CoolSculpting vs. Kybella: Doctors Explain the Differences

Photo Credits: Olena Yakobchuk/ Shutterstock | Image Used for Illustrative Purposes Only

Fat: we all have it. And even if we consider ourselves Flywheel devotees or clean-eating all-stars, so many of us still struggle with stubborn pockets of fat that don’t seem to respond to any amount of diet or exercise.

Lucky for us, the recent rise of non-surgical fat-reduction techniques has blessed us with fat-blasting innovations such as CoolSculpting (aka cryolipolysis, a procedure that freezes and kills fat cells) and Kybella (a fat-dissolving injection designed for "submental fullness," or the stubborn double chin). But what does each one do? Is one better than the other for certain areas? Along with a conversation with your board-certified doctor, the below will help guide you in the right direction.

You May Also Like: What's the Difference Between Radiesse and Sculptra? Dermatologists Explain All

Which areas do they treat?
The first thing to understand is what Kybella and CoolSculpting are each cleared to treat. Kybella—an injection comprised of deoxycholic acid, which is naturally found in our own bile—is FDA-approved for on-label treatment of submental fullness, aka a double chin. However, there are many off-label uses for Kybella, including the treatment of fat in the arms, love handles, knees and bra rolls, that have proven to be extremely effective. CoolSculpting is FDA-approved for treatment in eight areas: the abdomen, flanks, thighs, bra fat, back, banana roll, upper arms and chin.

Who is a good candidate for each?
When it comes to deciding between these two fat-fighting treatments, New York dermatologist Paul Jarrod Frank, MD says it all depends on the amount of fat you are looking to remove from the treatment area. "With either of these fat-removal techniques, there is no best," he says. "It's all about finding the right procedure for the right patient."

Because CoolSculpting can only remove teacup amounts of fat, it's best for those who are already in good shape, "but have select trouble spots, such as the love handles, abdomen, knees, arms, chin and thighs," says Dr. Frank. As for what makes a patient a bad candidate for CoolSculpting, Dr. Frank explains it's when the patient either has too much fat, not enough fat for the applicator to suction to, or when patients need several areas to sculpt.

"A good candidate for Kybella is someone with fullness under their chin," says New York plastic surgeon David Shafer, MD. "Usually, if you can pinch the fat between your fingers, it can be treated with Kybella." However, according to Dr. Shafer, if you have minimal or no fat under your chin—along with loose skin—you might be a better candidate for a neck or facelift to tighten the skin. 

Another reason doctors opt for Kybella instead of CoolSculpting: "It's better for the smaller areas of fat that CoolSculpting can't suction to," explains Dr. Frank.

How does each one work?
The treatments are totally different—both in their method of fat-removal and their application. Kybella is injected with very small needles—similar to those of Botox Cosmetic—or a cannula. Dr. Shafer says numbing cream is usually applied beforehand and, in some practices, a numbing medication is mixed into the Kybella itself. "Once injected, the Kybella disrupts the surrounding fat cells which are then absorbed by the body." As for the pain factor, Dr. Shafer says you shouldn’t feel anything worse than a mosquito bite.

CoolSculpting uses cold temperatures to freeze fat cells and eliminate them via suction and cooling plates. The applicator is positioned on top of the treatment area, which is then cooled down until the cold temperatures numb the area (this takes only a couple of minutes). Once numbed, the fat cells beneath the surface continue to drop in temperature, bringing them to a point of irreversible damage (eventually, they are naturally expelled by the body). You'll feel some coolness, suction and minor sensitivity, but your doctor may also massage the area for two minutes after the treatment in order to better disperse the fat cells for removal. Though quick, expect the massage to be more painful than the treatment itself. 

What is the downtime like for CoolSculpting and Kybella?
Both CoolSculpting and Kybella are non-surgical, so you can expect little to no serious downtime with each. However, significant swelling will surface after a Kybella treatment, and redness and numbness in the treatment area after CoolSculpting.

"With Kybella, patients can expect to experience some side effects such as, tenderness, bruising, temporary numbness and redness. They can also experience significant swelling, especially when treating that pocket of fat underneath the chin," says Dr. Frank. Dr. Shafer notes that this swelling is temporary, "but it's a good sign that it's working." After a CoolSculpting session, the treated area will feel extremely tender and numb—but that's normal. "Patients can return to work and exercise right away, with only mild tenderness to the touch in the treated area for 1-2 weeks," says Dr. Frank.

How long will it take before I see results?
About 2-4 weeks is required for patients to see the full results from Kybella, and the injections can be repeated for an enhanced effect. "It's important to note that most patients need 2-3 treatments for the full effect," adds Dr. Shafer. According to Dr. Frank, CoolSculpting results can be seen as early as 4-5 weeks post treatment and, final results are seen in 8-12 weeks. Multiple sessions are also usually required for ideal results. 

Are results guaranteed?
Dr. Frank says there are many non-responders to both CoolSculpting and Kybella. "For those areas that are resistant to fat removal, diet and exercise is the first step in terms to optimizing your body for contouring and contouring your shape. For those extra stubborn areas that do not see results from non-invasive fat removal options, a lot of my patients switch to a minimally invasive fat removal options like tumescent laser liposuction. Patients take this approach when they have already spent a lot of money and received non-invasive fat removal procedures, but were not good candidates in the first place." "As with any plastic surgery procedure, the ultimate effect is dependent on continued healthy diet and exercise," says Dr. Shafer.

How many treatments are needed?
Neither Kybella nor CoolSculpting are one-and-done treatments. "It's important to note that most patients need 2-3 treatments of Kybella for the full effect," says Dr. Shafer. "However, once the final effect is established, the results are permanent." The same goes for CoolSculpting: "Patients may see up to a 20-30 percent reduction with one CoolSculpting treatment. Depending on how much fat is in the area it can take more than one treatment to see the results," says Dr. Frank.

How much does it cost?
Pricing for both treatments vary on treatment size, location, patient goals and provider. According to Allergan, the cost for CoolSculpting typically ranges between $2,000-$4,000 for a personalized treatment plan depending on the number of areas being treated. The cost for Kybella starts at $1,200, but is dependent on treatment area and size, which then determines how many vials are needed.