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.