Each month, Modern Aesthetics will ask top aesthetic physicians about the newest editions to their practices. This month, Grant W. Stevens, MD, FACS of Marina del Rey, CA talks about a relatively new approach to the established CoolSculpting (Zeltiq) treatment.

Although there are a number of body sculpting technologies on the market, the one that I use most often in my practice is CoolSculpting® by ZELTIQ®— so much so that I built the website FreezeTheFat. com as a secondary practice website. In my experience, I have found CoolSculpting to be the most effective and efficient. This is not to say that I don't use other devices or procedures. I occasionally use TruSculpt (Cutera), which is especially helpful in areas where the CoolSculpting applicators aren't well suited, such as for targeting the lateral thighs. Of course, I also offer liposuction for appropriate patients.

CoolSculpting is a unique technology that freezes the fat to a temperature such that the fat dies, but the skin, muscles, and nerves are not affected. I generally use CoolSculpting as a primary procedure. However, CoolSculpting and other devices can also be used following liposuction or treatment with other skin-tightening technologies to address any persistent contour irregularities.

What Is treatment to transformation?

Initially, CoolSculpting, which is cleared by the FDA for the noninvasive reduction of fat, was used to treat “bulge areas” of the abdomen and flanks (love handles) typically with a single session or short series of sessions—a one-anddone approach. Now, after a more global assessment of the patient and with the availability of multiple handpieces, we can design a comprehensive approach that allows for better results.

For best results, many patients require more than one CoolSculpting treatment, so we use multiple cycles at one setting. Then, the patient can come back in a few months and receive treatment again if pockets of fat remain. Certainly, we do not do this every time. However, selective application of this serial approach on a case-by-case basis aids in achieving best outcomes for those patients who may have a bit more fat and require debulking initially, with more targeted sculpting subsequently.

This concept of providing repeat treatments over time to achieve the desired outcome is called “Treatment to Transformation,” and it is an exciting change in our approach to body sculpting. In addition to the serial approach, we have begun also to use multiple units at one time to treat a single patient—what the company calls “DualSculpting.” We use two CoolSculpting machines in a room and place applicators at different anatomical locations. We have six machines, so we are able to treat three patients at a time and keep the flow going.

Are There Practice Benefits?

CoolSculpting is a benefit to our practice in many ways. It is the Number One procedure we use for body sculpting. We found that 40 percent of new CoolSculpting patients are retained and are coming back for secondary and tertiary procedures. In the first three years, 67 percent of CoolSculpting patients had never been to our practice before, and of those, 62 percent had never had any cosmetic procedure before. With CoolSculpting, we are getting new patients and those who never availed themselves to plastic surgery. Additionally, it is the number-one source of revenue in our nonsurgical practice—comprising one-third of our nonsurgical-procedure revenue. Results are terrific, and patients are extremely satisfied.

There are a number of non-surgical body sculpting technologies, and some are better than others. Choosing the right technology depends on your practice goals and your patients' needs. Of the 11 different technologies in our practice, I believe CoolSculpting is the best technology we have. We continue to research and utilize different modalities. I am particularly interested in new and emerging technologies, such as Vanquish (BTL), i-lipo (Chromogenex), and Venus Freeze (Venus Concept). However, CoolSculpting has changed our practice: it is safe, effective, and makes economic sense for our patients and our practice.