INDEX
• - What is CoolSculpting?
• Process: Treatment considerations.
• Concern: What happens to the fat?
• Overview of fat cell reduction techniques.
• Alternate: Tumescent Liposuction.
• Drawbacks that some persons will experience.
• Relevancy: What is the Reality & Effectiveness?
• - Article: Why we said NO to offering CoolSculpting.

• Product: C-BURN [MAX].
• Product: Phen375 Fat Burner Supplement.
• Product: Belt, Cold Lipolysis Body Shaping.
• Product: Belt, FatFreezer-Reduction Machine.
• Product: Belt, Cryolipolysis-Lipo-Cold-Freeze-Fat.

What is CoolSculpting? INDEX
https://www.coolsculpting.com/what-is-coolsculpting/how-it-works/

LINK 2: https://www.coolsculpting.com/what-is-coolsculpting/
LINK 3: https://www.coolsculpting.com/what-is-coolsculpting/faqs/#faqs
LINK 4: https://en.wikipedia.org/wiki/Cryolipolysis

The number of fat cells in our bodies typically becomes a fixed number sometime in our teenage years.
Losing or gaining weight generally does not increase or decrease the number of fat cells. Instead, it changes the size of fat cells.

Popsicle panniculitis is a dermatologic condition that shows that exposure to low temperatures can selectively damage subcutaneous fat while leaving skin intact. Based on the premise that fat cells are more easily damaged by cooling than skin cells, cryolipolysis was developed to apply low temperatures to tissue via thermal conduction. In order to avoid frostbite, a specific temperature level and exposure are determined, such as 60 minutes at -5 °C (23 °F).

Years ago, scientists at Harvard University observed that some children who ate popsicles got dimples in their cheeks.
The scientists -- Dieter Manstein, MD and R. Rox Anderson, MD -- realized that the popsicles were freezing and eliminating small pockets of fat cells.

The idea that cold can target fat cells -- without damaging the skin or surrounding tissue -- was the insight behind cryolipolysis, the proven science on which the CoolSculpting procedure is based.

CoolSculpting technology safely delivers precisely controlled cooling to gently and effectively target the fat cells underneath the skin while leaving the skin itself unaffected.

CoolSculpting systems are the only controlled cooling devices that are designed with built-in safety measures.
If sensors detect that the skin is getting too cold, the system will shut down automatically.

In the U.S., the CoolSculpting procedure is FDA-cleared for the treatment of visible fat bulges in the submental area, thigh, abdomen and flank, along with bra fat, back fat, underneath the buttocks (also known as banana roll), and upper arm.

In China, the cryolipolysis system is used for fat layer reduction of the abdomen and flanks.

In Taiwan, the CoolSculpting procedure is cleared for the breakdown of fat in the flank (love handle), abdomen, and thigh.

Process: Treatment considerations. INDEX
https://www.coolsculpting.com/what-is-coolsculpting/what-to-expect/

Controlled cooling is delivered via an applicator to freeze the targeted fat.
Though you may feel intense cold initially, this feeling usually subsides within 5 to 10 minutes as the area numbs.
Because most applicators use a vacuum to draw fatty tissue into the applicator cup, you may also feel some pulling, tugging, and/or mild pinching.

After you and your physician select the area(s) to be treated, the device is positioned on your body and controlled cooling is applied.
A gel pad and applicator are applied to the targeted area.
Vacuum applicators draw the tissue into the applicator cup.
Applicators are secured to the treatment area. All applicators deliver controlled cooling to the targeted fat.

Following the procedure, typical side effects include
• temporary redness,
• swelling,
• blanching,
• bruising,
• firmness,
• tingling,
• stinging,
• tenderness,
• cramping,
• aching,
• itching, or
• skin sensitivity.

Sensation of fullness in the back of the throat after submental area treatment.
These effects are temporary and generally resolve within days or weeks.
Though rare, some additional side effects may occur.

