Zeltiq’s new CoolSculpting FDA clearance for the reduction of submental fat is heating up the race for the title of the best double chin vanishing treatment. Coolsculpting is already globally known for their fat-freezing process (cryolipolysis) to reduce stubborn areas around the thighs, hips, flanks and arms. Now, with their CoolMini applicator for submental fat, they are giving Kythera’s Kybella, formerly known as ATX-101, a run for their money.

Prior to 2015, the public had most likely never heard of submental fat. Double chin? Sure, but certainly not a non-invasive treatment for it. The American Society for Dermatologic Surgery (ASDS) showed that in 2014 approximately 68 percent of people were concerned with chin and neck fat, which has increased eight percent from the previous year. While this affliction may not be on everyone’s “to-do” list of cosmetic procedures, it is one that cannot be covered up by clothing or makeup. It proves to be another stubborn area of fat for many people to get rid of on their own. Clearly, with Zeltiq’s swift entrance into the submental fat ring after Kythera’s clearance, there is a large demand for this new to 2015 focused procedure.

So, what is the difference between these two treatments?

CoolSculpting essentially freezes stubborn fat cells, which the body then disposes of through the lymphatic system. The treatment is performed by placing an applicator on the treatment area, which attaches via vacuum suction, and gradually freezes the targeted fat over, typically, a 60-minute session. Patients may need to undergo a course of treatments to achieve their desired results, but many report seeing results after a single session. The unique effect of this treatment is that the fat cells in the targeted area are gone for good, which yes, is great, but you will need to keep up a healthy lifestyle (part of any fat reduction procedure protocol). Any fat subsequent weight gain can look disproportional in that area, which many report as a wavy or rolling appearance. Treatments typically run around $2,000.

Kybella is a proprietary injection that dissolves the fat cell’s membrane to effectively kill the cell, which is then disposed of through the body’s lymphatic system. This treatment is much quicker in which the series of injections typically takes between 15-20 minutes to perform and up to 6 sessions may be needed for the desired outcome. Like CoolSculpting, the fat cells do not come back, so with proper diet and exercise your submental fullness should be gone for good. Similar to CoolSculpting, some patients have reported disproportional reduction in their submental fullness. But, opposed to having gained any weight back as the cause, these reports stem from injector error – so it is always important to ensure your practitioner is an expert at this procedure (this goes for any cosmetic procedure) to ensure the best possible outcome and treatment experience. Treatments typically run around $1,500 per session.

Based on both patient experiences and post-treatment adverse effects it seems that each treatment is relatively similar with these aspects. The majority of patients who have tried either treatment report being satisfied with the treatment outcome. While there will be a population of patients that do not have any side-effects, the most commonly reported are post-treatment bruising, swelling or soreness that tends to dissipate within 2-4 weeks at most. As I mentioned in a previous article, the majority of these side effects, if any, can be reduced with laser treatments, specifically with 650 Microsecond Technology® (Aerolase – sorry, have to mention it!), to reduce bruising or soreness to just a couple of days. Either procedure is a great option for patients wanting to address their submental fullness quickly and without needing invasive surgery.

Unfortunately for practitioners, each treatment carries a hefty consumable price, with each CoolSculpting session running up to $450 for the practitioner (depending on the treatment area) and $300 as the initial pricing per 2 mL vial of Kybella. Of course, this isn’t going to break the bank for any physician with each treatment being so highly in-demand. We will see how these per-treatment prices fluctuate in the near future as the fight over non-invasive body contouring market share heats up even more so with Syneron’s no consumable UltraShape now coming to market.

So, with Allergan’s acquisition of Kythera for $2.1 billion over the summer, it will be interesting to view how they rationalize their expenditure on such a new, almost experimental product with, presently, a very finite niche. While the injectable formula will most likely receive future FDA clearance for other applications on the body outside of submental fat, CoolSculpting has already defined itself as the go-to treatment for non-invasive fat reduction – and patients absolutely love it. Who will be the leader to this newly founded turf in the ever-competitive aesthetics industry? Let’s see what aesthetic/pharmaceutical giant Allergan/Actavis will say and do about Zeltiq’s competitions as the world becomes more familiar with the world of non-invasive body contouring.