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 18

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

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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
5.0 out of 5 stars 245 reviews

Vanquish vs Coolsculpting vs Zerona

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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.

Freezing and heating fat works - Zerona doesn't

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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 - Account Suspended
San Diego Dermatologic Surgeon

SculpSure is the best!

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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 83 reviews

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

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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.

Vanquish, CoolSculpting It's all about choices

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Great questions, but let’s compare apples to apples and add some science as well. It’s all about “fat busting” getting rid of those fat cells, and doing so without surgery, and that’s what Vanquish, CoolSculpting and Liposonix do. They injure fat cells, so the body then eliminates them. Zerona is in a different ball park. It temporary shrinks the fat cells, but doesn’t knock them out. So how to choose? It’s all about choice. Vanquish is new and it offers (for the first time) a chance to treat it all - the full tummy and love handles in four treatment sessions. CoolSculpting has been a great choice for our patients as well. It is better for that more focused bothersome area of excess fat. For us and maybe for you, the answer is a combination of treatments, with many options.

Douglas J. Key, MD
Portland Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

Non-surgical Fat Reduction Advice

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There are several new options for non-surgical fat reduction out there. I would personally recommend BTL Vanquish! CoolSculpting is a little more agressive, and Zerona may take longer to see results. Vanquish is a nice medium ground, generally pain free, and gets great results after 3-4 treatments. I will caution you, some people are not going to be canidates for non-surgical fat reduction, depending on how much you expect to lose. If you're looking to loose a few inches around your waist, give Vanquish a try. 

Non-Invasive Body Sculpting

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There are a number of devices on the market to destroy fat and sculpt the body without an invasive procedure. If you are looking for circumferential reduction in your waist or thighs, Vanquish Me has been shown to destroy the greatest number of fat cells with a regimen of 4-6 treatments. CoolSculpting, BodyFX, and SculpSure are three devices that focus on focal fat destruction if you are targeting a very specific area that is not too large. In some physician offices they may combine more than one device to enhance the overall result. We have a program which we call Vanquish Me Now that combines four different treatments to achieve an excellent overall result. The results that can be obtained with non-invasive procedures has gotten much better in the past couple of years but I can still achieve a better overall sculpted look with Tickle Lipo. To determine which procedure will best fit your objectives, I recommend scheduling a consult with a reputable provider, discussing your goals, and seeing if they have a treatment plan to help you achieve those objectives.

Vanquish vs other technologies

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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 19 reviews

Coolsculpting works best and can be combined with Vanquish

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I have been using these technologies for years and find that Coolsculpting works the best.  Vanquish has some success with specific patients that you cannot treat with Coolsculpting.  I have many patients who had abdominal surgical procedures are just are not candidates for Coolsculpting.  Vanquish can help these patients. The Zerona laser is largely ineffective. Please consult 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

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.