Expert Doctor

CoolSculpting vs. Vanquish

CoolSculpting and Vanquish are both non-surgical cosmetic treatments used to reduce excess fat by delivering extreme temperatures. CoolSculpting uses low temperatures to freeze and destroy fat cells while Vanquish uses the heat from radiofrequency energy. Despite the temperature differences both treatments can eliminate fat on the larger regions of the body such as the abdomen, thighs, flanks and backside. These body contouring procedures provide better proportions and a more pleasing patient silhouette.

Ideal Candidates  

GOOD CANDIDATES for CoolSculpting or Vanquish include:

  • Any adult patient bothered by localized areas of excess fat
  • Men or women at, or near, their ideal body weight
  • Patients with good skin tone and elasticity
  • Patients looking for a non-surgical way to gain a better contoured body
  • Patients who wish to remove a larger amount of fat may be better candidates for CoolSculpting
  • Patients who desire to have smaller amounts of fat removed, while still tightening the skin, may be better suited for Vanquish

The following patients are NOT GOOD CANDIDATES for CoolSculpting:

  • Patients with loose, excess or hanging skin
  • Any patient with a history of anorexia or bulimia in the past 12 months
  • Patients with auto-immune disorders such as Fibromyalgia or chronic fatigue syndrome
  • Patients who are overweight or obese
  • Patients with cold urticaria. 

The following patients are NOT GOOD CANDIDATES for Vanquish:

  • A patient with significantly loose skin
  • Obese or overweight patients
  • Patients with a pacemaker
  • Patients with metal implants

Patients with lymphedema, or other conditions that impact the lymphatic system, are also not suitable for CoolSculpting or Vanquish since these procedures depend on the lymph system to remove the damaged fat from the treatment area. A woman who is pregnant or breast feeding should not undergo either treatment until they are no longer pregnant or breast feeding.

Advantages of CoolSculpting

CoolSculpting can be performed in an office or spa setting since it is non-invasive and does not require anesthesia. The treatment can take about an hour. The doctor applies an external device to the treatment area and it suctions the skin and fat into the head of the device. CoolSculpting is not painful but the patient will experience a tugging sensation until the cold temperature numbs the treatment area. The cooling technology targets the subcutaneous fat cells and freezes them to the point of crystallization. There is no damage to the healthy tissue or skin cells. The damaged cells are filtered through the lymphatic system and then metabolized by the liver. The cells are naturally released from the body through the urine.

Advantages of Vanquish

Vanquish is also performed in an office or spa setting and takes between 30 to 45 minutes. Vanquish is not painful and feels similar to having a heating pad placed on the treatment area. The adjustable panel hovers over the targeted area and delivers radiofrequency energy. It does not come in contact with the skin. The energy passes through the skin, to the subcutaneous fat, and heats the fat cells and melts them. The skin is left unharmed while the temperature on it reaches approximately 100 degrees. The core fat reaches a temperature of 120 degrees. The heat from the device creates a degree of skin tightening which is beneficial to anyone with a little bit of loose skin. The fat cells are also processed by the lymphatic system and eliminated from the body.

CoolSculpting and Vanquish Cost?

CoolSculpting can cost from $1500-$4500 depending on whether a small or large applicator is used. The large applicator is used for volume reduction and is considered a “debulking treatment” since it is used for larger areas with excessive fat. However, to obtain the desired outcome, only one CoolSculpting session is usually required.

Vanquish costs around $800-$2500 per session and multiple sessions are required. The need for multiple sessions can make Vanquish more expensive than CoolSculpting depending on the total number of treatments.

Recovery and Downtime

Neither CoolSculpting nor Vanquish require much in the way of RECOVERY or DOWNTIME. Patients are encouraged to drink plenty of water, after the procedures, to help eliminate fat more efficiently. With both procedures, patients can resume all activities immediately after the treatment.

CoolSculpting can cause some pulling on the skin and muscles as the fats begin to degrade. Therefore, patients who are very sensitive may take a pain reliever to manage discomfort and rest for a day. CoolSculpting patients may develop some redness, bruising and mild swelling which will subside in a few days. Skin discoloration, particularly in dark-skinned patients, is not uncommon after CoolSculpting.

Since the Vanquish device does not come in contact with the skin, it has minimal to no side effects. The treatment area may appear slightly pink and swollen but these conditions usually go away a few days after the treatment.


After CoolSculpting, the results can take some time since the body needs time to absorb the fat. Most patients see some results within three to four weeks. However, the treatment area will continue to shrink for another two or three months. Therefore, the final outcome will be noticed around three or four months later. At this time, patients who have not acquired the desired results can consider a second session.

To achieve adequate results with Vanquish, patients will need 4-6 sessions. Vanquish sessions are typically twice a week for 2 weeks or once a week for 4 weeks. When performed on the legs, Vanquish can be done twice a week for 3 weeks or once a week for 6 weeks. After one session, patients may notice a slight reduction in fat with Vanquish. However, it can take about 2-4 months for the body to dispose of the fat cells. Patients can usually expect about 2 inches of fat loss on the waist circumference.

To maintain the results from CoolSculpting or Vanquish, patients should follow a healthy diet and get regular exercise since gaining weight can void the effects of either procedure.

Limitations of CoolSculpting and Vanquish

The limitations of CoolSculpting and Vanquish include:

  • The amount of skin contraction that can occur
  • The volume of fat which can be removed per session
  • CoolSculpting is limited to areas of the body that can be suctioned into the head of the device
  • Patients who have had recent surgeries in the treatment area, including a body contouring surgery within the last 12 months, may be limited from CoolSculpting until after the surgical site has healed

Risks of CoolSculpting and Vanquish

The risks involved with CoolSculpting include:

  • Temporary redness, swelling and sensitivity at the treatment site
  • Stinging or aching sensation
  • Paradoxical adipose hyperplasia or an expanding of the fat cells
  • The need for more than one treatment to gain the desired results
  • The risks involved with Vanquish include:
  • Temporary pinkness and swelling in the treatment area
  • Hot spot
  • Skin burns
  • Mild fatigue
  • Increased thirst
  • The need for multiple sessions to gain the desired results

Choosing Between CoolSculpting and Vanquish

When choosing between CoolSculpting and Vanquish, the patient must realize that the choice depends on the size of the treatment area and the volume of fat in that area. Each procedure has advantages and disadvantages and sometimes combining them provides the best possible results. Patients should always consult with a board-certified surgeon and discuss their concerns, as well as their goals and treatment options, for the safest and best results.

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Written by Cosmetic Town Editorial Team- SP

Based on an exclusive interview with Debra Jaliman, MD in New York, NY