CoolSculpting Vs Laser Lipolysis

Both technologies melt away fat.  CoolSculpting does it via cryolipolysis (freezing fat) and laser via heating the fat.  SmartLipo is surgical and a one time procedure with a few days of downtime.  CoolSculpting is completely non surgical but requires multiple treatment sessions which can be performed over a 1 to 2 day period broken up into a few treatment sessions.  Laser liposuction will give you more skin tightening. CoolSculpting has made significant advancements over the past few years and a lot more is known about how to perform the procedure to provide near laser lipo suction results.  We now treat the abdomen for example with 4 to 6 treatment cycles and can repeat treatments for even greater results a month later.  This is in contrast to prior treatment modalities where only a few treatment cycles were performed- with suboptimal results. What's unique about CoolSculpting is that you can "treat to total body transformation" i.e. treat multiple areas such as the abdomen, waist, bra roll, legs and arms.  This is not possible with laser liposuction unless multiple surgeries are performed.  Its not possible to perform laser liposuction in one session for all those areas.  There would be multiple downtimes and the cost would be far greater.In summary, we other our patients both treatment modalities.  Both provide excellent results.  I think that CoolSculpting is ideal if you have good skin tone (don't need skin tightening), want no downtime, looking to spend less, and are ok with results that maybe slightly less than laser liposuction.  If you want to treat your entire body, again, CoolSculpting is more practical.  If you want more dramatic results in targeted areas and are ok with the downtime then SmartLipo maybe a better choice.  Ran Y. Rubinstein, MD
200 Stony Brook Court, Newburgh, New York
Board Certified Facial Plastic Surgeon
Clinical Professor New York Presbyterian Hospital
National Education Faculty (physician trainer) for:
Allergan (Juvederm, Voluma), Valient (Scultpra,
Restylane), Cynosure (Cellulaze, Precision Laser Lift)
& Solta (Fraxel, Thermage)Zeltiq( CoolSculpting)

CoolSculpting by Zeltiq is a non-surgical, FDA approved device for permanent fat reduction by using cryolypolysis to freeze localized areas of fat.  This mechanism works by damaging the fat cells  walls in the treatment area which are later removed through the body's  own metabolic process.  Unlike laser lipolysis, where a laser fiber is utilized surgically to damage fat cells by either heat or through photo- acoustic damage to cell wall. The damaged fat cells after laser lipolysis need to be removed by liposuction through a small cannula. If the majority of these fat cells are not removed, then the body's natural process will be unable to handle the large volume of ruptured cells.  They must be removed surgically through liposuction

 In terms of results, CoolSculpting is best for patients with small areas of localized fat, and those who are within 10 to 20 pounds of their ideal body weight.  One treatment of CoolSculpting will remove about 25% of fat in the treatment area and can be repeated 3-4 months later if desired.  Whereas laser liposuction, when done properly, can remove 85-95% of the fat cells in the treatment area in one procedure.

Results from  laser Liposuction is heavily dependent upon the experience of the plastic surgeon as well as the type of laser that is being used.  I have had good results using SmartLipo Triplex for patients who are good candidates. However, for those patients who have smaller areas to treat and do not want a surgical procedure, CoolSculpting by Zeltiq has been an excellent alternative with high level of patient satisfaction.  

I offer both CoolSculpting and tumescent liposculpture in my office. CoolSculpting is a noninvasive treatment that uses controlled cooling to freeze fat cells. Since fat freezes at a higher temperature than other cells in the body, the fat is targeted during the process while surrounding skin and tissue remain untouched. Studies have shown that a single CoolSculpting treatment removes 20-25% of the fat in a treatment area. Patients can opt to have additional sessions if they would like more dramatic results. Keep in mind that it will take time for you to see the full results of CoolSculpting, with the best improvement becoming evident at around the six-month mark.

I consider tumescent liposuction to be the gold standard in liposuction techniques, because it produces superior results with less discomfort and downtime than other liposuction methods in many cases. Micro-cannulas are used to gently suction the fat out of the area. The procedure can be performed with local anesthesia and patients are usually back up to regular activities within a few days. While this is technically a surgical procedure, the incisions used are too small to leave much - if any - visible scarring behind. Liposuction can remove more fat in a single session, so you enjoy more dramatic improvement and do not need to repeat the process. In my opinion, if you are a small person with small, isolated pockets of fat, CoolSculpting is great. It may get too expensive if there are many bulges or if you are a larger person. Tumescent liposuction offers a “one and done” approach. Both of these procedures should only be performed by an experienced, board-certified physician to ensure the best possible results.

Thank you for your question. Laser lipo and fat freezing use two different technologies. In my experience, fat freezing is more effective.

