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Let me preface the following overview with this disclaimer:

I do not offer or perform CoolSculpting  and have no experience with it.

This was largely a philosophical decision not to offer this non-surgical approach for the treatment of excess fat, whether for reducing the amount of it or for sculpting.

I want my patients to get the best, most precise, dramatic and predictable results for fat removal.

And generally, in one setting with results seen fairly early on – including immediately postoperatively.

Non-surgical fat removal largely doesn’t accomplish this. In fact, based on marketing information, on average around a 20 – 25% improvement may be expected.

This applies not only to CoolSculpting but other non-surgical options as well.

For my patients, 25% is not good enough.

However, this does not mean that CoolSculpting is bad or should not be pursued. For some individuals, it can offer exactly what they are seeking and without having to undergo surgery.


Liposuction is the surgical technique employed for the removal of fat – whether localized or diffuse. It provides the ability to obtain precise sculpting of areas.

Modern day liposuction in plastic surgery practices can be traced back to the early 1980’s. Since then, its popularity has skyrocketed and it remains one of the most popular surgical aesthetic procedures performed today.

In the simplest terms, liposuction involves using special tubes, known as cannulas, to remove unwanted fat through very small, strategically placed incisions. The cannulas are of varying lengths, diameters and hole configurations that provides for relatively precise results, with minimization of minor and major risks.

Generalized categories for liposuction include:

• Suction-assisted liposuction
• Ultrasound-assisted liposuction (UAL)
• Laser-assisted liposuction (LAL)
• Power-assisted liposuction (PAL)

Essentially, these techniques all provide the opportunity to obtain predictable, precise and customized results, most often in one surgical setting (with some exceptions).

Of course, there are many factors that can affect the overall results.

And to top this off, there generally is little to no significant postoperative discomfort.

Liposuction is the gold standard for fat removal against which other approaches must be compared.

However, the downside of liposuction for some is that it is surgery.

What is CoolSculpting?

CoolSculpting is an approach that offers fat reduction without the need for surgery.

Yes, you can have a reduction of fat in a variety of areas without having to have a surgical procedure.

How is this accomplished without surgery?

CoolSculpting uses a technique called cryolipolsysis whereby extreme cold is applied to the targeted areas of fat using two paddles. This results in the destruction of some fat cells in the treated areas which then disintegrate and leave the body as waste over a period of time.

Treatment times per session vary but can be between 35 minutes and around 1 hour 15 minutes.

Often, it can take up to 4 – 6 months for the cells to die and leave the body at which point one can then see the full effects of the procedure.

It is generally publicized that one can expect around a 20 to 25% reduction of fat in the treatment area.

Also, one must realize that although this is NOT surgery there are still risks and complications which can occur. Probably the most significant of these complications is paradoxical adipose hyperplasia (PAH) where there is the development of a firm, unsightly, fibrous protruding mass of fat that can even be resistant to corrective treatment by liposuction.

Advantages of CoolSculpting

•It does not involve surgery – There are no incisions, anesthesia and some other issues associated with a surgical procedure.
•It is non-invasive – This is another criteria for some individuals and it essentially another way of describing “no surgery”.
•There is no downtime – You can get this done and go about your business without downtime.

Disadvantages of CoolSculpting

•Often more than one session is required for treatment – Frequently more than one session is needed to obtain the very limited results
•Results are limited – One can expect around a 20 – 25% reduction of fat in the treated area(s). This is a relatively small fraction of what can be obtained with liposuction – like total treatment. In addition, there is no refinement of the results. There is an “overall” effect on the area as opposed to precision sculpting that can be obtained with liposuction.
•It can take 4 – 6 months to see the results – You don’t have any immediate results from the procedure. Instead, you may have to wait 4 – 6 months to see the limited results. With liposuction, results are seen immediately though it can take several months to visualize even more of the outcome.

In Summary

For more extensive, dramatic, precise and predictable results for fat removal and sculpting, liposuction is the better choice and gold standard.

If you don’t want surgery, anything invasive and no downtime and can accept limited results and possibly multiple treatments, then consider CoolSculpting.

Your Consultation

For more information on liposuction or to schedule your consultation, please call the Arizona Center for Aesthetic Plastic Surgery at (480) 451-3000 or contact us by email.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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