For a spare tire, liposuction or coolsculpting are both possibilities. In terms of pure cosmetic result, liposuction is better, but it is also more expensive and requires more downtime.
Which treatment is better for you depends on your overall health, physical exam, goals, whether you are able to have downtime, and your pocketbook.
Overall health: Liposuction candidates are people in relatively good health without heart problems, kidney problems, bleeding problems, or a history of anesthesia-related problems. Almost anyone can have coolsculpting, since it is noninvasive.
Physical exam: Liposuction can reduce soft fat as well as firmer, fibrous fat. Coolsculpting works best for soft, pinchable fat. Neither procedure addresses excess skin or visceral fat (fat around the internal organs). If excess skin is an issue, a tummy tuck in combination with liposuction should be considered.
Your goals: Liposuction can give a dramatic and “customized” result and can address the abdomen and flanks in one session. Coolsculpting can only reduce a limited area with each session so if your spare tire extends from your abdomen to your love handles, you will require multiple coolsculpting sessions to cover all these locations. These sessions can be done back-to-back.
Downtime: There is almost no downtime with coolsculpting. Most patients have minimal discomfort and can resume your normal activities immediately. With liposuction, you will have several days of downtime, bruising, and you will need to wear compression garments for at least a couple of weeks.
Pocketbook: Liposuction costs depends on the surgeon’s fees, anesthesia fees, facility fees. The price of coolsculpting depends on the number of coolsculpting sessions that you would need to get your desired result. (Melissa Chiang, MD, FAAD, Houston Dermatologic Surgeon)
Smart Lipo vs CoolSculpting
This depends upon the patient. CoolSculpting has several advantages in that it is a non-invasive procedure in which no needles, incisions, anesthsia or downtime are required. For many patients these are significant because they would prefer to avoid the risk of a surgical procedure and the downtime.
CoolSculpting however is limited in that the areas in which it can be performed are limited for the most part to the abdomen, love handles and back. In addition, the results can take upto two to four months although some patients can see results as early as three weeks.
Smart Lipo can be performed in areas where CoolSculpting can not be done and more fat can be removed than in a CoolSculpitng procedure. If you area of interest is the abdomen and or love handles and the areas are not overly large (i.e. are within 15 pounds of your ideal body weight) I think the advantages of CoolSculpting are significant enough that I would choose it over a liposuction procedure. One final note is that unlike another physician comment I have seen significant results in properly chosen patients significant results with one CoolSculpting treatment. (Ted Brezel, MD, Long Island Dermatologic Surgeon)
CoolSculpting or SmartLipo may be good options
SmartLipo is going to give you much more dramatic results more quickly because more fat can be removed at one time. CoolSculpting treats about 20-25% of the fat cells in the specific treatment area and takes about 3 months to show full results.
SmartLipo has minimal downtime and costs more. CoolSculpting is less expensive, and offers zero downtime. Some people do not want surgery and CoolSculpting offers a nice alternative with realistic expectations. We offer both procedures and have patients who may be candidates for either procedure but personal preference dictates which option they choose.
SmartLipo results will be highly dependent on the skills of your plastic surgeon. Be sure to look for a board-certified plastic surgeon if you decide to opt for liposuction. (Steven L. Ringler, MD, FACS, Grand Rapids Plastic Surgeon)
Both would work
Laser assisted Lipo would be faster and more expensive. Zeltiq is easy with no down time and cheaper. You might need more than one treatment and it will take months to see the full results. (Grant Stevens, MD, Los Angeles Plastic Surgeon)
I have seen very few if any artfully sculpted bodies with CoolSculpting.
I have been following this procedure since the research began four or five years ago. I have seen few if any artfully sculpted bodies using coolsculpting. Using SmartLipo or liposuction in general, multiple areas of the body can be sculpted beautifully in a single session with minimal down time and usually with less pain.
Frankly, I don’t see CoolSculpting being that popular a few years from now when people filnally realize that paying a few thousand dollars to reduce a couple of fat pockets by 20 to 25% is an unsatisfying body scuplting result limited to just a few body areas.
Most of the published photos are unimpressive compared to SmartLipo, Vaser and liposuction in general. (Mark Taylor, MD, Salt Lake City Dermatologic Surgeon)
CoolSculpting vs liposuction
For patients who have several centimeters of fat that can be pinched between two fingers on the love handles, and exercise and diet is being followed, this is not an unusual situation that this one area is stubborn.
In fact, that is an ideal patient for liposuction, regardless of it being tumescent liposuction, laser-assisted liposuction (smartLipo), power-assisted liposuction, water-jet liposuction,etc. However, some patients are not ideal candidates because they take medication or have medical conditions that add risk to the invasive procedure of liposuction, or some patients just don’t want to undergo surgery.
Then, CoolSculpting by Zeltiq offers a way to reduce the fat without surgery, but it is only 20% of the fat volume after one treatment, and that can take up to four or more months to see the result.
Liposuction, in such a patient as mentioned above, would obtain more removal of fat by liposuction. There are other patients who are quite slim and one area is slightly enlarged compared with the rest. In this patient, the SmartLipo would not be indicated as the risks of skin irregularities and even burn scars would be too high.
CoolSculpting can provide a non invasive method for fat reduction in such a patient with much less risk than the liposuction as it only involves freezing the fat, and no invasive procedure is necessary. (Ronald Shelton, MD, Manhattan Dermatologic Surgeon)
The advantages to Coolsculpting are that it is non-invasive and does not require anesthesia, however the gratification is delayed because you won’t see results for 2-3 months and I find many patients require 2 treatments to get the best results. (Rosalyn George, MD, Wilmington Dermatologic Surgeon)
Liposuction of hips
I always say that it is not the wand but the magician that waves the wand that creates all the magic. I think any form of liposuction can produce equal results as long as the surgeon does good work. (Steven Wallach, MD, New York Plastic Surgeon)