Concern: What happens to the fat? INDEX
https://www.realself.com/question/new-york-ny-happen-the-fat-and-eliminated-after-coolsculpting

What EXACTLY happen to the fat and how is it "eliminated" after CoolSculpting?
I understand cells are "destroyed & "eliminated naturally" but that doesn't answer the question:)
HOW exactly ? Research revealed fat is reabsorbed into the bloodstream, but unless one decreases calories or goes for a run - won't that fat then be reabsorbed & (horror!) relocated, to let's say: my thighs, if I don't burn it off? I'm worried I'll end up w/ a fat neck! If I now have to run miles to prevent reabsorption of "released fat"... isn't that what I should have done to begin with? Groan ....

Coolsculpting permanently removes body fat.
The process “grabs and holds” bulges of body fat with a suction applicator then cools the deep tissue to temperatures that result in death of fat cells which are far more sensitive to the low temperatures than the other tissues of the body. Skin, blood vessels, and healthy muscle fibers are preserved. The term for this specific programmed cell death is “ cryolipolysis” from the prefix “cryo” that means “cold” and the word “lypolysis” which means “breakdown of fat”. All destroyed components of the cell are taken up and eliminated through the lymph system and permanently eliminated. Fat is not reabsorbed. The treatment results in fat reduction in targeted areas and the re-sculpting of the anatomy.
Frank J. Baron, MD
Mercer Island Dermatologist
8435 SE 68th St., Ste. 118
Mercer Island, Washington 98040 US
(206) 232-7546

During the procedure, exposure to cooling causes fat cell apoptosis, which leads to the release of cytokines and other inflammatory mediators. Inflammatory cells gradually digest the affected fat cells in the months after the procedure. Lipids from the fat cells are slowly released and transported by the lymphatic system to be processed, much like fat from food. Because the lipid clearance process is gradual there is no harmful change in blood lipids or liver function. The fat will not be reabsorbed or go to another part of your body.
Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
1501 Forest Hill Blvd.
West Palm Beach, Florida 33406 US
(561) 571-8395

A Coolsculpting treatment uses a method called cryolipolysis (fat freezing) once the fat is frozen it goes through apoptosis (programmed cell death). This usually occurs a few days after your procedure and is aided by the immediate post treatment massage.

After fat cells die, your body naturally consumes the affected cells so they can be filtered and excreted by the body.
Since the fat cell is dead there is no way that it can be relocated to another area.

The process of elimination of the affected cells from your body generally takes about 3-4 months to complete, and is the same process that eliminated fat goes through as if it was burned off with exercise. Immediately after treatment you can be swollen for up to 2 weeks and many patients start seeing the initial improvement starting 3 weeks after their treatment.

A Coolsculpting treatment destructs about 20% of the fat in the treated area; sometimes multiple treatments in the same area are necessary for the best results. ...
LINK: http://www.totaldermatology.com/body-contouring/coolsculpting/
Nissan Pilest, MD
Irvine Dermatologic Surgeon
Irvine Medical and Science Complex
16100 Sand Canyon Ave., Ste. 190
Irvine, California 92618 US
(949) 344-2453

After the process of CoolSculpting is completed, the lipid contained inside the cells is gradually removed via the lymphatic system and then eliminated (as fat normally is) through the feces and urine. The process of fat removal may take weeks to months, which in fact makes the CoolSculpting process very safe in terms of how the levels of lipid in blood are maintained with this treatment. We were part of a multi-center study that checked what happened to the triglyceride and cholesterol levels at 1 week, 4 weeks, 8 weeks and 12 weeks after CoolSculpting. There was no significant change in such levels after the CoolSculpting treatment, confirming the safety of this procedure.
Leyda Elizabeth Bowes, MD
Miami Dermatologic Surgeon
Northeast Coconut Grove
3659 S. Miami Ave., Ste. 6008
Miami, Florida 33133 US

