Coolsculpting Vs. Liposuction: Who Should Get Which?

Here it is — the body-contouring showdown – CoolSculpting versus liposuction!  In one corner we have the reigning champion, liposuction, a treatment that’s tried and true, proven to eliminate fat. In the other corner, we have the challenger, CoolSculpting, a newer, non-surgical contender that’s been getting a lot of attention. No matter the choice, the ultimate loser is fat.

But which option should be the winner for you?   Both achieve noticeable results, yet do it so differently.  As a result, the decision itself can feel like a battle.

In the end, the winner needs to be you. And if you take the time to learn about both CoolSculpting and liposuction, and ask yourself some fundamental questions, you’ll ensure that happens. The more you know before walking into your first consultation, the better the decision you and your doctor will make.

The bottom line is that Coolsculplting and liposuction are NOT the same. As you read along, you’ll get a better sense of which is right for you.  We’ll start first with how they’re similar and then explore their differences.

What Liposuction and Coolsculpting Have in Common

Contrary to what you may have heard, neither procedure was designed to give patients substantial weight loss.  In both cases, fat cells are being removed from the body, which can cause you to lose a few pounds.  However, if you gain weight later, your remaining fat cells can respond by getting larger.

To get the best possible results, you need to be in good health and at a weight close to your target for either procedure.  Think about it, why invest your money in an improvement that diet and exercise can give you?   Not that lifestyle change is easy.  When you’ve gotten yourself to a reasonably healthy weight (i.e., BMI under 30), you can use either CoolSculpting or liposuction to reduce the size of areas that have been resistant to your efforts, your problem spots.

These are the parts of your body that, despite all of your best efforts, refuse to get smaller.  Though these can vary from patient to patient, there are some common trouble spot areas.  These include the abdomen, hips, thighs, butt, arms, and neck.  Your doctor may have an opinion on which option works best on a specific body area.  Be sure to ask.

Beware, some physicians may attempt to sell these services to you even if you’re not a good candidate. Licensed and experienced plastic surgeons know better and will not recommend either CoolSculpting or liposuction to a patient whose body is not ready.

Now that we’ve gone over their similarities, let’s discuss both CoolSculpting and liposuction in detail to examine what might be right for you.


CoolSculpting is more than just a nifty-sounding name. It’s a way of eliminating a portion of your fat by freezing it. The procedure is performed with a paddle that is attached to a sophisticated cooling machine.  When placed near the skin, the device cools the underlying tissue to fourteen degrees Fahrenheit.  As a result, your skin and the tissue directly underneath numb, and a layer of fat cells freeze and die.

Your skin won’t be damaged, because your doctor will use a special pad to protect it.  And because the procedure causes it’s own numbing, no anesthesia is needed.  Afterward, your doctor will massage the treated areas to aid in the breakdown and release of fat cells.  Your body will then, over several weeks, dispose of the dead fat cells naturally.

CoolSculpting removes about 25% of the fat it treats. Patients can, and often do repeat the procedure every 20 weeks or so.

Why Patients Get It

Patients choosing CoolSculpting are usually looking for a noninvasive way of eliminating fat in a trouble area.  They also need a solution that required little to no downtime.  For some, surgery has never been an option because they can’t take enough time off work or away from their family.  Also, for some people, the idea of a newer treatment that uses state-of-the-art technology implies that it’s better.

Who It’s Right for

As mentioned, CoolSculpting requires a patient to be at or near maintainable target weight.  It’s not a weight loss procedure but a way to improve the contours of an area of your body.

Like an artist, CoolSculpting slowly does its work over a period of time. Your first results show up in about a month, with full results visible usually in two months. Therefore, the procedure requires you to accept both its limited fat reducing potential and the time needed to see results.  And if you’d like an additional treatment, you must be willing to wait some time for the next one.

That said, many patients can and do opt for CoolSculpting treatments and are happy with the results.  One plus for some patients is that it does not have the non-smoking stipulation that liposuction does.


Patients can return to regular activity after CoolSculpting almost immediately, depending on their level of initial soreness. For some patients, this means taking the rest of the day off work.  And because no anesthesia is required, you’ll be able to come and go to your appointment on your own.

Patients usually feel numbness caused by the cooling for about three weeks after their treatment session.  After about five days, you may feel mild sensations of tingling or cramping.  Your doctor can recommend an appropriate pain medicine if necessary, to minimize discomfort.

