Liposuction versus CoolSculpting®: Which is Right for You?

Lipo vs CoolSculptingLiposuction and CoolSculpting® are two very different procedures that are designed to reduce unwanted fatty deposits. So with both procedures producing the same outcome in the end, how are you to decide which is best for you? Like so many things in cosmetic medicine, it depends . . .Let me break down the differences between the two so that you can make the best decision for you.

Liposuction was developed in the 1980’s and has been around a lot longer than CoolSculping. There are now many types of liposuction including Suction Assisted Lipectomy (SAL) – the original technique but still a great one; Ultrasound Assisted Liposuction (UAL) that uses sound waves to break up the fat, Power Assisted Liposuction (PAL) that uses vibration, Laser Assisted Liposuction (LAL) that uses laser energy, and Fluid Assisted Liposuction (FAL) that works like a water jet. Despite the different approaches, all of these techniques can work well, and none is clearly superior over the other, despite marketing claims to the contrary.

Liposuction is a surgical procedure and can be performed under local anesthesia, under sedation, or with full general anesthesia. The type of anesthesia you will need depends on the area(s) to be treated and the amount of fat that needs to be removed. In general, the more areas that you treat, the more sedation or full general anesthesia you will need. The incisions for liposuction are small, typically less than 1/4 inch, so there isn’t much scarring. There is, however, a recovery period that lasts for a few weeks – bruising and swelling are most common. Patients can usually resume light exercise after a few days.

As opposed to liposuction, CoolSculpting® is a non-invasive procedure that doesn’t require anesthesia at all. The CoolSculpting system includes a disposable gel pad that is placed over the treatment area. A cooling head is then placed over the gel pad and suction is activated. The machine has a base that cools the liquid flowing through the headpiece and pulls the fatty area into the head, therefore, freezing the fat. After an hour or so (or two hours for a non-suction treatment type) the cooling head is removed and the frozen area is massaged briefly. Although there can be some discomfort when the tissue is first pulled into the cooling head, this becomes numb once the cooling starts and the massage doesn’t hurt. Like liposuction, it takes a few weeks to see the final result, and although there really isn’t much pain, like liposuction, the treated area can feel a little tender for a while.

Liposuction is the more aggressive treatment of the two, allowing more fat to be removed in a single session. Because CoolSculpting removes less fat per treatment, patients may need several sessions of CoolSculpting to get their optimal result.

Patients who are thinking about other cosmetic surgical procedures may be better candidates for liposuction than CoolSculpting since they would already be under aesthesia. In addition, the combination of liposuction with an excisional procedure (think tummy tuck with liposuction) is very powerful and can deliver dramatic results. Another example of when liposuction is preferable is when a patient might want to add volume to an area and they want to do so with their own fat. Liposuction can be used to harvest fat for fat transfer to another site. Liposuction is often preferred when there are many body areas that the patient wants treated, as these can be done all at one time, rather than over many different sessions with CoolSculpting.

CoolSculpting can be a great option for smaller fatty deposits. It is also a great choice for patients that are keen to avoid surgery, either for personal preference or because of health issues that may increase the risk of surgery.

Patients always wonder which is more cost effective – liposuction or CoolSculpting. This is another it depends situation. If a patient is treating a single small area that will probably be effectively treated with two sessions, then CoolSculping makes a lot of sense and may be cheaper. However if there are multiple sites to treat, and some of these will need three or more CoolSculpting sessions to get full resolution, then liposuction may be the less expensive of the two.

In the long run the choice of which is best for you depends on you – how you feel about it, what issues are the most important, and how aggressive you want to be in removing the fat. If avoiding surgery is super important to you, and you’ll accept less dramatic results in order to do so, then CoolSculping might be your best option. On the other hand, if you’d rather get as much fat off as possible, and would rather do this in one session instead of several, then liposuction may be your best bet. Let the board certified cosmetic surgeons at the Emory Aesthetic Center help you figure out what approach is best for you.


About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

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