Coolsculpting is an excellent form of non-invasive fat reduction for the right patient.
Some applicators take 1 or 2 hours but the new advantage applicators take only 35 minutes and have significantly less risk for delayed onset pain (especially in the abdomen). Results are seen at 2 months and typically 1-3 treatments will be necessary on each area to achieve ideal results. The number of treatments depends on the amount of fat there and the patient's goals. There is not downtime and the results can be impressive in the right patient. We also use the Zimmer Z-wave for improved patient comfort and added results. The best candidates are those who are in pretty good shape with areas of stubborn fat that won't go away no matter what.
Sheila Nazarian, MD, MMM
Beverly Hills, Board Certified Plastic Surgeon

... There is no fat that is absorbed into the blood system as this could cause something known as fat embolism which would be quite dangerous. ...
Paul Flashner, MD
Boston Physician
Back Bay East
209 Newbury St.
Boston, Massachusetts 02116 US
(844) 325-8292

Overview of fat cell reduction techniques. INDEX
https://health.clevelandclinic.org/
does-fat-freezing-and-non-surgical-body-sculpting-work/
by Dermatologist Shilpi Khetarpal, MD
https://my.clevelandclinic.org/staff/19843-shilpi-khetarpal
Cleveland Clinic Main Campus
Mail Code A61
9500 Euclid Avenue
Cleveland, OH 44195
December 11, 2017 --- By Family Health Team

1. Cold treatments (CoolSculpting).
   These employ temperatures cold enough to kill fat cells but not damage your skin.
   A device pulls portions of skin in by suction, then cools it to destroy the fat underneath for a set amount of time.
   You can use this procedure on many body parts including the chin, arms, abdomen, love handles and thighs.
   It’s safe for most patients. However, those who have a vascular condition that makes them extra sensitive to cold temperatures (Raynaud’s syndrome, for instance) should not use this treatment.

2. Heat treatments (SculpSure).
   This laser is FDA-approved for fat reduction.
   The device uses laser energy to damage the structure of fat cells.
   The body then eliminates the dead cells.
   This device uses a flat applicator, so it doesn’t work well on body areas with curves.
   Heat treatments work best for the stomach and thighs.

3. Ultrasound energy (UltraShape).
   This type of treatment uses ultrasound energy to break down fat.
   It is the most time-intensive of the four types, taking approximately one hour per treatment session.
   Instead of hooking you up to a machine, a technician will move the device around manually.
   It uses a mechanical vibration to break down and destroy fat.
   This works on the abdomen and isn’t meant for other areas, Dr. Khetarpal says. There is no discomfort, she says.

4. Radiofrequency energy (truSculpt, Vanquish).
   Radiofrequency devices deliver energy to create heat and destroy fat cells.
   They target water in the cells, so it’s important to hydrate your body well beforehand, Dr. Khetarpal says.
   The treatment is not as effective if you’re dehydrated. You might feel a warm sensation during this procedure, she says.

Alternate: Tumescent Liposuction. INDEX
https://dermahealthinstitute.com/treatment/tumescent-liposuction/
Derm Health Skin & Laser
480-470-5747 --- 5 clinics in Phoenix, AZ, USA
Dr. William Shuell
CareCredit Financing: .../financing-options-derma-health/

LINK 2: https://www.realself.com/question/How-much-does-tumescent-liposuction-cost

LINK 3: https://www.tcclinic.com/surgical/liposuction/tumescent/
LINK 4: https://www.tcclinic.com/surgical/liposuction/cost/

TCC (Toronto Cosmetic Clinic)
5400 Yonge Street #110
Toronto, Ontario, M2N 5R5, Canada
(416) 221-5554 or (416) SURGERY
(also, Helpful LINKS)

Tumescent liposuction or (liposculpting) is a minimally invasive, outpatient procedure eliminating stubborn, unwanted fat.
The procedure takes about two hours and sculpts your body for immediate dramatic, smooth results.
The procedure reduces the risks associated with traditional liposuction for quick recovery time and little residual pain.

You should be in good health and free of medical conditions such as diabetes, untreated high blood pressure, significant heart disease or blood clotting disorders.

... The wet technique of tumescent liposuction entails adding sterile fluid to the treatment area before liposuction begins.
This fluid contains anesthetic to reduce pain during the procedure. Because of this added anesthetic, and because the wet technique makes tumescent liposuction easier on the body, general anesthesia is usually not necessary, depending on the treatment area. Adding this fluid also results in less blood loss, and does not require a blood transfusion.

