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Are you sick and tired of those extra lbs weighing down on you (literally)? Haute Beauty expert Dr. Cameron Rokhsar gets it, which is why he is here to dive into the two most popular fat removal options: liposuction and CoolSculpting.

What are the key questions you ask a patient in a fat removal consultation?

The key question a patient should ask during the consultation is whether the treating physician is well-versed in both surgical and non-surgical methods of fat reduction. This way, the patient is getting a nonbiased view of all possible modalities without any potential bias. The physician should, at the very least, offer and be able to talk about the realities of expectations with Kybella injections, CoolSculpting, and liposuction. It is also important for the patient to know that the physician is board-certified in dermatology or plastic surgery. Do note that both the number of years a doctor has been in practice and the number of cases they perform can be helpful indicators to ascertain the doctor’s level of experience.

At what age would you recommend a person look into fat removal procedures?

Age is not a deciding factor, as many people have genetically determined areas or pockets of fat which are hard for them to lose, regardless of how much they diet and exercise. For both men and women, love handles, double chins, arms, and thighs can be areas of fat that are resistant to diet and/or exercise.

Another important point is that fat reduction methods should not be pursued by patients as a means to weight loss, but rather, only as a way to change contour. This is because fat weighs far less (in terms of volume-to-weight ratio) than muscle and bone. I don’t like to perform any fat reduction procedures for anyone under 18 years old in general.

Is there a certain weight a person should be at to receive a fat removal procedure?

There is no precise weight, as both methods really should be regarded as a way to optimize contour as opposed to lose weight. Weight loss should be achieved through diet and exercise. Though, patients who are obese are generally not good candidates for these procedures. Another question that patients often raise is whether they should do these procedures before or after they have achieved their ultimate weight goals.

I always tell patients that in reality, you can look at it in two ways: one way is to try to diet and exercise to get to their desired goals, and then pursue liposuction or CoolSculpting as a way to tweak areas that are still bothersome. The second is to pursue these procedures as a way to motivate other weightless methods, such as diet and exercise.

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What makes a person an ideal candidate?

The ideal candidate for liposuction or CoolSculpting is an individual with areas or pockets of fat that are bothersome to them and exist within certain areas of their body. For example, a person with a small double chin may be an ideal candidate for Kybella injections. Kybella is an FDA-approved drug that disrupts the membranes of fat cells. Results will be seen in one to three sessions, depending on how heavy the double chin is; but, the result of Kybella will never be as good as liposuction because surgeons are in better control of removing the fat from all parts of the neck through liposuction.

How do the results of liposuction and CoolSculpting differentiate?

Liposuction is the gold standard for body contouring. The results of liposuction are transformative and it’s the difference of dropping a few sizes in your clothes. Liposuction has come a long way from its early days. I perform all my liposuctions under local anesthesia with the tumescent technique. This makes the procedure extremely safe and reduces downtime. Patients have to wear compression garments only for a week and can go about their life within 3-4 days after their procedure.

CoolSculpting is good for patients who are surgery averse and understand that it can improve the treated areas by only 10-20 percent with each procedure. The results are in no way close to liposuction results. The advantage of CoolSculpting is that it is completely nonsurgical and has no downtime at all.

How quickly do the results show for each treatment?

The results of liposuction are immediate; some swelling will be present for three months, but the post-surgery results still look far better immediately after treatment. With Kybella injections and CoolSculpting, the results are not immediate either; you will need to wait 2-3 months to see a difference. Also, with Kybella injections and CoolSculpting, more than one session may be necessary (whereas liposuction is only a one-time procedure).

What is the downtime associated with liposuction and CoolSculpting?

There is no downtime associated with CoolScupting. Downtime with my liposuction technique is only three days, but the patient needs to wear a compression garment for one week. Many other doctors keep their patients in compression garments for 4-6 weeks. With my technique, patients are back to their regular life within a few days.