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Aesthetics Practice Today

Battle of the Bulge

Published November 1, 2011 1:43 PM by Kimberly Cray

Diet and exercise. These are two words patients do not want to hear when they seek consultation for fat reduction. Most likely they have been dieting and they have been exercising. Yet those stubborn pockets or bulges of fat remain. Many patients are not candidates for surgical procedures such as liposuction or abdominoplasty. Similarly, many patients desire a noninvasive approach to body contouring. To meet this demand, a new treatment modality was created. CoolSculpting by Zeltiq was developed by dermatologists Dieter Manstein, MD, and R. Rox Anderson, MD, at Massachusetts General Hospital. CoolSculpting is a nonsurgical option that requires no down time or anesthesia. Ideal candidates are patients in relatively good shape with select areas of fatty bulging that is unresponsive to more traditional therapies, such as diet and exercise.

The device employs the scientific principle that fat cells are susceptible to permanent damage under controlled low temperatures. Using this concept of “cryolipolysis,” a cold enough temperature is reached during treatment to selectively target fat cells without harming skin or soft tissue. The targeted area of fat is placed into an apparatus with cooling plates that initiate the process. A complete treatment cycle (per area/per side) is 1 hour. Common treatment areas include “love handles,” upper and lower abdomen sections, and upper back fat. The cells later become crystalized and undergo apoptosis or natural cell death. This process takes place over several months and results are seen 2 to 4 months after treatment. Potential side effects from treatment include temporary bruising, numbness/dulling of sensation within the treatment site, redness of skin, cramping, and tenderness/pain.

While this is a great new option for patients, this procedure does not replace surgery and does not treat obesity. Most importantly, I believe a healthy and active lifestyle should be encouraged before any elective procedure. No procedure, invasive or noninvasive, keeps weight off. Best results therefore require a healthy commitment from the patient to maintain their weight.

What are your experiences with this device? Other body-contouring devices? I’d love to hear your clinical experience and/or feedback. Based on the research and results I have seen so far in practice, CoolSculpting is certainly a “cool” new option for patients. In fact, very “cool” indeed.

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    Occupation: Physician Assistant/Nurse Practitioner
    Setting: Miami & Upland, Calif.
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