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“The Skinny” on Coolsculpting vs Vanquish…..Which is Better?

There are only two non-invasive devices on the market that have been proven to permanently destroy fat cells: Vanquish and Coolsculpting. Neither device removes as much fat as surgical liposuction, however both Vanquish and Coolsculpting are very effective at fat reduction, are non-invasive, more cost effective, and less risk compared to liposuction.

Vanquish and Coolsculpting are not weight loss programs, but rather devices that can be used for those problem areas that don’t seem to go away with exercise and a healthy diet.

Coolsculpting destroys fat cells by freezing; Vanquish destroys fat cells with heat. Once the fat cells are destroyed, the body’s lymphatic system carries away the cellular debris, and it is excreted.

Fat cells generally don’t regenerate. With weight gain the fat cells swell, and with weight loss they shrink, but the number of fat cells remains fairly constant. So, when the fat cells are destroyed they don’t come back, and it is a permanent effect.

Vanquish and Coolsculpting both work, but in very different ways.

Here are the facts:
FDA Study Results:

Vanquish is a newer technology than Coolsculpting, and was FDA approved for permanent fat reduction in June, 2015 and is a treatment offered at EvolvMD MedSpa & Body Contouring serving the Milwaukee, WI area.

In the FDA studies, Coolsculpting destroyed 20-25% of the fat cells treated, Vanquish destroyed 25-30%.


The size of the area treated with Coolsculpting is about the size of a stick of butter. The area treated with Vanquish is a half circle that includes the entire abdomen, front and sides.

Coolsculpting requires a small area of fatty tissue to be sucked into the device and left in place for one hour. Then, another area is treated, and so on. Because of this technique, the treatment is often uneven, and lumpy.

By contrast, Vanquish treats the entire abdominal area at once, as the device hovers above the skin without contact, providing a more even, smoother result.

To treat the entire abdominal area, the Coolsculpting device will often require 4-6 areas of treatment, each one requiring one hour of treatment. In the FDA study, Vanquish patients were treated with 4 treatments, 45 minutes/per session, at one week intervals.

The Coolsculpting “freezing” treatment is more uncomfortable for most patients, compared to the non-contact Vanquish heat treatment.


After Coolsculpting treatment, many patients suffer from neuralgia (nerve pain) due to freezing of the nerves. This usually resolves without treatment after weeks or months.

Neuralgia has never been reported with Vanquish.

PARADOXICAL ADIPOSE HYPERPLASIA (PAH) is a complication of Coolsculpting in which the area adjacent to the treated area undergoes rapid proliferation of the fat tissue, usually months after the initial Coolsculpting treatment. Further treatment with Coolsculpting is ineffective, and even liposuction has failed to remove the abnormal tissue. It may result in the need for surgical excision of the PAH tissue.

PAH has NEVER been reported with Vanquish.


The cost of Vanquish vs Coolsculpting is about the same for a large area such as an abdomen, or flank. Patients who desire to only have an area treated about the size of a stick of butter may find Coolsculpting to be more cost effective for a small treatment area.


Most patients with a large area of treatment, such as an abdomen or flank, will have a better outcome with the Vanquish compared to Coolsculpting, in terms of the amount of fat that is destroyed; a smoother, more even result; less discomfort; and less risk of complications.
Every patient has individual needs, issues, and goals. As always, Dr. Reiswig and the staff at EvolvMD MedSpa & Body Contouring serving the Milwaukee, WI area recommend a consultation to determine the best treatment.

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