Emsculpt vs Coolsculpting
Medically Reviewed by Arash Akhavan, MD, FAAD
When it comes to non-invasive body contouring, two of the most well-known treatments are Emsculpt NEO and CoolSculpting. Both procedures are designed to help patients reduce stubborn fat and achieve a more sculpted physique—without surgery or downtime.
While Emsculpt NEO and CoolSculpting share the goal of fat reduction, they use fundamentally different technologies and produce very different results. CoolSculpting works through a process called cryolipolysis, which freezes fat cells to destroy them. However, it is strictly a fat-only treatment, meaning it has no effect on muscle tone or overall body definition beyond reducing fat. In contrast, Emsculpt NEO is a dual-technology treatment that combines high-intensity focused electromagnetic (HIFEM) energy to build and tone muscle with radiofrequency (RF) energy to burn fat—delivering both muscle-building and fat reduction in a single treatment. This fundamental difference means that while CoolSculpting targets only fat, Emsculpt NEO sculpts and defines the body by improving muscle tone and reducing fat simultaneously.
At first glance, both treatments might seem like comparable options for body contouring. However, as we’ll explore in detail, Emsculpt NEO delivers far superior results, while CoolSculpting has become, in our opinion, an outdated technology with a history of concerning side effects.
Emsculpt NEO vs Coolsculpting: Two Very Different Body Contouring Devices
While Emsculpt NEO and CoolSculpting are both classified as non-invasive body contouring treatments, they use completely different technologies, deliver vastly different results, and have very different safety profiles.
Emsculpt NEO: Muscle Building and Fat Reduction—Two Treatments in One
Emsculpt NEO is a groundbreaking body contouring treatment that combines HIFEM (high-intensity focused electromagnetic energy) to build muscle with radiofrequency (RF) energy to burn fat. This dual technology allows Emsculpt NEO to treat both muscle and fat in the same session, making it the only non-invasive body contouring device to address two key components of body shape simultaneously.
- Fat Reduction: Emsculpt NEO reduces fat by an average of 30% in treated areas, thanks to radiofrequency heating, which destroys fat cells permanently.
- Muscle Building: With HIFEM technology, Emsculpt NEO induces thousands of supramaximal muscle contractions per session, building and toning muscle with an average muscle increase of 25%. This results in improved definition and a sculpted appearance that cannot be achieved with fat reduction alone.
- Side Effects: One of the greatest advantages of Emsculpt NEO is its safety profile. The procedure has virtually no side effects. Patients typically experience only mild muscle soreness, similar to what is felt after an intense workout. There is no risk of complications such as nerve pain, contour deformities, or skin laxity.
Emsculpt NEO also tightens the skin by stimulating collagen production through its radiofrequency heating, reducing the risk of loose skin after fat reduction—a common problem with many other body contouring treatments.
CoolSculpting: Outdated Fat-Freezing Technology with Significant Risks
CoolSculpting, once a popular non-invasive fat reduction treatment, uses cryolipolysis to freeze fat cells, causing them to die and be eliminated by the body over time. However, CoolSculpting has significant limitations and a growing reputation for serious side effects.
- Fat Reduction: CoolSculpting typically reduces fat by about 20-25% in treated areas, but results are often less dramatic and less consistent compared to Emsculpt NEO. Additionally, CoolSculpting does not build muscle, so it only reduces volume without improving muscle tone or definition.
- Side Effects and Risks: Unlike Emsculpt NEO, CoolSculpting carries a significant risk of side effects, some of which can be severe and permanent:
- Paradoxical Adipose Hyperplasia (PAH): A rare but serious complication where the treated area enlarges instead of shrinking, forming hard, lumpy fat deposits. PAH is disfiguring and often requires surgery to correct.
- "Shark Bite" Deformities: Uneven fat loss can create indentations and contour irregularities, sometimes referred to as “shark bite defects.”
- Loose Skin: Because CoolSculpting reduces fat without improving skin quality, it can leave patients with loose, sagging skin, especially in areas prone to skin laxity.
