truSculpt iD
truSculpt iD uses several flat pads at once. A wide area is heated in one session, and nothing is clamped on or drawn up into a cup.
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Trusculpt vs CoolSculpting
truSculpt heats fat, and the abdomen is the only area it is meant for. It uses monopolar radiofrequency, and holds the skin at about 44 to 45 degrees Celsius. CoolSculpting freezes fat, and it has the far bigger published record. It chills tissue to about minus 11 degrees, across seven named body areas plus under the chin and jaw.
At a glance
| The difference | truSculpt iD | CoolSculpting |
|---|---|---|
| What it is | A handpiece that heats tissue from inside | An applicator that chills a fold of tissue |
| What it is best at | A broad, flat abdomen | A pocket of fat you can pinch |
| Cost | Usually cheaper, and priced per session | Usually dearer, and priced per cycle |
CoolSculpting
The applicator draws a fold of skin and fat up into the cup and holds it there while it chills. That suction is why the area feels tugged for the first few minutes.
Side by side
The differences that matter
What it is
truSculpt iD
A handpiece that heats tissue from inside
Radiofrequency current passes through the tissue. Only the large hands-free handpiece is meant for fat.
CoolSculpting
An applicator that chills a fold of tissue
A vacuum cup draws a fold of tissue against a chilled plate and holds it there.
How it works
truSculpt iD
Heat, at about 44 to 45 degrees Celsius
The skin is held at that temperature. The fat beneath it gets hot enough to be damaged. Biopsies showed about 33% of fat cells died, down to about 1.5 cm deep.
CoolSculpting
Cold, down to about minus 11 degrees
The fat is cooled for 35 to 60 minutes, until the fat cells are hurt badly enough to die.
What it is best at
truSculpt iD
A broad, flat abdomen
Flat applicators do not need a bulge to grip.
CoolSculpting
A pocket of fat you can pinch
The vacuum cup needs something to draw in.
What was actually measured
truSculpt iD
Fat-layer thickness in 12 people
The main efficacy study had 12 people, one arm and no control group. It found 4.6 mm off the fat layer, or 24%, at 12 weeks.
CoolSculpting
Blinded doctors picking the "before" photo
The main endpoint in most CoolSculpting submissions is a spot-the-difference test, not a fat measurement. A pooled FDA review put mean ultrasound reduction at 21%.
What it will not do
truSculpt iD
Not weight loss, and not other body areas
Its fat wording covers the abdomen only. Treating fat anywhere else is off-label.
CoolSculpting
Not weight loss, and not a broad flat area
Pooled studies found no real change in body weight.
The downside
truSculpt iD
Redness and swelling for a few hours
11 of the 12 people had brief redness and swelling. It cleared in one to four hours. Pain scored 2 to 4 out of 10.
CoolSculpting
Numbness, firmness, and pain days later
Sharp cold, then an uncomfortable thaw, then numbness and firmness for days to weeks. Delayed pain is common, and in one review it lasted 3 to 11 days.
Sessions
truSculpt iD
Marketed as one 15-minute session per area
That figure comes from the maker, not a trial. The published study used one 60-minute session.
CoolSculpting
One or more cycles per area, 35 to 60 min
In a review of 3,262 patients, the median was 4 cycles in 1 session.
Cost
truSculpt iD
Usually cheaper, and priced per session
Reviewers reported an average of $2,183, ranging from $750 to $4,500.
CoolSculpting
Usually dearer, and priced per cycle
Reviewers reported an average of $3,268, ranging from $750 to $8,800. Pricing per cycle is why the totals spread so widely.
The at-home or drugstore version
truSculpt iD
Home radiofrequency wands
A wand warms the surface of the skin. The clinic device heats the fat layer itself, and holds it there. A wand does neither.
CoolSculpting
Freezing wraps and cold packs
A strap or a pack chills the skin first and hardest. Chilling the surface is not a slower version of holding the fat itself at a set low temperature.
Who tends to be happy with it
truSculpt iD
- Best for — Someone with a broad abdomen rather than a pinchable bulge.
- The mindset — One or two short appointments, and a result on the abdomen only.
CoolSculpting
- Best for — Someone near a stable weight with a defined bulge and fairly firm skin over it.
