SculpSure and CoolSculpting (fat freezing): FDA-Approved Liposuction Alternatives to Permanently Eliminate Fat

SculpSure alternative to liposuction, Kybella, CoolSculpting animated Before & After offered by Dr. Brian Machida, facial plastic surgeon, Inland Empire, California

As summertime approaches, many want to make sure they’ll look good on the beach or in their favorite summer clothes.  That’s true in Inland Empire, California where I live and across the country. But even a good program of diet and exercise often leaves stubborn fat deposits you may want to eliminate.  For years, liposuction was the treatment of choice.  According to Medical News Today, more than 300,000 liposuction treatments are carried out in the U.S. each year.  Newer treatments like SculpSure, CoolSculpting (fat freezing), Kybella, and a host of ultrasound and radio frequency treatments offer noninvasive alternatives.  Do they work?  Which ones can deliver the lasting results you want?

Editor’s Note: Dr. Brian Machida is a highly experienced, board certified facial plastic surgeon.  He taught for years at the University of Southern California’s Keck School of Medicine.  Dr. Machida is the Medical Director at STC Plastic Surgery in Ontario, CA in California’s Inland Empire.

SculpSure Before & After, female, offered by Dr. Brian Machida, facial plastic surgeon, Inland Empire, CAThis is a question worth asking.  Liposuction permanently removes fat from the body.  However, there are limits on how much fat your doctor can safely remove.  If too much fat is sucked out, it can cause lumpiness or even dents in the skin.  Liposuction also carries risks like numbness, scarring and infection.  According to experts, as the amount of fat removed increases, risks increase as well.  If you want to lastingly lose a smaller amount of stubborn fat, today there are noninvasive alternatives.  What are your options?


As a facial plastic surgeon I’m quite familiar with Kybella.  It’s an FDA-approved medication for excess fat under the chin (double chin).  When properly injected, Kybella eliminates fat cells by destroying cell walls.  Unfortunately, as Cosmetic Surgery Times points out, Kybella can also destroy skin cells and cause nerve damage.  The resulting numbness usually resolves itself in time.

Kybella injections replace fat with scar tissue.  Fibrous scar tissue can pull on the skin.   This may cause inflammation, redness and discomfort.  In addition, Kybella is not approved to treat fat around the abdomen and flanks.  There are other treatments that are both proven and FDA approved for these areas.


Today, CoolSculpting and SculpSure are the only treatments approved by the FDA for permanent fat removal.  CoolSculpting works by cooling fat cells to the point of crystallizing the fat inside, effectively freezing it.  This triggers the fat cells to die.  But since fat crystallizes more quickly than other body tissues, adipose cells can be targeted without harming surrounding cells.  The immune system removes the dead fat cells, causing fatty areas to noticeably shrink.

While CoolSculpting (“fat freezing”) has advantages over liposuction, it has some disadvantages as well.  The effect of freezing a section of fat cells can leave an area that resembles a stick of butter below the surface.  If your doctor doesn’t carefully massage and smooth these hardened areas you can be left with irregularities under the skin.    JAMA Dermatology reported on the case of a man in his 40s who developed a large mass under his skin after a single fat-freezing treatment.  One doctor, quoted in Cosmetic Surgery Times said:

Last week, we saw two patients who had this major side effect from CoolSculpting, where instead of taking the fat away, you get an increasing amount of fat. People, then, have to have liposuction to get rid of it.

In addition to this issue, the CoolSculpting official website lists “freeze burn” and late-onset pain that can last several weeks as possible side effects of this treatment.  Understandably, the physician quoted above chooses to offer SculpSure to his patients as I do.


SculpSure alternative to liposuction Before & After offered by Dr. Brian Machida, facial plastic surgeon, Inland Empire, CaliforniaSculpSure is a new, FDA-approved procedure for reducing fat in the flanks and abdomen.  Like CoolSculpting, it totally eliminates some fat cells.  But its laser technology, which destroys fat cells while cooling the skin for patient comfort, offers an additional advantage for busy patients.  Dr. Katz, previously quoted, told Cosmetic Surgery Times:

With SculpSure, you can treat up to four areas at one time and it only takes about 25 minutes per treatment. With CoolSculpting it takes an hour per area. So, if you’re going to treat people’s flanks, you can do both flanks at the same time with SculpSure, and it takes 25 minutes. With CoolSculpting it takes an hour on each side, so it takes two hours. SculpSure is a big time saver for patients and also for staff.

Of course, since the body must reabsorb the fat cells it destroys, improvements are seen over time.  But where liposuction left loose skin behind, SculpSure tightens skin.  Thus, these brief treatments can result in a slimmer waistline or flanks with smoother, tighter skin than many other methods.   And, unlike CoolSculpting, SculpSure patients rarely report pain after the procedure.


By The-villages-onli…-Clips, CC BY 3.0,

While there are many noninvasive treatments now on the market, the fat reductions they bring are usually temporary.  That’s because they often remove fat but not the adipose cells that contained it.  Kybella injections can permanently destroy fat cells, but at the risk of damaging skin and nerve cells as well.  It’s only approved for treating fat under the chin.

CoolSculpting, or “fat freezing,” is FDA approved to permanently remove fat from the belly and flanks.  But it must be done right to avoid irregularities under the skin.  It can cause significant discomfort.  And treatments can take hours.

SculpSure removes up to 24% of fat cells in treated areas forever.  Therapy sessions last just 25 minutes.  During the weeks after treatment, your body will absorb the fat cells destroyed by SculpSure without the loose skin seen in liposuction.  Of course, you’ll need to eat right and stay fit or your remaining fat cells will help you pack on extra pounds.  If you’d like to look leaner and firmer this summer, why not contact a medical professional who offers SculpSure, as we do at my practice in California’s Inland Empire.

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About Dr. Brian Machida, MD, FACS

Dr. Brian K. Machida, MD, FACS is a double board certified facial plastic surgeon. He has an exceptional level of experience, having performed ( read more )

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