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Common areas of the body where IPL can be used include

The Face

Neck and Chest

Arms and Hands

Your Laser Skin Care

Laser hair removal works by using lasers to emit light pulses at a particular wavelength that is absorbed by the pigment (melanin) in the hair follicle. The light energy is absorbed by the follicle, which causes it to heat up, and results in the follicle being damaged. Eventually, the hair attached to the follicle falls out, and the damaged follicle does not grow new hair.

Although laser hair removal is often promoted as giving permanent results, the truth is somewhat more complicated. This blog post explains why.

Phases of Hair Growth

All individual human hairs go through a growth cycle with four distinct phases: Anagen, Catagen, Telogen, and Exogen. The Anagen phase is when hair follicles create new hair shafts, and the hair shafts grow longer. The Catagen phase corresponds to a period when hair growth slows down, and the hair follicle shrinks. The Telogen phase is a resting state, during which old hair remains connected to the follicle, while new hair begins to grow underneath. The final Exogen phase occurs when old hair shafts fall out, and new hair continues to grow.

The four phases also take very different periods of time: Anagen can last anywhere between two and seven years. Catagen lasts up to two to three weeks. Telogen takes between three and four months. Exogen is harder to define; it actually overlaps with the other phases.

Effectiveness of Laser Hair Removal

Laser hair removal procedures are most effective during the Anagen phase, while the hair follicle is growing a new hair stalk, and the hair follicle contains the most melanin. The laser is tuned to a frequency that is absorbed by the melanin, which results in the light energy being efficiently converted to heat. This heat damages or kills the follicle, inhibiting future hair growth.

The following factors combine to prevent single laser hair removal treatments from being able to remove all hair in the treated area:

• the hair growth cycle results in not all hair is in the Anagen phase at any given time.
• individuals vary greatly in the lengths of their hair growth cycles, influenced by hormonal and genetic factors.
• hair thickness also varies greatly between individuals, which may influence how effective the laser is at damaging hair follicles.
• the period during which hair does not grow is influenced by many factors, including age.
• the damage caused by the laser heating up individual follicles may not be enough to completely prevent new hair growth. Partial damage can result in the regrowth of lighter, finer hairs.
• the laser equipment being used may not be a perfect match for the patient’s hair and skin colors.
• the practitioner’s skill may also influence how effectively hair removal occurs.

Permanent or Temporary?

Given that a single laser hair removal treatment will not be 100% effective, in most cases patients will be advised to have several treatments, spaced out appropriately. This technique will certainly increase the percentage of hairs removed in the treated area, over time.

The various factors that influence the effectiveness of laser hair removal combine to make it quite unlikely that even a skilled practitioner will be able to achieve permanent 100% removal of hair in a given area after just a few treatments. In some of the real-world cases, further treatments will be needed to maintain the results, although the intervals between these treatments will generally become longer over time.

Your Laser Skin Care

Your Laser Skin Care practitioners are medically qualified and highly experienced in performing laser hair removal. We also have extensive experience with a wide variety of other non-invasive cosmetic procedures. We can help you choose the safest, most effective, and most cost-effective way to achieve your cosmetic goals. Call us at (323) 525-1516 to schedule a free consultation, or visit us online for more information.

Choose the Right Treatment Provider

Maintain a Healthy Diet and Exercise Regimen

Stay Hydrated

Avoid Smoking and Alcohol

Follow All Aftercare Instructions

Your Laser Skin Care

CoolSculpting is a fast-growing non-invasive cosmetic procedure that can selectively remove unwanted fat from many parts of the body. It uses precisely controlled cooling pads to cool fat cells down to a temperature that kills them, while leaving adjacent skin cells undamaged.

This article explains the history of CoolSculpting, how it’s able to achieve remarkably effective results, and which patients are the best candidates for the procedure.