While CoolSculpting is widely-used and preferred by many patients, many others opt for liposuction.  Let’s take a look so you can see how it’s different.


First, it’s best to dispel any preconceived notions you have about liposuction.  As stated, it’s NOT for obese people looking for instant weight loss.  Performing the procedure in this way would only result in an abundance of loose skin.  Instead, it’s best used for moderately fit people looking to eliminate areas of stubborn fat.

The term liposuction comes from “lipo,” meaning fat, and “suction.”  However, it’s not as simple as sticking a tube under the skin and turning on a vacuum. There are two common methods for this procedure: traditional or tumescent liposuction, and ultrasound-assisted liposuction.

The traditional method involves your doctor first injecting a fluid mixture into the target area.  This mixture usually contains lidocaine to reduce pain, epinephrine to prevent bleeding, and saline to help loosen the fat.  Then, along with the fat itself, the fluid is suctioned away using a small straw-like device called a cannula that is inserted via a small incision.

The newer ultrasound-assisted method uses liposuction that uses sound waves to loosen fat. Then, as in the traditional approach, the fat cells are suctioned out of the body with the cannula.

Why Patients Get It

Patients choose liposuction for a variety of reasons.  First, liposuction immediately eliminates fat. There is no waiting period for the body to process and eliminate dead fat cells.

Second, more fat can be removed in one session. While again, liposuction is not a weight-loss procedure, patients can lose five to seven pounds of fat in one sitting.  Therefore, repeat procedures aren’t usually necessary

Third, the fat taken from your body can be reused.  Patients now can have the fat taken from liposuction injected into other areas of their bodies.  For instance, fat transfer is growing in popularity for breast augmentation or as a way to eliminate wrinkles.

Still, despite its benefits,  liposuction is not right for everyone.

Who It’s Right for

As mentioned, you’ll need to be reasonably healthy.  Patients should be at or around a target weight that they can easily maintain.

You’ll also need to be a non-smoker with elastic skin. Smoking, unfortunately, degrades the quality of your skin by restricting its blood blow.  Elasticity is necessary because you want your skin to be able to shrink to your smaller body size after liposuction.


After the procedure, you may have drainage tubes in place for any excess fluid. Typically, they’re removed in a few days.  Within seven to ten days, you’ll return to the doctor’s office to have any non-dissolvable stitches removed.  You also should be able to return to work around this time.

Post-surgery,  patients can experience some swelling and soreness.  The swelling begins to dissipate after one week and, for most patients, has subsided within six to eight weeks.  It can, however, take as long as six months to abate fully.  Any soreness can usually be managed by over the counter or prescription medicine as directed by your doctor.  Overall, patients begin to see results within a couple of weeks.

Key Questions to Consider

Given all we’ve discussed here, you may still be thinking over which treatment is right for you.  If so, there’s no need to be discouraged. The following questions will help you make a preliminary decision.  They’ll arm with you with the right information so you and your doctor can make the best possible choice.

Do You Smoke? Is Quitting Smoking an Option?

Again, your skin has to be in it’s best possible shape to recover from liposuction. Don’t forget, recovery from surgery of any kind requires some effort. If remaining nicotine-free isn’t feasible before and after surgery, you may want to consider CoolSculpting.

How Do You Feel About Minimally Invasive Surgery and Anesthesia?

Although not extensive, liposuction does involve incisions.  And it will require either local or general anesthetic. With all surgery, there is some risk of infection, and general anesthesia carries its own, slight, but serious risks.  If you know you want neither surgery nor anesthesia, CoolSculpting is your choice.

How Quickly Do You Want to See Results?

With liposuction, the recovery can be longer, but the results can be seen quicker.  With CoolSculpting, you may need multiple treatments over several months to see the result you originally wanted.  If more immediate results are your goal, choose liposuction.

How Much Fat Do You Want to Remove?

While extensive fat removal is not recommended,  your doctor can remove more fat in one session with liposuction than with Coolsculplting, which may require multiple visits.  If one-time fat removal is vital for you, liposuction is your better choice.

Whatever choice you make, remember you won’t be making it alone.  A competent physician will be your most reliable resource in the decision-making process.

The Importance of Choosing the Right Physician

No two patients are the same, and therefore, it takes an experienced and skilled physician to guide you through either procedure.  Do yourself a favor by working with a physician who specializes in plastic surgery.

Contact the board-certified plastic surgeons at the Plastic Surgery Center of Nashville at (615) 467-6777 to schedule your consultation!