Liposuction removes fat surgically through small incisions; CoolSculpting uses controlled cooling to treat localized fat without incisions. They differ in how treatment is delivered, the areas and degree of change being considered, recovery, possible complications and whether repeat sessions are needed.
In this June 30, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD compares the approaches and explains his preference for surgical contouring in many patients. His opinions, numerical estimates and practice examples belong to that recording; they are not universal outcome guarantees or a current price quote.
Key takeaways
🎯 Start with the goal.
Dr. Smith describes liposuction as a shape-change procedure for localized concerns, rather than a way to lose weight.
🔎 The treatment methods differ.
He contrasts a surgeon working across an area and its transitions with fat freezing delivered through applicators.
🔎 Consider the complete treatment course.
The discussion compares one surgical procedure with potentially repeated nonsurgical sessions, including time and cost.
⚠️ Noninvasive does not mean risk-free.
The episode discusses pain, altered sensation, contour problems and paradoxical fat growth after fat freezing, alongside surgical complications of liposuction.
🎯 The bonus segment addresses a different goal.
Dr. Smith introduces Emsculpt and its muscle-focused role in his 2020 body-contouring practice.
💬 Questions answered
Is CoolSculpting the same procedure as liposuction?
No. The recording distinguishes surgical removal of fat from an applicator-based cooling treatment. The appropriate approach depends on the specific concern, anatomy, preferences and willingness to undergo surgery.
Can fat freezing cause fat to grow instead of shrink?
The episode describes paradoxical adipose hyperplasia, in which treated fat enlarges. The FDA's patient guidance notes that this complication may require surgery. See the FDA's current overview of noninvasive body-contouring risks.
Which option costs less?
A meaningful comparison includes the areas treated and the full course of sessions. Dr. Smith discusses this in the recording, but his 2020 comparison cannot establish today's price or the number of treatments an individual will need.
🎧 Episode chapters
01:00 — Candidates and the goals of body contouring
02:24 — Surgical contouring versus applicator-based treatment
05:52 — Time to results and recovery experiences
07:59 — The historical cost and session comparison
09:20 — Risks of liposuction and fat freezing
12:35 — Bonus: Dr. Smith's 2020 discussion of Emsculpt
🔗 Related information
Explore current information about liposuction, liposuction cost factors and nonsurgical care, or request a consultation with Dr. Smith in New York City.
About the host — current biography
Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.
Originally released June 30, 2020. Show notes updated September 30, 2026. This is general education, not a complete current risk comparison. Suitability, risks and expected results require an individual assessment.
Full transcript and related resources
