5 Areas CoolSculpting Works Better Than Liposuction

When I began my training in plastic surgery, liposuction was just being introduced. Since that time, almost 35 years ago, we have seen significant improvements in how liposuction is performed. Recently we have seen the emergence of non-surgical fat reduction. Of all the different technologies that have been developed for this, CoolSculpting is clearly the most effective and most popular.

Now that we have over five years of experience with CoolSculpting, we and our patients can attest to its effectiveness. While liposuction remains the gold standard against which all other methods of fat removal or reduction must be measured, there are some areas of the body where CoolSculpting is now my “go-to” procedure recommendation.

Surgical liposuction does have the advantage of being of a single procedure (one and done) where a larger volume of fat can be removed, but is has the disadvantage of being an operation with anesthesia and recovery time. CoolSculpting, on the other hand, does not require surgery and has almost no downtime. This is balanced by the fact that it is a less aggressive method of fat removal and may require several treatments to achieve the same results.

Many parts of the body can be treated equally well with either liposuction or CoolSculpting. Some of these areas are:

• The abdomen
• Hip rolls, love handles, muffin tops
• Outer (lateral) thighs

On the other hand, there are some parts of the body where I think CoolSculpting can actually be better than liposuction. The reason is that there is a lesser amount of fat removal needed and the shape of the area being treated is ideal for the CoolSculpting or CoolMini applicator.

Five areas CoolSculpting is better than liposuction:

• The armpit puffs (axillary fat). The shape of the area being treated fits perfectly into the CoolMini applicator. Usually there is only a moderate amount of fat to be removed, so CoolSculpting is the winner.
• The upper, inner thighs. Again, the shape here is right for CoolSculpting. The other consideration is that this is an area where there can be some skin looseness, and a gradual, less aggressive method of fat removal may do better than liposuction.
• The banana roll, or fat on the upper thigh beneath the buttock. This can be a very difficult area to treat with liposuction due to skin looseness that can develop afterwards. This can result in a roll of skin that can only be corrected by skin excision. CoolSculpting is less likely to run into this issue due both to it being a more gradual method of fat removal, and it may better preserve some of the connective tissue within this area of fat.
• Bra-line fat of the mid back. Definitely CoolSculpting all the way.
• The neck to treat a double chin. Although CoolSculpting and liposuction are equally effective here, we are certainly doing more CoolSculpting here than liposuction since the CoolMini applicator arrived. The other day Natasha came into my office with her latest before and after photo saying, “I love treating chins!”. I expect this will continue.

There are two areas where we do not yet have enough experience with CoolSculpting to know if it is better than or equivalent to liposuction, so the jury’s still out. These are:

• The upper arms
• The inner aspect of the knee

Whether or not one method of fat removal/reduction is better than another, it’s really great that we have both options available. Frequently I will be seeing someone for liposuction in whom I feel that CoolSculpting may be a better option. On the other hand, someone may come in requesting CoolSculpting or liposuction, when what they really need is a tummy tuck or a neck lift. That’s the subject for a different blog.

Certainly, there will be new methods of fat reduction that will come on the market, and we will continue to evaluate them to see if they are right for our patients. In order for us to bring them into our practice, they will need to be, at least, equivalent to what we have available now: liposuction or CoolSculpting.

All the best,

David B. Reath, MD

Helpful CoolSculpting Resources:

• CoolSculpting Before and After Photos Men
• CoolSculpting Before and After Pictures Women
• CoolSculpting 101
• How to Find the Best CoolSculpting Practices
• The Real Skinny on CoolSculpting Applicators
• CoolMini for Double Chin and Armpit Puffs
• CoolSculpting in the News
• Dr. Reath Gets CoolSculpting (Video)
• CoolSculpting vs Liposuction vs Tummy Tuck INFOGRAPHIC