The History of CoolSculpting

The origin of CoolSculpting is due to the curiosity of two Harvard Medical School dermatologists. Drs. Dieter Manstein and R. Rox Anderson observed that children who ate many frozen popsicles were apt to develop dimples in their cheeks. There’s even a medical term for this condition: Popsicle Panniculitis. Further investigation (#1) showed that fat cells are more sensitive to low temperatures than other skin cells, and that cooling then down to near freezing can actually kill off the fat cells.

This observation would not have been so important, were it not for one other characteristic of fat cells – unlike most other cells in the body, fat cells do not regenerate. This means that once eliminated, fat cells will not grow back.

Drs. Manstein and Anderson formed a company (EHR International) to research the most effective ways to cool fat cells, and to determine which parts of the body could most effectively be treated. Zeltiq Aesthetics acquired the technology in 2010, and further developed it. More recently Allergan acquired Zeltiq in 2017; they have continued to develop CoolSculpting technology and market it to licensed healthcare professionals.

As of 2022, Zeltiq have stated that over 11 million CoolSculpting procedures have been performed worldwide.

What is CoolSculpting, and How Does it Work?

CoolSculpting is the name given to the procedure developed by Zeltiq. The procedure involves cooling unwanted fat deposits to a precise low temperature, which causes the targeted fat cells to crystallize (or “freeze”), without damaging any adjacent cells.

The process of freezing fat cells is known as cryolipolysis. Lipolysis is the name given to the natural mechanism by which the body breaks down fat cells; the prefix “cryo” indicates the use of low temperatures. Cryolipolysis occurs at temperatures of between -1°C and 4°C (between 30°F and 39°F); CoolSculpting actually applies temperatures several degrees cooler (depending on the depth of the fat deposits) to penetrate beneath the skin’s surface.

This cooling process damages the fat cells, which causes then to progressively shrink and die after the procedure is complete. Unlike liposuction, there is no surgery and little downtime. This process continues after they return to their normal temperature. The body naturally and gradually absorbs and eliminates these dead fat cells following treatment, resulting in a reduction in the size of the treated area.

Results will start to be visible in as little as three weeks after treatment; full results may take two or three months to fully develop.

How Effective is CoolSculpting?

CoolSculpting can remove anywhere up to 20% or 25% of fat cells in the targeted area in a single treatment. This amount will vary according to the body area being treated, the patient’s body type, and the skill of the person performing the procedure. Multiple treatments can increase this percentage, and depending on the area being targeted, it may ultimately be possible to achieve 30% or more fat reduction.

It’s important to have appropriate expectations – your practitioner should give you an estimate of the results achievable for your particular situation after one or more treatments. This will, of course, depend on your body type and the areas being treated, but also on your lifestyle, your diet, and the amount of exercise you perform. Research indicates success rates in 86% of treated patients; patient satisfaction with CoolSculpting also rates higher than other non-invasive techniques (#2).

Bear in mind that CoolSculpting should not be viewed as a way to lose weight – its purpose is to selectively remove unwanted fat deposits, allowing the contours of the body to be improved (hence the name “CoolSculpting”). Even though the treated fat cells won’t grow back, other fat cells in your body will, if you continue with the lifestyle that originally led to excess fat accumulation.

Which Body Parts can be Treated?

CoolSculpting is cleared by the FDA as safe for use on these body parts:

• Submental. The under-chin area, including double-chins.
• Submandibular (under the jaw).
• Abdomen.
• Flanks (“love handles”).
• Inner and outer thighs.
• Bra strap area.
• Upper arms.
• Beneath the buttocks (“banana roll”).
• Backs

The procedure has also been used “off label” on these areas:

• Calves and ankles.
• Inner knee.

The procedure is most effective when used on packets of excess fat in the above areas, particularly when these fat deposits have proven resistant to exercise and/or dieting.

CoolSculpting is not effective on fat deposits that occur in the body’s core. It’s most effective when used on fat deposits that lay closer to the skin surface, and particularly on fat deposits that can be physically isolated. Cooling fat deposits close to the surface down to the required temperature is relatively easy and low-risk. Attempting to cool deeper fat deposits down to the required level would be far harder and carry elevated risk.