Then, as liposuction is performed, targeted body fat is suctioned out of the subcutaneous tissue, along with a portion of the added solution. Some of the fluid will remain in the body for several hours after the procedure and will slowly drain out during recovery. ...

The tumescent technique with local anesthesia involves the injection of large volumes of very dilute lidocaine (local anesthetic) and epinephrine (drug that shrinks capillaries) into subcutaneous fat. With the tumescent technique, the volume of dilute lidocaine injected into fat is so large that the targeted areas become swollen and firm. The tumescent technique produces profound and long-lasting local anesthesia of the skin and subcutaneous fat preventing pain during and after treatment. This eliminates the need for general anesthesia, sedation or prescription pain medications.

All regular day-to-day activities may be resumed almost immediately, with the exception of impact exercise such as jogging or contact sports. Patients should wait seven days before swimming. You may walk, fast-walk, use free and fixed weights and stretch the day after your procedure. Unlike other forms of surgery, minimally invasive liposuction allows you to get back to normal as soon as you wish.

The limiting guideline is likely to be soreness as your body heals itself over time.
The soreness usually is most obvious for the first three to seven days. Over the counter acetaminophen (Tylenol) is usually effective to keep you active.

Benefits

1. Tumescent liposuction does not require hospitalization or blood transfusion.
   You may even be able to go home the same day.

2. Some tumescent solutions contain epinephrine, which provides excellent hemostasis (inhibition of bleeding) due to its vasoconstrictive (narrowing of blood vessels) properties.

3. Tumescent liposuction usually doesn't require general anesthesia, which presents risks to the patient such as fluid overload with the possibility of pulmonary edema, the development of a fluid sac in the lung which could lead to respiratory failure.

4. The amount of blood removed along with fat is as little as 1% or less.

5. The slow absorption of the tumescent solution into the subcutaneous tissue allows for gradual intravascular volume replacement. This maintains equilibrium within the body throughout the procedure, minimizing the risk of complications.

6. The anesthesia is slowly drained from the body, which means you are still anesthetized after the procedure, thereby minimizing pain. This reduces the need for too many additional medications, and reduces risk of complications. This can also reduce cost.

COSTS, Suggested from other Sites:

... The cost of each area runs from $1200 to $2500.
Common areas include the abdomen, upper hips, outer thigh/ buttock, inner thighs, and back. ...

... The prices can vary from state to state, and city to city. We charge for liposuction per area. The abdomen (upper and lower side to side) is one area. The waist (from the ribs to just above the buttocks from side to side around the back) is one area. The thighs (both inner and outer) is one area. Our costs, including the board certified plastic surgeon's fees, board certified anesthesiologist's fees, operating room, labs, garment, vitamins, and follow-up at 1 day, 1 week, 1 month, 3 months 6 months, and every year after forever, are listed below. If you need more follow-up appointments, those are free as well. The cost per area does go down as you add more areas:

One area: cost per area around $5000. Two areas: cost per area round $3200. Three areas: cost per area around $2500

When comparing quotes from different doctors, check to make sure that the costs you are quoted are for the same thing! For instance, often the cost per area is quoted as lower, yet the abdomen is comprised of upper and lower, and sometimes even lateral areas (2 to 4 areas for the abdomen, instead we consider the entire abdomen one area) or the thighs are inner and outer (2 areas when we consider the thighs one area). Make sure you are comparing apples to apples. Also check to see what type of anesthesia and facility you are going to be treated in. If the total price is lower but you are not going to receive proper anesthesia from a board certified anesthesiologist, then are you getting a better deal (or inferior treatment)? If the facility is not a certified outpatient surgery center but is an in-office procedure room, is the difference in safety worth the cost reduction? If the doctor is not a board certified plastic surgeon, is that worth the discount in the fees? I would say the answer to all three of these questions is no! ...
Gary Lawton, MD, FACS

San Antonio Plastic Surgeon
Far North Central
525 Oak Centre Drive, Ste 260
San Antonio, Texas 78258 US
(210) 960-8526 

... It’s often assumed that tumescent liposuction using only local anesthesia is less expensive than traditional liposuction because general anesthesia is not utilized. In the vast majority of cases, this approach is more expensive because operative times are longer and this represents a significant source of expense.

