Liposuction or CoolSculpting? Which is right for you?

CoolSculpting is everywhere these days- I’m sure you have seen an ad pop up in your social media feed or perhaps on the back of a bus.  What is CoolSculpting and is it better than liposuction?  Well- that depends on you!  CoolSculpting is a technology that works by making fat cells very cold, causing them to undergo apoptosis or cell death.  Fat cells die at a higher temperature than skin cells, this is why you don’t get frostbite from the treatment. 


When you get a CoolSculpting treatment, your skin and fat is sucked up with a vacuum into the applicator which then makes the area cold for 30 minutes to an hour, depending on the location and type of applicator.  Sometimes, two applicators can be placed at the same time.  Then, over the next eight weeks or so, the fat cells die and are cleared away by your body.

Typically one can expect about a 20% reduction in fat per treatment cycle, so often two cycles are recommended per area.  This treatment can be good if your fat deposit is small enough to fit into the applicator. It also requires that the fat is underneath skin stretchy enough to be pulled into the vacuum.  

On the plus side, CoolSculpting requires no anesthesia and you can drive yourself home and do all normal activities right away.  However, most people need two rounds and multiple applicators to get a good result, so it can get time consuming and pricey.  Also, if the applicators are not spaced correctly or not enough are used, you can get an indented look where the applicator stops.  And there is a rare but unfortunate side effect called “paradoxical adipose hyperplasia” which means that instead of shrinking like it is supposed to, the treated fat grows larger instead, creating a poofed out area. 

How does liposuction work?  

First, some fluid containing local anesthesia and epinephrine is injected, this makes the area numb and shrinks blood vessels to prevent bleeding.  Then a tiny incision is made and a small tube attached to suction is placed under the skin to remove the fat cells.  Usually the incision can be closed with a single stitch.  

If only a small area is being treated, this can usually be done in the office without general anesthesia.  If the area is very large or liposuction is combined with additional surgery, then most likely you are better off having the procedure under anesthesia.

After liposuction, there is a period of swelling and bruising that usually gets better by a week or so after surgery.  I recommend taking it easy for a few weeks to let the body heal. The benefit of liposuction is that it can be more precisely tailored to your exact needs, and any area can be treated and sculpted as necessary.  For people who need more than just a few CoolSculpting applicators, the cost can be very similar or even less with traditional liposuction.  


Our office also offers BodyTite in combination with regular liposuction.  This is a radiofrequency device that delivers heat energy to the skin’s collagen, causing skin shrinkage over time.  This is an added benefit over CoolSculpting or regular liposuction alone, which only treat extra fat, without treating the overlying skin.

You Have Options

The best way to decide what is right for you is to meet with a plastic surgeon who can discuss all of the different options and come up with a plan that meets your needs and expectations.  Sometimes you may learn that neither liposuction nor CoolSculpting is the best plan and that you really need a body contouring surgery to get the results that you are looking for. 

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