CoolSculpting is also not a solution for loose skin – it can reduce fat cells but will not provide a solution for any skin laxity.

Long-Term Benefits

• CoolSculpting confers important long-term benefits, in particular:
• As the procedure is non-invasive, recovery time is almost eliminated.
• There are no scars or visible signs of any treatment.
• Fat loss is permanent, as treated fat cells cannot grow back afterwards.
• A skilled practitioner can ensure that results are balanced and natural-looking.
• Patient self-confidence is boosted by the procedure, which in turn increases their ability to control their diet, and also to maintain or increase their exercise levels.
• Fat cells are eliminated from the body using natural processes; this results in a very low level of side effects or complications after treatment.

How Does CoolSculpting Differ from Other Fat Reduction Treatments?

• CoolSculpting offers some very significant advantages compared to other ways of reducing fat, such as liposuction:
• CoolSculpting is a non-invasive procedure, hence the risk of infection or side effects is dramatically lower. Costs are also correspondingly lower.
• No need for anesthesia, with its associated risks and recovery time.
• Cryolipolysis is highly effective and safe; it makes use of the body’s natural mechanisms for eliminating dead fat cells from the body.
• Natural-looking results: fat elimination occurs naturally and gradually, so no sudden change in your appearance.
• CoolSculpting gives highly targeted results, allowing fat reduction exactly where you want it, and nowhere else.
• Zero downtime. No recovery time is needed after treatment, so there’s minimal impact to your daily schedule.
• Extremely low chance of any unwanted side effects.
• Guaranteed long-term results, as long as a healthy diet and lifestyle is maintained.

The CoolSculpting System

The CoolSculpting system hardware has evolved since its introduction. It now comprises the following elements:

Control Unit

The control unit uses a combination of thermoelectric and traditional refrigeration technology to chill liquid coolant down to the required temperature. The coolant then circulates to the applicator and back again. It’s also able to generate a low-pressure vacuum that can be used by various applicators to increase thermal coupling with the skin. The vacuum may also be used to help massaging the skin and fat cells after cooling.

The control unit display allows the exact parameters of each treatment to be input, and more importantly closely monitored and adjusted as necessary. The coolant is chilled to precisely -11 degrees Celsius. The temperature applied to the skin must be held to within +/- 0.5 degree Celsius for the treatment to be both safe and effective.

The control unit software ensures that the procedure is performed using the exact cooling temperature and duration required for optimum cryolipolysis to occur; it also constantly monitors the patient to ensure that no unwanted situations develop.

Applicators

Various applicators are used, depending on the area(s) of the body being treated. Applicators are either hand-held, or function when strapped to the body. Some applicators use vacuum to increase the thermal coupling with the body. Applicators are instrumented, and allow the controller to monitor the exact temperature being applied to the skin.

Thermal Coupling Gel

A special thermally conductive gel is applied to the applicators to ensure that they make perfect thermal contact with the skin, with no hot or cold-spots. The gel also protects the skin from cold burns during the procedure. They also serve to increase the effectiveness of the vacuum function, when it’s applied.

All aspects of the CoolSculpting device are subject to rigorous inspection by the FDA. In common with other medical devices, no change to the system hardware or operating software can be made without prior approval from the FDA.

CoolSculpting Applicators

The applicators (also called handpieces) used as part of the CoolSculpting procedure are each optimized for use on specific parts of the body; they’re typically rounded paddles in various sizes and shapes. The applicators are important part of the process – they’re designed to efficiently cool subcutaneous fat in specific parts of the body, many of which may be hard to reach.

• CoolMini: Designed to help reduce fat in small, difficult-to-treat areas, such as the double chin.
• CoolAdvantage Petite: Designed to target localized fat deposits on smaller areas of the body, such as the arms.
• CoolAdvantage Plus: Designed for use on larger areas, such as the abdomen and love handles.
• CoolSmooth Pro: Designed for use on body parts that typically have minimal pinchable fat, such as the outer thighs, and provides smooth and even fat reduction.
• CoolCore Advantage: Designed for use on the upper abdomen.
• CoolFit Advantage: Designed for use on the flanks and love handles.

