from The Aesthetic Guide

THE Aesthetic Guide January/February 2013

This is a “peer reviewed magazine” I am treating you to what normally is only read by other physicians

” limiting factors of cryolipolysis ( fat freezing for us normal people ) “is only useful in areas where the fat will fit into predetermined sizes, so there is no way to really feather around,” he said. “You are simply taking a lump of fat, freezing it and ending up with a 20% reduction. Also, the apoptosis rate for cryolipolysis is three months versus a reduction in nine to ten days with Exilis. Thus treatment is much faster when you heat fat as opposed to cooling it.” Likewise, cryolipolysis does not tighten skin. “If you are dealing with skin flaccidity ( loose skin) over a lipodystrophic area, you are much better off treating all the layers with heat and creating some injury to the dermis and fat, and getting the skin to compensatorily tighten and take up the slack where the fat was,” Dr. Salzman commented. On the other hand, reportedly, one problem with focused ultrasound ( yet another procedure) can be associated pain.  

So for those of us who dont speak doctor he is saying that coolsculpting takes months vs  days for Exilis ( those are the two he is comparing)  He also mentions ultrasound in the last sentence, since there are also new machines that work with ultrasound.  He also says that if you use heat the skin will get “injured” so your body will tighten up and create new collagen offering you smoother tighter skin.  (PS we also dont like explaining in detail the process whereby the body creates new collagen. But I am sharing with you because I believe most people are intelligent enough that if you give them the facts they will understand and decide.


Exilis Tummy 5:16Exilis obviously a huge smooth result after 4 treatments.  This is a great result considering 4 treatments would be four weeks. Of course all before and afters are showing the best results

thighs 2 inchesExilis another great result 2 inches around the thighs


cool sculpting Not sure why they even posted this.

Is this the  one in a million best result after many months ?

Clearly not the best alternative or procedure for a variety of reasons.   People want fast results.  Exilis or Thermage clearly wins in that category.  The TV Show The Doctors reported 5 inches right off the table.  I think thats a lot, they may have pulled the tape too tight we regularly get a few inches after the one hour treatement.  Exilis is next results in 10 days according to research.  Our patients report seeing a really nice difference after the 3 or 4th treatment ( we do 6 for the body, Coolsculpting you see nothing for around 3 months, then as they admit you see what chunk of fat you have killed and go back in to do some more. Safety time on market, Thermage wins with over 14 years, next comes Exilis with around 9 years, lastly we are still learning about coolsculpting which is really just a few years now.  People dont lose weight so we have to assume the fat redeposits some place else.  We also hope that the people who experience and complain about lasting pain do not have nerve injury.  Time will tell.  Also one coolsculpting treatment can take from 2 to four hours vs 20 minutes for Exilis and one hour for Thermage.  It is way more painful than Exilis which feels like a warm stone massage although Thermage is painful. In fact considering number of treatments and cost its not cost effective for the patient.  It is the treatment for the low information patient who doesnt want to spend 5 minutes researching before they give away thousands of dollars, and also the treatment of choice for those who respond to advertising and assume that the one who advertises the most is the best.  Nothing could be further from the truth.  Thermage is the favorite of Hollywood and celebrities like Gwynth Paltrow, Demi Moore, Jennifer Aniston  to name a few that admit to loving the procedure.  So Thermage doesnt have to advertise.  And as I said if you dig even deeper you will see where Exilis is better than Thermage.  But hey thank god advertising works if not our whole economy would be in trouble.  Coolsculpting knows that if they spend 45 million advertising they will create another billion in treatments and sell thousands of machines.  All is well until the public actually understands there are other non surgical options and actually do the research and use their common sense and trust their intuition to choose the best one. I was just speaking to a prospective new patient today  ( thats what I do) She said it makes no sense to do a treatment that doesnt affect the skin at all.  She figured that out on her own.  I also have spoken to many new patients who have told me that they have friends who did Coolsculpting who come out lumpy and they were therefore not even considering it as an option. So we shall see how it goes for the next few years until the knowledge is more public.  I am doing my part.  By the way this would not be the first hyped system that falls away in the market place.  We have tested many machines that did not live up to the hype or were not as good as ones we already have.  My guess is that as long as there are “results” and a lot of advertising it will probably be around for a while.  For some reason people more easily relate to apoptosis ( killing fat cells) via freezing vs melting, I have no idea why, but I would guess its advertising.