There are several differences. They also have a similarity in that both permanently remove fat. Coolsculpting is non invasive. With the new head pieces it only take as little as 35 minutes, has no significant down time in almost everyone, and is not uncomfortable to most patients with the new head pieces. No anesthesia is required. Lipo removes more fat, is invasive, has significant down time, and requires anesthesia. Coolsculpting removes an average of 20-25% of the fat pulled into the machine. More than one treatment may be necessary. Lipo removes significantly more fat in one session. Loose skin almost never occurs after Coolsculpting, it is not infrequent after Lipo. You must maintain a healthy life style after both or you may lose some or all of the effect. So longevity of both should be the same if you do not gain weight. Best Wishes, Maurice Vick MD