Some applicators use suction to increase their cooling efficiency. The suction effect from a partial vacuum ensures good thermal transfer between the applicator and the body, and also helps increase blood flow to reduce discomfort. Some applicators have multiple heads to allow larger areas to be treated at the same time. Most contain curved and/or flexible components to better adapt to different body shapes. All applicators are used with a thermally conductive gel to ensure that cooling is applied evenly over the are being treated.

All applicators are designed to precisely control the temperature that’s applied to the targeted fat cells, to both increase the effectiveness of the procedure and to ensure that no unwanted damage is caused. The software that’s used to control the procedure is also rigorously inspected by the FDA, and is subject to the same approval process.

Safety Concerns

It’s normal to have concerns about any procedure, including non-invasive ones. Fortunately, CoolSculpting has a well-established record of minimal side effects, dating back for over ten years.

The CoolSculpting system contains many safeguards to ensure that each procedure is performed at the optimum temperature and over the appropriate time. The applicators are each designed to facilitate correct use on a particular body part. The best way to guarantee that the procedure goes smoothly and that you get the results you want is to ensure that the practitioner performing the procedure is medically qualified, appropriately trained, and highly experienced in use of the CoolSculpting system.

CoolSculpting has been cleared for use in the US by the FDA, and has received EU CE certification in Europe – both guarantees that the procedure has been extensively studied and found to be safe.

Having a board-certified physician available to supervise the process is the ultimate assurance that you’re in safe hands. You should have the opportunity to discuss any concerns you have with the supervising physician beforehand, and they should be able to address any concerns you have.

FDA Clearances

Zeltiq and Allergan worked with the US Federal Food and Drug Administration (“FDA”) to conduct extensive clinical trials into the safety and effectiveness of the CoolSculpting procedure, resulting in the FDA granting clearance for use of the device.

The regulatory process has continued as the device has been enhanced and refined, and clearances have been obtained for use of the device in additional body areas.

This is the list of FDA clearances obtained since 2009 (#4); the list shows that Zeltiq remains committed to refining the CoolSculpting device, and is continuing to seek approval for its use in new body areas:

These various clearances are the result of rigorous supervised clinical trials – they were designed to prove the safety of each procedure, and its effectiveness over both short and long terms. FDA clearances may come with various caveats, such as limitation on the age of qualifying patients, or their BMI. CoolSculpting is currently the only cryolipolysis device cleared for use by the FDA in the US.

Some FDA clearances are also tied to specific variants of the CoolSculpting machine (including its applicator), hence the repetition in some cases.

Note: FDA “clearances” are not the same as “approvals”. The FDA only issues “approvals” when use of the device or procedure is considered high risk. Clearances are given for low-risk non-invasive cosmetic devices like CoolSculpting.

What Makes Someone a Good or Bad Candidate for CoolSculpting?

A good candidate for CoolSculpting would exhibit the following characteristics:

• having fat deposits that have stubbornly resisted exercise and dieting.
• has reasonable expectations.
• is looking for a safe, effective alternative to liposuction or surgery.
• has good skin elasticity and good skin tone.

Negative characteristics include:

• morbidly obese (BMI > 46).
• poor skin tone and elasticity.
• looking for an easy way to lose weight.
• expects to remove all unwanted fat.
• has sensitive skin or rashes in the are being treated.
• suffering from cryoglobulinemia, paroxysmal cold hemoglobinuria, or cold agglutinin disease.

Possible Side Effects

CoolSculpting can provoke a number of side effects (#3) in the treated area, all of which are temporary.

You may experience the following during treatment:

• Sensation of skin being pulling.
• Intense cold, with possible tingling, aching, or cramping.

Immediately after treatment:

• Redness and a feeling of firmness.
• Mild bruising at the edges.
• Tingling and/or stinging.

