Coolsculpting vs. Smartlipo

Both Coolsculpting and Smartlipo are modern ways to permanently remove unwanted fat.  This post outlines the differences between them both.

The Technology

Coolsculpting by Zeltiq uses a combination of suction and freezing to kill the fat.  It turns out that fat is more susceptible to freezing than surrounding tissues, so it you freeze an area in a controlled way, the fat will die, but the surrounding tissues will not be damaged.

Smartlipo laser liposuction uses laser energy to blast and destroy unwanted fat cells.  It literally zaps unwanted fat away.  The liquefied fat is then suctioned away.


Coolsculpting is totally non-invasive.  The skin is not cut.

Smartlipo is minimally invasive.  Small openings are made in the skin through which the laser fiber and suction tubes are inserted.  The holes are very small.  Smartlipo is done under local anesthesia.

Pain and Recovery

Coolsculpting may be slightly uncomfortable for the first few minutes that the device clamps on and starts freezing the fat.  Recovery is minimal.  There may be bruising of the treated area that usually resolves in one week.  Most people can return to usual activities almost immediately.

Smartlipo can be uncomfortable during the initial stages as the skin is numbed.  After that, it is not uncomfortable.  There is soreness and discomfort for a few days to a week afterward.  It is not debilitating and most people can return to work within 1-2 days and exercising within a week.

TechnologyFreezes fatZaps fat
InvasitivityNon-invasiveMinimally invasive
PainMinimal (+)Mild (++)
RecoveryMinimal (+)Mild (++)
Time for area to look normal1 week2-3 months
Time to full results2-3 months3-6 months
Areas that can be treatedMany but not allAll
Other benefitsNoneTightens skin

Effectiveness and Results

Coolsculpting reduces fat in the treated area by about 20% on average with one treatment.  Treatments can be repeated for more improvement.  Final results take 2-3 months to appear.  There is no swelling, but it takes time for the body to resorb the fat cells that were killed.

Smartlipo reduces fat in the treated area by 60-80% with one treatment.  Final results can take 3-6 months for swelling to fully subside, but significant improvement healing is seen by 2-3 months.

Areas That Can Be Treated

Coolsculpting needs to be able to grab onto a roll to treat it.  Areas that commonly have rolls that can be treated are the lower abdomen, hips, waist, bra rolls, inner thighs, and arms.  It is not possible to treat the outer thighs, chin, and fat bulges in front of the underarms, and it is often difficult to treat the upper abdomen.

Just about any area can be treated with Smartlipo.  Multiple areas can be treated at once such as the full abdomen, hips, waist, and bra rolls.  Treating adjacent areas can give a dramatic result.

Other Benefits

Smartlipo may tighten the overlying skin.


Both techniques permanently remove fat.


Both Coolsculpting and Smartlipo are excellent techniques to remove unwanted fat.  The choice of which one to do can be based on many factors.  Not every area can be treated with Coolsculpting.  However, if an area can be treated with either technique, the choice often comes down to improvement versus recovery.  With a single treatment, Smartlipo definitely gets you more improvement but has a greater recovery.


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