The term tumescent liposuction appears to mean different things to different physicians based on their surgical backgrounds. The term tumescent means to engorge, and tumescent liposuction involves infusing fluid into the anatomic area that will be undergoing liposuction. This fluid contains epinephrine, which minimizes bleeding and local anesthetic which helps with post-operative pain relief. When this approach is utilized the technique can be performed in some cases without general anesthesia. Many surgeons prefer general anesthesia when they utilize tumescent technique because break through pain can occur when local anesthesia is used alone.

Tumescent liposuction costs vary and are dependent upon multiple factors.
These include the surgeon’s fee, facility fee, anesthesia charges and location of the procedure.
Tumescent liposuction and traditional liposuction have similar cost if other variables are constant.

In the Midwestern United States, liposuction fees range from $2,700 to $3,600 per anatomic area.
This would typically include the surgeons fee, facility fee, anesthesia charges and after care. ...
Richard J. Bruneteau, MD

Omaha Plastic Surgeon
Central Omaha
8900 W. Dodge Rd.
Omaha, Nebraska 68114 US
(402) 512-4389 

At TCC (Toronto Cosmetic Clinic), the price for just one area of the body starts at $5,000 plus tax.
This includes the following:
• Local anesthesia (appropriate for very small areas)
• Skilled and experienced surgeon
• Skilled surgical staff
• Surgical tools and equipment
• Clinic operating room accreditation
• Compression garments


Factors that can Affect Costs:
1. Number of Procedure Areas, $3,000 for extra areas
2. Type of Anesthesia, General is $1,000 extra
3. Hospital or Clinic Facilities, depends on patient concerns ..
4. Overnight Stay, in hospital or locally
5. Home Medical Assistance
6. Scar Treatment removal/fading.

Risks:
Two risks that are unique to tumescent liposuction are lidocaine toxicity and fluid accumulation.
Lidocaine toxicity occurs when the amount of lidocaine in the tumescent solution is too high, making it difficult for the body to adequately metabolize the drug. When too much solution is injected into the treatment area, it is possible for fluid to accumulate in the lungs.

Drawbacks that some persons will experience. INDEX
This is a personal summary of the content of many posted "patient" disappointments.

1. Lifestyle:
   A resistance and denial to improve a weight gain diet towards something of better weight and nutritional balance my result in a person losing SOME fat cells, only to bulk up ever more the remaining ones.

2. Drug Interactions:
   Both legal, illegal, and recreational drugs can reduce or even eliminate any benefit which may be gained from one or more of the ingredients in the "Fat Burner" supplements.

3. Lower Cost Spot Reducing:
   Using smaller CoolSculpting devices will only enable small more highly defined areas to be treated.
   Without careful placement of the device and its application over a wide area, uneven, patchy, lumpy results may result.
   This will be aggravated if certain areas are treated multiple times, yet, adjacent areas are not treated at all.

4. High Cost:
   Quoted service costs can often range between (USA or Ca) $750 to $1500 per session with each session limited to an equipment coverage area and with an effectiveness that may be limited to the treatment duration. Consultations may be initially required services with fees between $300 and $600. CoolSculpting therapy is recommended for application up to 3 times per target area with each repeat application taking place between 3 and 6 weeks apart. Travel arrangements may add to costs. The use of Fat Burner supplements can range from $100 to $500 per month with expected durations of use ranging from 3 to 6 to 9 months, depending on the amount of fat to be reduced and other relevant personal factors.