Hi.  You will be able to treat a larger area in one setting with laser lipolysis (potential for burns, anesthesia, postop garments, numbness, bruising are to be taken into consideration) and may be more economical and appropriate.  Coolsculpting treats pockets of excess fat, 20% of the thickness per area per session (no frostbite type burn, no anesthesia or garments, some numbness/bruising has been reported). During your examination, the areas you want treated will dictate which procedure is recommended.  Best wishes,

Thank you for the question, and the photos. They are different modalities.  CoolSculpting can get a 25% reduction.  We have found it to be very effective for the love handles, abdomen, bra area, arms, thighs, neck, and other areas. We have found that treating the area twice usually improves the fat cell kill significantly.  Other physicians I have spoken to have found similar findings.  The fat cells die and are taken up by the normal cell disposal mechanisms of the body.  Liposuction is a surgical modality that is usually more dramatic, with a greater reduction. The fat cells are physically removed with liposuction.  Laser lipolysis is where a laser will cook the cells before extraction.  It is usually accompanied by liposuction.  It is controversial if it makes a significant long term difference.   Again, the CoolSculpting is non invasive, no surgery, no downtime.  As always, the modality should be appropriate to the individual patient.  Best to see a Board Certified Plastic Surgeon, who can evaluate for all modalities.

Coolsculpting is an excellent form of non-invasive  fat reduction for
the right patient. Some applicators take 1 or 2 hours but the new advantage
applicators take only 35 minutes and have significantly less risk for delayed
onset pain (especially in the abdomen). Results are seen at 2 months and
typically 1-3 treatments will be necessary on each area to achieve ideal
results. The number of treatments depends on the amount of fat there and the
patient's goals.  There is not downtime and the results can be impressive
in the right patient.  We also use the Zimmer Z-wave for improved patient
comfort and added results. The best candidates are those who are in pretty
good shape with areas of stubborn fat that won't go away no matter what.

My best,

Sheila Nazarian, MD, MMM

Beverly Hills, Board Certified Plastic Surgeon

Hello and thank-you for your questionOur office offers both Laser Lipolysis, which is a more invasive surgical procedure involving liposuction and the non-invasive alternative Coolsculpting. CoolSculpting is a great, FDA-approved treatment for fat reduction of the abdomen and flanks. Coolsculpting relies on Cryolipolysis due to the fact that fat cells are more sensitive to cold than are other tissues. We utilize the new Cool Advantage applicators which are much more comfortable and reduce treatment time to 35 minutes.  We currently have 4 Coolsculpting machines and can offer "Dual Sculpting" which further reduces the treatment time.  It can be used safely for off-label treatment of the upper arms, inner/outer thighs, bra-strap area, chin, and above the knees. The advanced cooling technology selectively targets and eliminates fat cells gently and gradually without affecting the surrounding tissue. Patients in our office have seen an average fat reduction of 20-25% with each treatment. Depending on the patient's body composition and outcome goals, it generally takes more than one treatment to achieve optimal results. A second treatment is general scheduled 30 to 45 days after the initial treatment. It takes about 2-3 months to get a general idea of the final results. The results are long-lasting as long as you maintain a stable healthy lifestyle. I recommend scheduling a consultation with a Board Certified Plastic Surgeon well versed in all options for body contouring to determine if you an ideal candidate for CoolSculpting or laser lipolysis.Best regards,Andrew Lyos MD FACS

Many of my patients would like to know how long the Coolsculpting procedure lasts after the treatment has been given. The answer is that the cells are sent into a pathway of cell death called, "apoptosis". This is a cycle of programed cell death. The cells are consumed by macrophages and excreted from the body. So to answer the question of, How long does it last". It is permanent. This means that the cells which are deleted do not come back. What may be noticed a the 3 month follow up visit is the adjacent cells are still present and thus may now be more noticeable. Therefor in this case an adjacent treatment will further enhance the patients great results.This patient would be an very reasonable candidate to consider Coolsculpting; however, a tummy tuck is also a very reasonable option. The decision would be best made based on the patient's goals and aspirations.

Coolsculpting is very popular because it works very well and the results are comparable to Laser Lipolysis. The key is that Coolsculpting is such a comfortable procedure that larger areas can be treated more easily, and patients are more likely to get great results because they will come back for more treatments to optimize results. Laser Lipolysis can be painful and it is a more uncomfortable procedure to sit through, and then have repeat sessions. - Dr. P

Cool sculpting is great for small localized areas that fit the cool sculpting adapters well. Smartlipo is more versatile and aggressive.  You really need to be evaluated on an individual basis to determine what is best.