New In My Practice | Devices: Trusculpt ID from Cutera

In each edition, Modern Aesthetics® magazine asks top cosmetic physicians about the newest devices that they are introducing to patients. Here, Amy Forman Taub, MD, Medical Director and Founder of Advanced Dermatology and skinfo in Lincolnshire and Glencoe, IL, shares her experience with Cutera's Trusculpt ID for permanent fat reduction.

What is Trusculpt ID and how are you using it?

Amy Forman Taub, MD: Trusculpt ID is a permanent fat reduction device that also seems to tighten the skin. It works by monopolar radiofrequency (RF), so via heat transfer to the fat, and resulting lipolysis. Because it uses a 2Mh frequency, the fat heats more than the skin by 3-4 degrees C, which makes it safer, as well as more comfortable for the patient and more efficacious, compared to previous RF-based fat reduction devices.

How does Cutera's Trusculpt ID compare to other body contouring devices?

Dr. Taub: Compared to other fat-reduction devices, Trusculpt ID can treat more areas in less time, which is its main advantage. For instance, it can treat the equivalent area of three regular size handpieces of CoolSculpting in one 15-minute treatment period. This makes it far more convenient and slightly less expensive in terms of disposables. It also offers an improved ROI in terms of room management and staff time.

Is there a learning curve?

Dr. Taub: Generally a physician extender performs the procedure. Like every procedure, proper positioning and execution of the technique will affect outcomes. That said, there is not a huge learning curve for those experienced with energy-based devices.

Please share your treatment protocol/s and any pearls.

Dr. Taub: We generally identify areas of concern and any adjacent areas we feel need treatment in order to achieve an overall good outcome. We mark these out to make certain we offer a complete treatment and explain to the patient what to expect and the probability of needing more than one session for each area. I think preparation for these procedures is the most important part. If the areas are not adequately treated or undertreated, as is often the case, then the clinical result cannot be met.

Proper candidates must be selected. This procedure is not meant for people with a body mass index (BMI) over 30. Those with BMIs of 25-30 need to be cautioned about the degree of improvement they can achieve.

Positioning the applicators two at a time (there are six) with two being close to each other is critical. They must be positioned exactly on the tegaderm sticky patches. It is important that the treating technician does stay in the room. Even though the algorithm is well engineered, it is important to address any patient discomfort and manually reduce the energy (which is easy to do) during the procedure, if necessary, in a specific area. Also, the heat generated is quite a lot and we don't want the patient to sweat, so positioning two large fans directly across from the patient helps.

How has the ROI been?

Dr. Taub: We haven't had the device long but we are very busy with it. We thought more people would resist our suggestion to use Trusculpt ID instead of CoolSculpting since the latter is well known, however, they seem to allow us to make the determination after learning about the differences. We sometimes use both devices on the same patient. It is our anecdotal experience—and makes sense based on the science—that firmer or more fibrous fat is penetrated better by heat as opposed to cold, so we use the Trusculpt ID in that situation. Also we think that there is more tightening with the RF, so if there is a lot of laxity, we tend to choose Trusculpt ID. If there is typical fluffy type of fat, we can choose either, and sometimes it just comes down to which office the patient wants to go to, as we have two offices and the devices are located in different ones.

How are you marketing Trusculpt ID?

Dr. Taub: We have posters, flyers and a stand-up sign in office. We have discussed it in our newsletter many times, which our patients faithfully read. (We still mail them out and they come in with excerpts underlined and highlighted). We have marketed it on the website and have some good search engine traffic from it because we did the original clinical trial on both Trusculpt 3D and ID and have been mentioned in many publications.

In addition, we did a spot on “Windy City Live” where we had a video of a patient's treatment who then was on air discussing her experience. After the TV appearance, we had a roundtable discussion with media personalities from Chicago at Neiman Marcus which was well attended. We had significant phone traffic from this for one week after the event. Also, we simply discuss it in our body shaping consultations. The first thing people ask is, “Which is better: Coolsculpting or Trusculpt?” We describe the differences and their strengths and then we make our suggestions based on their body type. We have priced them the same per “cycle” so that price is not an issue. Overall we feel it has increased our ability to personalize treatments for individual patients and it gives us an additional tool in our body shaping armamentarium.