5. Professional Incompetency; Operator Greed:
   There are reports of patients receiving as many as 12 treatments over a period of TWO days.
   For a cost of over USA $10,000, they notice little if any change months later.
   For many individuals, they would NOT have a lymph system which was healthy enough to cope.
   For ANY lymph system to clear away that much potential cell damage effectively, the person would have to indulge daily in considerable lymph activity lifestyle behaviors such as very light pressure lymph massage, long sonic massage sessions, long periods of walking, running, swimming, ... and/or longer periods of Hot House infrared therapy, steam baths, or sauna sessions. To this, also on a continuous basis, for their lymph to work efficiently, and, in accord with their metabolic system and blood type food requirements ... a long duration increase in fluid intake, a decrease in dairy products, and a possible restraint on starches and all prepared foods, and, most sugars ... would likely be mandatory.

   A more gradual use of the technology would place less elimination strain on one's lymph system and could result in fewer potential health complications. IF the burden resulting against the lymph system, especially if it is not in the best of health to begin with, could encourage the development of and appearance of health difficulties that mirror toxin overload.

   • a blocked lymph system;
   • inflammation and enlargement of lymph nodes;
   • increases in pain, stiffness, arthritis symptoms;
   • assimilation and digestive complications;
   • cognitive and mental decline;
   • cancers.

An oversimplification of the health reality and dynamic of the individual may sabotage ALL results.
If the person is already under the health burden of high levels of mineral and chemical toxins, has an under-performing thyroid or adrenal glands, has clogged or impacted intestines, is experiencing high blood pressure and low circulation viability, or, is overweight and/or diabetic ... any and MOST of these may require improvement before an effective CoolSculpting or Fat Burning regime is considered.

Relevancy: What is the Reality & Effectiveness? INDEX
https://www.realself.com/question/Tumescent-liposuction-vs-smart-lipo
Comment/Post by Armando Soto, MD, FACS

Aesthetic Enhancements Plastic Surgery & Skin Care Center 
Orlando Plastic Surgeon
7009 Dr. Phillips Blvd., Ste. 100
Orlando, Florida 32819 US
(407) 219-9042 

... In well motivated patients, body contour improvement can be a very healthy endeavor, but how is an otherwise intelligent and well-adjusted person to know the difference between a responsible provider of aesthetic services offering them safe options for help with their body contour and a poorly trained and inexperienced provider more interested in their wallet than in their outcome and safety?

It is first important to realize that all of these devices will require you to undergo a liposuction procedure.
The only difference is the approach to the treatment of the fat prior to its removal.

Because they all involve liposuction, and this is in fact a surgical procedure, it is very important that you "do your homework" and find a surgeon certified by The American Board of Plastic Surgery who has the years of training in liposuction necessary to give you the safe experience and superior outcome you deserve and desire.

Behind the amazing number of machines now available to remove your fat, there has followed an army of their sales representatives and an equally impressive number of providers marketing themselves as "liposuction experts".

What has made them "liposuction experts"? In almost all cases, a few days or weekends training with the salesman for the device or with someone more experienced in the procedure. It is their promise that if you have the device in their possession brought to bear on your behalf, your fat will be gone, your skin will miraculously shrink away, you won't need any anesthesia because the device allows painless removal of the fat, and it can be done on your lunch hour. The only thing I am surprised by at this point is that they don't promise you'll get rich and be more sexually alluring after the procedure too.

Selling the particular device to patients is not unlike someone saying to you that because they will give you access to Tony Stewart's racing car that you will be able to win this weekend's race and make a million dollars. Tony Stewart wins races because he is a great racing car driver AND he has a great car .... This is no different...

Getting the best outcome from a body contouring procedure depends most on finding a well-qualified and experienced surgeon, and much less on the device used.

Most of these people are so aggressive in their marketing of these questionable devices because they are, in fact, not trained plastic surgeons but rather are either not physicians at all, or they are doctors with core training which would not have prepared them to do liposuction. Many have read recently about a death in my home state of Florida after a healthy 40ish year old mother had liposuction performed be a rehabilitation medicine doctor. Amazingly, I know of eye doctors (!!) doing liposuction as well- and yes, they market themselves as "liposuction experts".

The particular device used can affect the overall experience, however.

