Question 1

What are common patient expectations and limitations for CoolSculpting?

Accepted Answer

Patients often expect CoolSculpting to be a one-time treatment that completely removes fat. However, there isn't an applicator large enough to treat an entire area at once. The standard Cool Advantage applicator treats an area approximately the size of a stick of butter, effectively treating about an inch and a half of pinched fat. If the fat is thicker (e.g., 3 inches), only the outer layer that fits into the applicator will die, meaning only a portion of the fat will be killed in one session.

Question 2

How is CoolSculpting applied to ensure smooth results?

Accepted Answer

CoolSculpting applicators are applied with slight overlap because the freezing only occurs where the applicator is metal, not on the plastic edges. The actual freezing area is slightly smaller than the physical outline. The practice intentionally uses this overlap to achieve a totally smooth final result.

Question 3

What are the typical steps and duration of a CoolSculpting session?

Accepted Answer

Each CoolSculpting cycle takes 35 minutes and is followed by a 2-minute massage. Some people undergo CoolSculpting more than once, with a second treatment typically occurring about 2 months later if needed. If the amount of fat is smaller than what fits in the applicator, a patient may not need additional treatments.

Question 4

What is Fire and Ice Body Contouring and how does it compare to CoolSculpting alone?

Accepted Answer

Fire and Ice Body Contouring is a procedure that doubles CoolSculpting results by first heating the fat, which can include ultrasound fat cavitation (22 minutes for the front, 8 minutes for back/side) and radiofrequency body contouring (12 minutes front, 12 minutes back). This heating pokes many holes in the fat, allowing the CoolSculpting applicator to 'wring out' the fat like a sponge, causing it to leak out and be absorbed. This method allows for the removal of all fat, even a 3-inch pinch, in one treatment, which most other places cannot do. It saves time and money compared to CoolSculpting alone, which might require two or three sessions for the same amount of fat.

Question 5

How many Fire and Ice Body Contouring sessions are typically needed?

Accepted Answer

Most people with 3 inches of fat will only need one Fire and Ice treatment. For patients with 4.5 inches of fat, a second treatment session may still be required, where the first session treats approximately 3 inches and the second addresses the remainder. While some individuals tolerate the heat well enough to potentially treat 4.5 inches in one session, this is uncommon.

Question 6

What are the benefits and typical downtime for hyperdilute Radiesse?

Accepted Answer

Hyperdilute Radiesse can make patients look 5 years younger by providing immediate volume and delayed skin rejuvenation. It stimulates collagen growth, restoring lost collagen and elastin to erase wrinkles, improve skin elasticity, and rejuvenate the skin. While initially described as having 'no downtime,' skin restoration with hyperdilute Radiesse typically involves about 2 hours of downtime due to swelling from the added water, which usually subsides after a few hours.

Question 7

How is hyperdilute Radiesse administered and what is the recommended maintenance?

Accepted Answer

During the procedure, the skin is numbed, so patients do not feel the creation of the eight portals. A painless blunt cannula is used to spread the diluted Radiesse through these portals to treat the entire face, followed by massage for even spreading. A very thick syringe of Radiesse is thinned out by adding water to make it easily spreadable, refilling eight watered-down syringes. Tiny round spheres of Radiesse act as a scaffold for collagen growth. Maximal collagen growth requires eight months, and results can last for two years. The practice recommends doing the procedure once a year as maintenance.

Question 8

What is the Evo fractional CO2 laser used for and what are its benefits?

Accepted Answer

The Evo fractional CO2 laser is highly effective for improving crepey, hanging skin of the eyelids and is considered a non-surgical blepharoplasty. It provides long-term results, similar to a blepharoplasty, with results lasting at least five years. It works best for patients whose brows have not dropped significantly and who do not need a brow lift.

Dr. James W. Goodnight, MD

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