Liposuction, Vanquish, and CoolSculpting in Santa Barbara

Over more than three decades of my cosmetic surgery practice, I have found Spring and Summer to be a popular time for people to “renew” their appearance. In preparation for beach gatherings and pool parties, body contouring is often addressed. While liposuction is undoubtedly the most reliable and quickest way to improve contour issues on any part of the body, patients are hearing/seeing advertising about non-invasive fat reduction and I thought I would use this blog post to discuss the pros and cons of liposuction versus non-invasive techniques currently available.

Liposuction is a surgical procedure that is now most frequently done using oral and intravenous sedation plus local anesthesia (so patients don’t have any added risk with general anesthesia). The procedure permanently removes excess fat from beneath the skin to improve “problem” areas and if you have excess skin this can often be removed at the same time. Liposuction incisions are small (less than 1/4 inch) and placed in “hidden” locations. Pain is usually minor – often controlled with ibuprofen or Tylenol – and light activity can be resumed a few days after the procedure.

Non-invasive fat reduction has been around for a few years now and we know that it can work. For patients who do not want or cannot have surgery, several devices are currently available and others are on the horizon. Two technologies currently available are CoolSculpting (freezes fat cells) and Vanquish (heats fat cells). Both devices cause cell injury that leads to eventual death and elimination resulting in less fat volume. Non-invasive methods involve a series of treatments and the results are not as predictable or dramatic as liposuction but there is usually some noticeable contour improvement.

CoolSculpting (or cryolipolysis) uses a vacuum-like applicator with cooling plates that cools skin and destroys fat cells by freezing some of them. The frozen cells die and are “cleaned up” over the next 2 to 3 months. An “optimum” result is about a 20% reduction, so several treatments are usually needed to obtain the contouring goal.

Vanquish is a selective radio freqency treatment that targets the deeper subcutaneous fat and heats the cells to cause destruction. As with cryolipolysis, the cells are “cleaned up” over the next few weeks. Treatment time is much faster than with CoolSculpting. The percentage reduction is variable but at least 20% is common. A series of treatments is recommended. A side-effect “bonus” with radio frequency is that some degree of skin tightening is also seen.

The answer depends on the amount of improvement you are looking to achieve. If you want a more dramatic change, have a larger amount of fat, or want to do just 1 treatment and be done, then liposuction is probably the better choice. Those needing only small changes, or who cannot take any time off and don’t mind doing a series of treatments to achieve an end result, may do well with non-invasive options.


If you would like to discuss your concerns, contact my office (Cosmetic Surgery Center in Santa Barbara) to make a consultation appointment (805-563-0000). I look forward to bringing out the best in your appearance now or any other time of the year.

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