Dr. Michael Suzman

TruSculpt, Coolsculpt, Kybella: new body contour alternatives for fat removal

By: Dr. Michael Suzman


Fat Melting, Freezing, and Non-Surgical 
Reduction Techniques

With many new devices offering reduction of unwanted fat without surgery, people have been asking whether these treatments really work. Coolsculpt and truSculpt both offer reduction in unwanted fat by placing a device on the skin over the course of an hour or so.  When we added non-invasive fat reduction services to our New York Plastic Surgery practice, demand from patients was immediate.

Coolsculpt uses cold to damage the fat cells and truSculpt uses heat.  Both seem to be safe, and in certain patients, quite effective.  But in other patients, particularly heavier people, results are limited.   Both are probably best for people in good shape with small, stubborn areas that seem resistant to exercise. Freezing kills fat cells directly while truSculpt heats skin and fat to 45 degrees Celsius, which stimulates the fat to shrink and dissolve. I like  to think of it as similar to how exercise reduces your fat-- just much more direct and rapid. truSculpt may also help tighten the skin through the radio frequency energy effect on collagen. 

Which is better? A tough question to answer, but I would say very heavy patients may do better with multiple coolsculpt procedures, while firm fat areas, such as the bra line, hip regions, small abdominal or neck pockets, can get a faster treatment with truSculpt.

A fat freezing expert in California ( whom I respect and trust) summed it up nicely on RealSelf.com:

Trusculpt utilizes radio frequency energy to heat fat cells and cause their damage and shrinkage to sculpt the body and areas of unwanted fat. Coolsculpting utilizes cold to freeze fat cells and destroy them and create body contour by targeting specific areas of fat. Though both technologies are similar in that they improve body contours they do so by different modalities.  We have both technologies in our office.  If fat is too firm to compress or diffusely distributed then Trusculpt is a good option.  If fat is localized and is able to be drawn up into the applicator then Coolsculpting is a good option.  For the best option for you, consider a consultation with a practice that has both technologies and can help you decide which treatment is best for you and not try to sell you on what they have.  

Web reference: http://www.freezethefat.com/photo-gallery/details.cfm?ID=2789&StartRow=11

Grant Stevens, MD

Los Angeles Plastic Surgeon

Who are my favorite patients to treat?  

Here at WESTMED Plastic Surgery, we are really focused on both patient safety and delivering results and service that make our patients happy.  We measure patient and staff satisfaction closely. Our studies show that the best patients are :

-relatively fit and near ideal body weight.

-understand results will be better, but never as complete as surgical treatments such as liposuction or abdominoplasty. These treatments are companions to optimized fitness through exercise and healthy eating.  

-treat focused areas- like arms, neck, hips, abdomen or thighs or the bra strap areas. This is not an entire body reduction treatment.

Advantages are that you can drive yourself home immediately with no down time at all.  Disadvantages include some sensitivity or redness at treatment sites.  In heavier patients, fat destruction is more extensive and some Cool Sculpt patients report significant pain, occasionally for weeks or longer.   Some truSculpt patients can feels lumpiness in the areas of significant fat-- which typically softens over time.

truSculpt offers the advantage of radiofrequency energy- which may have a collagen tightening effect. It can therefore be used after liposuction, breast reduction, or tummy tuck surgery as an additional tightening procedure.  Other similar  procedures include Thermage and Ultherapy.

What do results look like?


Here is a nice link to West Coast Plastic Surgeon’s website with good truSculpt info:

truSculpt Photos

And a nice New York Magazine article: 

What about new fat dissolving injectables?  New products are being tested all the time.  A previous treatment, lipodisolve, had inconsistent results: http://www.webmd.com/beauty/spa/fat-busting-injections-under-scrutiny


A new injectable has been approved for under the chin-- but there is risk of uneven results.  It is really early to predict long term outcomes. This area under the chin - neck area is also very easy to treat a small surgical procedure- with safe and predictable outcomes.  

Today show discussion of ATX 101  ( known as Kybella).  

I would say proceed with caution with any new treatment. I tell my patients to wait a bit longer to assess  problems that can arise in those brave pioneers who did get treatments as part of a study.


If you are interested in the truSculpt procedure in the New York area, you are welcome to contact our practice.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.