One to two weeks after treatment:

• Redness, bruising, swelling.
• Tenderness, cramping, aching.
• Skin sensitivity, itching, numbness.
• Back-of throat fullness sensation after submental and submandibular treatments.

There is a very small risk of developing PAH (Paradoxical Adipose Hyperplasia) after treatment. This condition can result in some fatty tissue thickening and expanding.

Finding the Best Practitioner in California

The FDA determined that the CoolSculpting device is a Class II medical device. This means that it can only be operated by licensed healthcare professionals, including suitably trained and certified doctors, nurses, and physician assistants. In California a licensed and trained aesthetician can only use the device when supervised by a physician.

You should look for a practitioner who is both medically trained and highly experienced in performing CoolSculpting procedures. In common with all other non-invasive procedures, using a trained and experienced practitioner will lead to better outcomes and fewer unwanted side-effects.

Your practitioner should also give you plenty of opportunity to ask as many questions as you need to set your mind at rest. They should also help set reasonable expectations, and ensure that you have no medical conditions that might lead to complications. They will of course discuss the financial aspects of the procedure or procedures. Don’t compromise on a practitioner who doesn’t set you at ease, or who appears too rushed to answer all your questions.

References

1. Selective cryolysis: a novel method of non-invasive fat removal.
   Dieter Manstein, Hans Laubach, Kanna Watanabe, William Farinelli, David Zurakowski, R Rox.
   Lasers Surg Med. 2008 Nov; 40(9):595-604.
   https://pubmed.ncbi.nlm.nih.gov/18951424/
2. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction.
   Nils Krueger, Sophia V Mai, Stefanie Luebberding, and Neil S Sadick.
   Clin Cosmet Investig Dermatol. 2014; 7: 201–205.
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079633/
3. CoolSculpting Safety Information.
   https://www.coolsculpting.com/pdfs/CSC125713-v3-CoolSculpting-Important-Safety-Information.pdf
4. FDA Clearances for Zeltiq CoolSculpting Devices.
   https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&productcode=OOK&knumber=&applicant=ZELTIQ%20Aesthetics%2C%20Inc%2E

Choose the Right Practitioner and the Right Filler

Avoid Excess Sun Exposure

Avoid Temperatures Extremes

Take Care of Your Skin

Adopt a Healthy Lifestyle

Follow Your Practitioner’s Advice

Your Laser Skin Care

Dermal fillers are well known as an effective way to combat wrinkles and fine lines and as a way to restore sunken areas, such as cheeks or under the eyes. However, they can also provide an effective treatment option for many types of acne scars, as described below.

What Kinds of Filler Are Used?

Hyaluronic acid-based fillers (the most common type) are widely used. Hyaluronic acid occurs naturally in the body, where its purpose is to hydrate and bind moisture. Hyaluronic acid fillers are used to fill in the skin under indented or sunken scar tissue; they can also serve to raise the skin surrounding raised scars, thereby evening out the skin surface.

Synthetic collagen fillers using Poly-L-lactic acid are also an option. They can be injected in a similar manner to hyaluronic acid fillers to compensate for sunken or raised scar tissue. These fillers can also serve to stimulate the body’s production of collagen, providing wider benefits as they improve the overall tone and texture of the skin. Synthetic collagen fillers are more effective when used on deeper scars.

Your practitioner should have the experience to be able to select the most suitable candidates from the wide range of available fillers – there are very many different formulations, allowing dermal fillers to be used to address a very wide range of cosmetic issues.

Limitations of the Procedure

Not all types of acne scars can be treated effectively using dermal fillers. In particular, treating deep scars or scars with sharply defined edges may not produce the intended results. Similarly, raised thick scars are not suitable candidates for dermal filler treatment.

Duration of the Benefits

Dermal fillers only provide a temporary solution. As they are made primarily from naturally-occurring substances, the body slowly absorbs and disperses the injected material. The length of time before needing to top-up the filler varies according to the filler, the part of the body being treated, and the patient’s metabolism. It will eventually be necessary to repeat the procedure to prevent the scars from becoming visible again. Benefits typically last between six and twelve months.

