CoolSculpting vs. Liposuction: 3 Things to Consider

One of the top complaints I hear from my patients is that despite seeing a lower number on the scale, their weight is not coming off in the places they’d hoped.

Most of us are genetically predisposed to store fat in certain areas, such as the belly, hips, thighs, and chin, and this fat will resist the forces of diet and exercise. Unfair, but that’s biology for you.

CoolSculpting applies a precise temperature to destroy a percentage of fat cells in an area. Liposuction physically removes larger amounts of specific fat cells.

Fortunately, plastic surgeons have effective fat reduction tools, two of the most popular being liposuction, and CoolSculpting®, a non-surgical alternative that “freezes” away fat. I offer both in my Fairfax plastic surgery practice as each has its merits; to understand which might be better for you, let’s compare.

1. Your Goals: Are you looking mainly for fat reduction, reshaping, or both?

This is the most important thing to think about, as the whole point of any procedure is to achieve your goals. When it comes to liposuction vs. CoolSculpting, the main difference comes down to sculpting vs. simple reduction.

Liposuction is the gold standard for body sculpting and precise fat removal

During liposuction, a plastic surgeon uses a long, thin instrument called a “cannula” to sculpt problem areas and suction out the fat through a tiny incision. Performed well, liposuction can truly sculpt the body to achieve a more shapely silhouette, reveal underlying musculature, and, of course, reduce stubborn fat bulges.

Liposuction is also the only fat reduction option that can work almost anywhere, including very small areas like the knees and underarms as well as larger areas like the hips, thighs, and belly.

CoolSculpting is great for spot-reduction without surgery

CoolSculpting uses a cooling technology called cryolipolysis—fat cell destruction by cold temperatures—to spot-reduce fat deposits. A suction-cup-like applicator is placed on the skin and emits a controlled temperature which is precisely cold enough to destroy fat cells, but not cold enough to harm skin, muscle, or nerve tissue. Your body then treats the destroyed fat cells as waste and eliminates them naturally. Each CoolSculpting treatment can achieve up to about a 20% reduction in an area, but we can’t literally “sculpt” the area, nor can we determine the exact result.

Part of that is because CoolSculpting results take time to appear; the other reason is the applicators can not be used as precisely and flexibly as a liposuction cannula. That said, most patients see a nice, general reduction in treated areas and are happy with their CoolSculpting results, provided they have realistic expectations.

CoolSculpting is also limited to certain areas of the body; we can use CoolSculpting to reduce on the abdomen, flanks, thighs, back, upper arms, under the buttocks, and under the chin.

2. Pricing: How much does CoolSculpting cost vs. how much does liposuction cost?

Because it’s non-surgical, many patients assume CoolSculpting is cheaper than liposuction. The truth is more complex than that. Yes, CoolSculpting costs less per treatment—starting at $750 for one area. In comparison, here in Fairfax liposuction costs start at around $3900 for one area, including surgeon’s fees, operating room and anesthesia, and post-op care.

CoolSculpting is expected to give you a 20% fat reduction in an area, but many patients hope for a 50-60% reduction in the size of a given bulge. To achieve that, you would likely need three CoolSculpting treatments.

That seems like a dramatic difference in cost, but keep in mind that with liposuction, in most cases, we can completely fulfill a patient’s goal with one liposuction procedure. Additionally, your plastic surgeon has control over how much fat is removed and how your shape will look after surgery.

With CoolSculpting, we can expect noticeable results, but there’s a good chance you may need to return for additional treatments to achieve your desired level of fat reduction. CoolSculpting is expected to give you a 20% fat reduction in an area, but many patients hope for a 50-60% reduction in the size of a given bulge. To achieve that, you would likely need three treatments.

Liposuction vs CoolSculpting Comparison

Liposuction of the Hips Cost	CoolSculpting of the Hips Cost
One time procedure to remove ~1,000cc fat=$3900+Cost of one week’s time off work*	$750 left side + $750 right side X 3 sessions=$4,500No cost of time off work*
Liposuction of the Hips Results	CoolSculpting of the Hips Results
Noticeable in the days immediately after surgery. Continued improvement as swelling dissipates over 2-4 weeks. Predefined, sculpted changes are made	Results gradually appear over the course of 3 months. 3 rounds of treatment = gradual improvement over 9 months total. General reduction in fat deposit size

*depends on area(s) treated and nature of your job

In general, this is what I recommend to my patients regarding cost: if you have one or two small-to-medium fat bulges you’d like to reduce, but you’re generally happy with your shape, CoolSculpting can be a great value. If you have multiple areas or a larger amount of fat you’d like to reduce, or if you have specific goals to change the shape of an area, you are probably going to be much more satisfied with liposuction.

3. Recovery: How much (if any) downtime can you take?

It’s hard to find a more convenient fat reduction procedure than CoolSculpting

Each CoolSculpting treatment takes less than an hour, and we do it in our office. Because there are no needles or incisions, and no anesthesia needed, almost all of our Fairfax CoolSculpting patients return to their normal daily routine immediately, although it’s normal for the treated area to feel numb for a few hours and/or sore for a few days.

When will I see results after CoolSculpting?

CoolSculpting results appear gradually, as your body clears out the affected fat cells. Typically, patients will notice improvements beginning about 3 to 4 weeks after treatment, with full results in place after about 3 months, when the body is finished eliminating the fat cells. At this point, some patients choose to repeat treatment to achieve further fat loss, which starts the cycle over again.

Results with CoolSculpting will be less dramatic than with liposuction, but the benefit of little to no downtime is pretty significant, especially if modest fat reduction is your goal. If you are hoping for more extensive reduction, but downtime is out of the question, CoolSculpting can still be considered—provided you have patience, don’t need precise sculpting, and are aware that the total cost may end up exceeding that of liposuction.

You’ll need to do a little more planning with liposuction, but the results can be well worth it.

Liposuction does require downtime, but it’s usually a lot less than people think. Most of our patients are back to desk jobs and daily tasks within 4 to 7 days, and can resume exercise after about 3 weeks. I also apply a special localized, liquid anesthetic (in addition to general anesthesia and/or sedation) when performing liposuction, which significantly minimizes post-op discomfort, swelling, and bruising, helping my patients look and feel better even faster.

When will I see results after liposuction?

Some patients notice improvements immediately, while others will not see much change until swelling dissipates.

In any case, what you see right after liposuction (or any plastic surgery, for that matter) is not the final result; normal post-op swelling and bruising will obscure your results for a little while. For most patients, these effects subside within 2 to 3 weeks, and you’ll continue looking better over the next 3 to 6 months as your skin adjusts to your new shape.

One more thing: whichever option sounds best for you, make sure you consult with a board certified plastic surgeon

I certainly hope this info has been helpful, but ultimately the best way to determine the right fat reduction option for you is to consult with a board certified plastic surgeon who offers both liposuction and CoolSculpting. You’ll need someone with the experience, training, and knowledge you can trust to tell you honestly what you can achieve with each option. If you’re in the Fairfax or Washington DC area, give my office a call: 703-752-6608. I look forward to meeting you!