- Neurogenic Pain: Some patients experience persistent nerve pain or numbness after treatment. This pain can last weeks or even months.
- Lack of Muscle Benefit: Since CoolSculpting only targets fat, it does nothing to tone or define muscles, often resulting in a flat or deflated appearance, rather than the sculpted, athletic look that many patients desire.
Comparison: Emsculpt NEO vs Coolsculpting
| Comparison | Emsculpt NEO | CoolSculpting |
|---|---|---|
| FDA Approval | Approved in 2020 | Approved in 2010 |
| Purpose | Builds muscle and reduces fat simultaneously | Reduces fat by freezing and eliminating fat cells |
| Technology | HIFEM (High-Intensity Focused Electromagnetic) energy with synchronized RF (radiofrequency) | Cryolipolysis (controlled cooling to freeze and eliminate fat cells) |
| Treatment Areas | Abdomen, flanks, buttocks, arms, thighs, and calves | Abdomen, flanks, thighs, back, upper arms, and under the chin |
| Duration of Results | Muscle improvement lasts up to one year. Some improvements of fat are permanent. | Fat reduction is permanent with healthy lifestyle maintenance |
| Number of Treatments | 4 sessions spaced 1 week apart | 1-3 sessions per area depending on fat thickness |
| Procedure Time | 30 minutes per session | 35-60 minutes per area |
| Downtime | None | Several days (temporary redness, swelling, or numbness) |
| Pain Level | Mild to moderate muscle contractions, warming sensation | Mild to moderate discomfort during cooling, possible numbness, tingling, or pain after |
| Results Onset | Visible improvements within 4-6 weeks, with continued improvement over months | Results begin to appear in 3 weeks, with full results in 2-3 months |
| Ideal Candidate | Patients wanting to reduce fat and build muscle simultaneously | Patients seeking non-surgical fat reduction in specific areas |
Emsculpt NEO is Superior to Coolsculpting
Emsculpt NEO Is the Clear Choice
When comparing results, safety, and long-term benefits, Emsculpt NEO clearly outperforms CoolSculpting. Not only does Emsculpt NEO reduce fat more effectively (by 30% compared to 20-25% with CoolSculpting), but it also builds muscle and improves skin quality, creating a sculpted, toned look that CoolSculpting simply cannot achieve.
Additionally, the safety profile of Emsculpt NEO is far superior, with no serious side effects, unlike the well-documented complications from CoolSculpting such as PAH, skin irregularities, and nerve damage.
Why We Do Not Recommend CoolSculpting
At The Dermatology and Laser Group, we prioritize proven, effective, and safe technologies for our patients. In our opinion, CoolSculpting is now considered outdated, with an unacceptable risk profile compared to modern technologies. Emsculpt NEO has become our go-to solution for patients seeking body contouring, because it offers:
- Better results (fat reduction and muscle building)
- No significant side effects
- Firmer skin with no sagging
- A more toned, athletic body shape
For patients considering body contouring treatments, the choice is clear: Emsculpt NEO delivers superior results safely and efficiently, making CoolSculpting a thing of the past.
Arash Akhavan, MD is founder and owner of The Dermatology and Laser Group, one of the top centers for cosmetic procedures in New York City for over a decade. Arash Akhavan, MD, FAAD is a Board Certified Dermatologist and an Associate Professor at The Mount Sinai School of Medicine. Dr. Akhavan is a Castle Connolly Top Doc, New York Magazine Best Doctor, and Super Doctor featured in The New York Times. Dr. Akhavan is a key opinion leader that has been featured on hundreds of media publications including The New York Times, Allure, Marie Claire, Women’s Health, Cosmopolitan, ABC News, Fox News, Fox 5, NY1, WPIX, and more. He has been featured on nationally syndicated television programs such as The Doctors.
Dr. Akhavan serves as an educator and lecturer for multiple aesthetic device and injectable companies. This allows his office access to newer technologies at an earlier date than other offices, as well as a higher level of expertise in the use of these devices. This, in turn, translates to more effective and safer treatments for our patients.
By Arash Akhavan, MD, FAAD | | Categories: Body, Body Contouring