Other Treatment Options

There are many other ways of treating acne scars, including skin abrasion, chemical peels, laser resurfacing, and more invasive surgical techniques. Your practitioner should have the experience to be able to offer you a treatment plan adapted to your specific situation and needs, including a combination of different treatment types when appropriate.

Your Laser Skin Care

Your Laser Skin Care practitioners are medically qualified and very experienced in performing dermal filler procedures. We also have extensive experience with a wide variety of other non-invasive cosmetic procedures. We can help you choose the safest, most effective, and most cost-effective way to achieve your cosmetic goals. Call us at (323) 525-1516 to schedule a free consultation, or visit us online for more information.

Restylane is the name of a widely-used commercial range of dermal fillers. In common with most other dermal fillers, their primary ingredient is hyaluronic acid, a naturally-occurring substance found in the body that helps to retain moisture, a vital mechanism that not only influences how youthful and healthy our skin looks but is also a key part of how our body’s joints and eyes function.

Restylane fillers come in several varieties; the formulations vary depending on the intended usage. Some variants (such as Restylane Silk) prioritize a smooth texture and are intended for use in and around the lips. Other variants (such as Restylane Lyft) include ingredients that create stability over a longer distance. These variants can be used to fill in lost volume, for example, in the cheeks, where the filler may be injected over a larger area, and where it’s important that the filler not migrate away over time.

Restylane fillers not only add volume and fullness to the skin, but they are also very often used to treat wrinkles, fine lines, and other signs of aging. They can also be used to improve the appearance of many types of scars.

Benefits of Using Hyaluronic Acid

Restylane fillers are made from hyaluronic acid, a natural substance that is found in the body. As a result, there is a very low risk of allergic reactions or other side effects. Hyaluronic acid fillers allow particularly natural-looking results to be achieved when used by a skilled and experienced practitioner.

Restylane fillers are mostly used on and around the face, but they can also treat other body parts, such as the hands, that can exhibit wrinkles and loose skin. They can also be used to treat many types of acne and surgery scars.

Hyaluronic fillers are not permanent – the results typically last from six to twelve months, depending on the product, the area being treated, and the metabolism of the patient. One advantage of hyaluronic acid-based fillers is that they can also be removed or adjusted afterward by injecting a neutralizing substance (hyaluronidase) in cases where the initial treatment led to unwanted or exaggerated results.

The Procedure

The procedure for performing a Restylane filler treatment is relatively simple and non-invasive. The filler is injected directly into the skin using a fine needle, and the procedure typically takes about 30 minutes. The results of the treatment are immediately visible. The procedure is relatively painless, and the results are immediate.

Possible Side Effects

Common side effects include mild swelling and/or redness and bruising. These side effects typically last anywhere from a few hours to a few days. Less common side effects include lumps or bumps, itchy skin, or rashes caused by allergic reactions.

Before and After Treatment Precautions

Your practitioner will probably recommend avoiding blood-thinning medications for a week prior to each treatment, as well as recommending avoiding all sun exposure, excessive exercise, and alcoholic drinks for at least a day afterward.

The Practitioners Role

The skill and experience of the practitioner performing the treatment are crucial to achieving optimum results. Selecting an experienced practitioner is very highly recommended – they will be better able to evaluate your suitability for the procedure, select the most appropriate products and techniques for your particular case, as well as being able to effectively treat any unwanted side effects that may occur.

Your practitioner should also give you the opportunity to discuss the treatment and its expected results beforehand and provide you with answers to all of your questions and concerns.

Your Laser Skin Care

Your Laser Skin Care practitioners are medically qualified and very experienced in performing dermal filler procedures. We also have extensive experience with a wide variety of other non-invasive cosmetic procedures. We can help you choose the safest, most effective, and most cost-effective way to achieve your cosmetic goals. Call us at (323) 525-1516 to schedule a free consultation, or visit us online for more information.