Despite the claims of the manufacturer and the practitioners who plunked down the large sum the device costs, Smartlipo has never been proven to shrink skin better than tumescent liposuction. SmartLipo, SlimLipo, Prolipo, and Coolipo all use a laser to destroy the fat cells, allowing them to be removed by liposuction. My problem with these is that, first of all, as a scientist and doctor I am offended when false claims of benefit are made, and that because the lasers will burn whatever you point them at, I worry that your nerves, blood vessels, muscles, and skin may be injured by the laser. In fact, I see at least one patient every month with severe contour deformities and injuries after being treated with one of these devices by a local "liposuction expert".

Bottom line (and in my opinion) - there is no benefit to these devices, they are expensive (meaning that the cost to you, the patient, will be higher as well), and the risks are higher.

Tumescent liposuction is the gold standard to which all other techniques must be compared.
It has been proven to be safe and effective over many years (provided that it is performed by a well-trained surgeon).
It involves the injection of a fluid into the fatty tissue layer that causes blood vessels to shrink and the fat to expand, making it easier to remove and lowering the risk of a complication.

VASER lipo involves an additional step, in which the fat (after injection of fluid but before suction is applied) is treated with ultrasound energy. Unlike the laser filaments used in SmartLipo and the other devices mentioned above, the VASER probe is blunt and the ultrasound energy it uses is much more specific for fat, so that the risk of injury to the blood vessels and nerves, as well as the muscles and skin are much lower. This is seen in the patient experience of reduced swelling and bruising.

Each time a new (revolutionary!) liposuction machine comes out, I think the most important questions to ask are not "Does it work?", but rather, "Does it work better than what is already available, is it less expensive (not more), and is it safer than what is already available?"

The VASER (in my opinion) passes this test, while the laser based devices do not.

Having said all of that, I would emphasize that it is the education, training, experience, and skill of the surgeon at the end of the liposuction device that will make the greatest difference in your outcome and safety. There is not substitute for the years of training Board Certified Plastic Surgeons receive in liposuction, directly supervised by other Board Certified Plastic Surgeons. A well trained and Board Certified Plastic Surgeon would be more than capable of achieving a better outcome through tumescent liposuction than any eye doctor with a Water Jet. As in the analogy of Tony Stewart above- a great professional with a great tool (like the VASER) would only make those results and their safety even greater. ...

Zeltiq, purchased by Allergan in 2017, is the exclusive licensee to the patents relating to cryolipolysis that are owned by Massachusetts General Hospital.

Article: Why we said NO to offering CoolSculpting. INDEX
https://dermahealthinstitute.com/blog/decided-not-offer-coolsculpting-derma-health/
Derm Health Skin & Laser
480-470-5747 --- 5 clinics in Phoenix, AZ, USA
January 1, 2018

Over the last six years, CoolSculpt has been performed on thousands of people and the technology has now evolved to meet our standards of excellence, proving to be more than a fad.

1. CoolSculpt now has a very high patient satisfaction rating, with patients reporting a 25% decrease in fat with only 1-2 treatments with no surgery and no down-time.

2. CoolSculpt has also reduced the time it takes to have a treatment from 1 hour to 35 minutes per area.

3. CoolSculpt now offers ‘dual-sculpting’ – which is using two CoolSculpt machines at once to treat 2 areas at the same time, making the process easier and more convenient for the client.

4. Allergan, the makers of Botox and Juvéderm purchased the technology in 2017, providing much technological backing and support for this body contouring option.

While Tumescent Liposuction still gets a more effective result with minimal to no down-time, there remains a large group of the population who want a ‘lunch time’ solution. Derma Health has come full circle in offering three options for body contouring:

    CoolSculpting – freezing fat cells (non-invasive)
    BTL Exilis Ultra – body contouring and fat reduction using heat (non-invasive)
    Tumescent Liposuction – removing fat cells and contouring the body (minimally invasive) 

Why we said ‘NO’ in 2016 to CoolSculpt
In 2016, we considered offering CoolSculpting to our repertoire of body contouring options. Below are the reasons why we said, ‘no’ and you will see our responses to the technology in 2018.

