best non-painful, non-invasive fat reduction results available.

SculpSure is the best!

The newest technology is also the best when it comes to non surgical fat reduction.  SculpSure is the world's first FDA indicated LASER for non surgical fat reduction of the abdomen and flanks.  It can also be used off label for other areas of the body.  It takes only 24 minutes and there is no down time.  Multiple areas can be treated at once and it is not painful.  What more could you ask for!!!!!!!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 69 reviews

Non-invasive Fat Reduction

We have done a trial with Zerona and we offer Coolsculpting and Vanquish as well as Smart Lipo in our office. Zerona took too much patient participation (!) for us to offer it. Its success is dependent on diet and lifestyle changes that are great but I felt our staff would really have to work with the patients to assure that they got the results possible and we just are not geared for that type of interaction.

We have had Coolsculpting since its inception. I love the science behind it and it does kill fat non-invasively. We have definitely gotten great results for SOME patients and my advice is to make sure you have the right problem for Coolsculpting to be the solution. Patients who need 1-3 applications to grab the majority of their abdominal fat do very well!

We added Vanquish because it seemed likely to help patients for whom Coolsculpting would be too expensive and time consuming to give visible results. That has proved to be the case. For big tummies, our patients that follow the protocol and hydrate well the day before, day of, and day after treatment are seeing more than the average 2 inch loss that the company promotes after 4 weekly treatments. Those patients are thrilled because it is quick, neat and painless.

I think both systems have a place in our fat fighting arsenal.

Rutledge Forney, MD
Atlanta Dermatologic Surgeon
3.5 out of 5 stars 6 reviews

Vanquish vs other technologies

Our practice has had a terrific experience with Vanquish, with minimal negative effects. After looking closely at the available devices, I decided to offer Vanquish due to treatment area (the whole abdomen) as well as what appears to be a low incidence of side effects that are self limiting. When performed with a consistent protocol, in an established practice with close supervision to ensure that the treatments are being done properly, Vanquish works beautifully for the right patients with the right expectations. It is certainly to your advantage to seek out any of these treatments at the office of a Board Certified Plastic surgeon who can offer the full range of surgical treatments, such as liposuction, abdominoplasty, or any other body contouring procedures. This will ensure that you will receive the best treatment program for you, not just the one or two things they offer.

Russell Babbitt, MD
Fall River Plastic Surgeon
5.0 out of 5 stars 16 reviews

Coolsculpting works best

I have been using these technologies for years and find that Coolsculpting works the best.  Vanquish has some success with specific patients. Please find a board certified dermatologist who is certified for Coolsculpting and knows about all of the available devices on the market to have the best cosmetic result. Best, Dr. Green

SculpSure - the best non-invasive fat reduction treatment

Your question dates back two years ago, so I am not surprised you did not reference SculpSure, the new and only FDA-approved laser to provide the quickest treatment (25-minutes) and easiest recovery (none).

Patients complete the treatment and walk out of our office ready to resume their ordinary activities. Sculpsure is a non-invasive lipolysis device that leverages controlled and targeted hyperthermic laser. The technique dives past your dermis for minimal absorption and then penetrates deeply to destroy subcutaneous fat.

I suggest you consult a board certified facial plastic surgeon to receive the highest quality knowledge, treatment, care and skill available.  A consultation provides you the opportunity to relay your concerns and desired outcome to the surgeon while the surgeon can assess your health profile and discuss his/her pertinent advice.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 92 reviews

Experience with Vanquish, Sculpsure, Coolsculpt, Zerona, & Ultrashape

I have personally used all four machines and continue to use Vanquish and Sculpsure to provide the most effective, permanent fat removal. 

For circumferential reduction (losing inches around the waist or thighs), Vanquish has the best reproducible results.  In Houston, our patients typically lose 2 inches and one to two pant sizes.  There is no limitation based on a patient's size or BMI.  The fat reduction is permanent and the procedure is painless.  It feels like you are sitting under a heating blanket. 

The Sculpsure is the only device in the world that uses a laser (1060 mm) to permanently remove pockets of fat.  Up to four areas can be treated in 25 minutes.  The ideal candidate is a person who is fit but cannot remove stubborn areas of fat.  Like the Vanquish, the patient feels warmth over the fat areas being permanently removed.  The treatment is incredibly effective and pain-free. 

The Coolsculpt device uses a vacuum suction to permanently reduce fat pockets.  Similar to Sculpsure, the ideal candidate is looking to remove smaller pockets of fat.  The difference is pain noted with the suction and the hour long treatment for one area.  The results are highly dependent on the person applying the suction.  The most common side effect is numbness and tingling lasting from one week to three months following the procedure. 

The Zerona is not effective in reducing fat.  Theoretically, fat cells are reduced in size but effects are highly variable depending on patients strictly following the prescribed diet.

The Ultrashape may be effective in temporary fat reduction.  Unfortunately, the results are highly dependent on the technician performing the treatment.  The areas being treated must be heated to the correct temperature for the appropriate amount of time.  Results are highly variable and not always reproducible. 

Based on our extensive testing and long term experience, we currently offer Vanquish and Sculpsure to permanently remove fat.  Results are impressive, reproducible, and painless. 

Suneel Chilukuri, MD
Houston Dermatologic Surgeon
5.0 out of 5 stars 3 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.