A healthy diet and consistent exercise are commonly touted as the fail-safe formula for achieving a slim and toned physique. While diet and exercise are indeed essential to health and wellness, many people discover that despite a strict diet and consistent exercise, certain areas of their body are resistant to change. For individuals unable to achieve their aesthetic goals by conventional means, a suitable surgical or nonsurgical fat reduction procedure may offer auspicious resolve. While liposuction remains the gold-standard surgical treatment for excess subcutaneous fat, nonsurgical treatment options, such as cryolipolysis (aka CoolSculpting), continue to gain popularity among patients seeking less invasive measures. While both liposuction and CoolSculpting have proven to be effective in reducing adipose tissue and improving body contour, these two cosmetic procedures are, in fact, very different.
Liposuction is one of the most commonly performed surgical procedures in aesthetic plastic surgery. According to ASPS Statistics, liposuction was the second most popular cosmetic surgical procedure in 2016, with over 235,000 procedures performed in the United States, alone. Liposuction is a surgical approach to removing excess subcutaneous fat and improving body contour. During a liposuction procedure, a plastic surgeon makes one or more very small incisions in targeted areas of excess fat. A long, narrow suction tool called a cannula is inserted though the incision(s) and functions to remove fat from the targeted treatment area. Depending on the number of body areas treated and the amount of fat removed, liposuction may be performed under general anesthesia, local anesthesia, or under sedation. Liposuction effectively treats a wide range of body regions and is commonly performed for fat reduction in the abdomen, waist, back, hips, buttocks, thighs, knees, upper arms, chin and neck.
From 2015 to 2016, nonsurgical fat reduction procedures increased by nearly 6%. CoolSculpting is a noninvasive, FDA cleared device that uses cryolipolysis technology to reduce localized subcutaneous fat. The device uses a vacuum applicator to deliver controlled cooling at the surface of the skin. By exposing fat cells to a critically low temperature, the CoolSculpting device induces crystallization and subsequent cell death in targeted fat cells. CoolSculpting is currently indicated for use in the submental region ("double chin" area), thighs, abdomen and flanks.
Which option is right for me?
When choosing between liposuction and CoolSculpting, the prospective patient should consider a few key questions:
What are your treatment goals?
- The CoolSculpting device is designed to treat focal pockets of fat. For patients seeking a nonsurgical method to reduce fat in a localized area, such as in the love handles or outer thighs, CoolSculpting may be the appropriate treatment. Patients undergoing a CoolSculpting procedure should expect mild to moderate improvement in the area being treated. It is important to note that multiple treatment sessions may be necessary to achieve the best results. The number of necessary treatment cycles is dependent on the treatment area. Additionally, patient should understand that the results of CoolSculpting are not immediately noticeable. Changes in the treated area may become apparent as early as three weeks after CoolSculpting, and the most dramatic results can be seen one to three months after treatment. Your body will continue to process the injured fat cells from your body for approximately four months after your procedure.
- For patients looking to treat excess fat over a larger area of the body or for patients desiring a more dramatic change in body contour, liposuction may be the more suitable choice. Liposuction is a more aggressive treatment option and allows for more fat to be removed during a single session. Further, liposuction can be performed in conjunction other surgical procedures, namely autologous fat transfer, for patients that desire more extensive body contouring. The fat that is extracted during liposuction can be reinjected into areas of the body where more volume is desired, commonly the breasts, buttocks and face. As opposed to CoolSculpting, an overall reduction in fullness and improved contour is noticeable within days after the procedure.
How long is the recovery period?
- CoolSculpting is a nonsurgical procedure and, as such, offers patients a quick recovery, minimal associated discomfort and a low risk of complications. Typically, patients can resume normal activities immediately following the procedure. Occasionally, patients will have experience redness, minor bruising, tingling, numbness or discomfort in the treated area. These signs and symptoms can be expected to resolve quickly.
- Following liposuction surgery, the recovery is relatively quick. Patients can typically return to work and resume most normal activity within a week of surgery. Swelling, bruising and numbness are common after liposuction and will subside over the weeks to months following surgery. It takes several months to one year to see the final results of most surgeries, as the body continues to make adjustments for up to a year after surgery. However, within days after liposuction procedure, you will notice an overall reduction in fullness and improved contour. It is important to note that the recovery is dependent on the amount of fat removed and the number of areas treated.
Are you a good candidate?
- The ideal candidate for CoolSculpting is in good physical health, exhibits localized fat deposits and minimal skin laxity and has realistic expectations of the procedure. Patients considering CoolSculpting treatment should have expectations of mild to moderate improvement and understand that it is not designed for weight loss.
- The ideal candidate for liposuction is in good overall health, exhibits excess fat deposits and has realistic expectations about the procedure. Liposuction is best suited for patients with minimal skin laxity as liposuction intervention can exacerbate the appearance of loose skin in the targeted treatment area. Discontinuing the use of any tobacco/nicotine for several weeks before and after a liposuction procedure is essential as tobacco/nicotine use can impair the healing process and increase the risk of complications. During the surgical consultation, you will discuss your aesthetic goals with your surgeon and your surgeon will determine whether liposuction is a good option for you. It is important to note that liposuction is not a substitute for proper diet and exercise and it is not an alternative to weight loss or a treatment for obesity.
Ultimately, the most appropriate treatment option is that which aligns with the aesthetic goals and individual preferences of the patient. Consulting with a knowledgeable board-certified plastic surgeon to discuss your aesthetic objectives is, undoubtedly, the best way determine which procedure is right for you.
The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.