- The mindset — One area, volume only, and a wait of two to three months.
truSculpt iD is not truSculpt flex
truSculpt iD
A clinic offering "truSculpt" may mean either one, so ask which. A muscle device and a fat device do not treat the same complaint.
Before you book
truSculpt iD
Ask which truSculpt machine the clinic owns, and which handpiece it will use. Only one handpiece setting is meant for fat, and only on the abdomen. A clinician may treat other areas legally, but it is worth knowing first.
CoolSculpting
Three blood disorders rule out CoolSculpting. In all three, the blood reacts badly to cold. They are cold agglutinin disease, cryoglobulinemia and paroxysmal cold hemoglobinuria.
The fine print
truSculpt iD
truSculpt iD is cleared for the abdomen only. K180709, cleared 6 June 2018, and repeated in K221407 and K223110 in 2022. It covers reduction in abdominal circumference and non-invasive lipolysis of the abdomen, and applies only to the 2 MHz setting on the 40 square centimetre handpiece. Separate wording covers pain, muscle spasm, local circulation and the temporary appearance of cellulite.
truSculpt flex is cleared as a muscle device. Its clearance is K212866, from 3 December 2022. It is held by a different company from truSculpt iD.
CoolSculpting
CoolSculpting was authorised through a De Novo request. DEN090002, decided 24 August 2010, created the FDA device category for cryolipolysis. CoolSculpting Elite, K212707, was cleared on 5 November 2021 for seven areas, including the upper arm, thigh, abdomen and flank, in people with a body mass index of 30 or less. Under the chin and jaw are cleared separately, up to a body mass index of 46.2.
Common questions
Questions Patients Ask
Is truSculpt FDA cleared for anything other than the abdomen?
Not for fat. The lipolysis and circumference wording applies to the abdomen only, and only to the 2 MHz setting on the 40 square centimetre handpiece. The device also carries older wording for topical heating to relieve pain and muscle spasm and improve local circulation, and a separate massage claim for the temporary appearance of cellulite. Treating other areas for fat is off-label.
Which hurts more, the heat or the cold?
They are uncomfortable in different ways. truSculpt is a sustained heat, with pain scores of 2 to 4 out of 10 in the published study and redness that mostly settled within four hours. CoolSculpting is intense cold, an uncomfortable thaw, then numbness and firmness for days, with delayed pain in the following week or two that lasted 3 to 11 days in one review of 554 procedures.
Is truSculpt flex a fat treatment?
No. truSculpt flex is electrical muscle stimulation, cleared for abdominal tone and for strengthening, toning and firming the buttocks and thighs. Its clearance contains no fat or lipolysis wording, and it is held by a different company from truSculpt iD. If you want fat reduced, flex is not the machine.
How many sessions will I need?
truSculpt iD is marketed as a single 15-minute session per area, though that figure comes from the manufacturer rather than a trial; the published study used one 60-minute session across four areas. For CoolSculpting, the largest real-world review of 3,262 patients found a median of 1 session and 4 cycles per patient, with a very wide range.
Is 24 per cent fat reduction realistic?
Nobody can say from what is published. The figure Cutera uses could not be traced to a named study, and the closest published number - 24 per cent off the fat layer at 12 weeks - comes from twelve people in a single-arm study with no control group. It is also a percentage of the thickness of a fat layer at one point, not a percentage of your body fat.
Which one is safer?
Neither has a strong safety signal in the short term, but they fail differently. The documented truSculpt side effects were redness, swelling and mild pain resolving within hours to a day, in twelve people. Cryolipolysis has a much larger record and carries a specific, rare complication - paradoxical adipose hyperplasia - that needs surgery to correct.
Will either one help me lose weight?
No. The FDA states that non-invasive body contouring will not result in weight loss, and CoolSculpting's manufacturer says the same about its own procedure. A pooled analysis of cryolipolysis studies found no significant weight change. These treatments are aimed at the shape of one area, not at the scales.
Safety to keep in mind
FDA is plain about this whole class. It does not treat obesity, and it will not cause weight loss.
A 510(k) clearance is not a finding that a device works. It means FDA agreed it is much the same as one already on the market.