2016: CoolSculpting stated in its press release that one can expect an average of 20% improvement and that multiple treatments are usually needed. Only 5% of our staff saw noticeable results and most thought it was an uncomfortable procedure. Many also experienced painful post treatment symptoms for about two weeks!

2018: Clients of CoolSculpt are now seeing up to a 25% reduction in fat in treated areas.
Our staff have seen considerable results themselves and report the treatment to be much more comfortable than before! (image below from actual DHI employee)

2016: CoolSculpting treatments appear to be a low-cost alternative to tumescent Liposuction, but actually end up costing thousands of dollars after performing multiple treatments. In the long run, repeated CoolSculpting treatments are more expensive and less effective than tumescent liposuction.

2018: Because CoolSculpting is now seeing greater results with fewer treatments, CoolSculpt is now a reasonable solution for body contouring.

2016: The long term health effects of CoolSculpting’s aggressive tissue cooling are not known.

2018: CoolSculpt has proven to be a safe treatment for surrounding tissue.

2016: The CoolSculpting machine can only grab a small amount of fat at a time and takes an hour for every small area.
The abs, for example, require two hours. If you have treatments done for your love handles, which are very popular, that would be another two hours. To get the maximum results with CoolSculpting for these areas, it would take three treatments and a total of twelve hours.

2018: CoolSculpt now comes with various size attachments, allowing a targeted and controlled treatment.
These various pieces are crafted to fit different body parts, offering a more thorough treatment. This means clients do not need as many treatments as before. Further, CoolSculpting now offers ‘dual sculpting’, which cuts treatment times in half!

2016: Weight loss fads come and go. These can be very tempting because they seem to offer what the patient wants — claims such as “non-surgical” and “less expensive”. First there was SmartLipo, Zerona and Bodytite. Today it’s CoolSculpting.

2018: While it is true that fads come and go, CoolSculpting has only grown in popularity, due to the increasingly positive results. The technology is now tested through time and has won Derma Health over!

Product: C-BURN [MAX]. INDEX
https://www.canadianprotein.com/c-burn-max
Spec Ca $49.99 --- MSRP: Ca $69.99 --- You save: Ca $20.00 (28.58%) -- 2018-04-22
Product Number: 31D --- 60 doses
Recommended: 3 caps twice daily = 6 caps/day --- Ca $5.00/day

Based upon C-BURN, C-BURN [MAX] is an even more potent and powerful fat burning supplement that provides copious amounts of mental and physical energy, along with hugely impressive fat loss results. Enriched with potent, powerful, and all-natural ingredients, all blended together ... losing body fat is a tedious, time consuming, and stressful process that is extremely difficult. C-BURN [MAX] is designed to be used when diet and exercise just are not enough. ... the results will quickly become noticeable ....

Increased metabolism
... not only will you find it easier to lose weight, you will also find it tougher to gain fat, because your metabolism will be burning through so many calories. This is useful for training, as the increase in metabolism means that you will generate more energy as a result.

Scientifically proven formula
... contains powerful and potent ingredients which have been scientifically proven to speed up fat loss within the human body. The ingredients are designed to work in synergy with one another, providing you with a fat burning supplement you can trust.

Fat loss
As you might have expected, the primary benefit associated with C-BURN [MAX] is fat loss.
C-BURN [MAX] is enriched with powerful and natural stimulants, herbal ingredients, and other proven nutrients which are designed to speed up fat metabolism and other physiological processes, allowing your body to burn through calories and stubborn body fat ...

Weight loss
... helps users to lower their weight ... eliminate water retention, so you look less bloated, and weigh less as a result. This provides a psychological benefit when you step on the scales. Plus, if you are an athlete and have to make weight for your chosen discipline, C-BURN can also prove very useful.

Caffeine
Caffeine is a natural stimulant which is extracted from camellia sinensis plant leaves.
Once consumed, it provides physical and mental energy increases for the human body, and initiates thermogenis which raises the core body temperature, and subsequently increases the metabolism. This is very important for a fat burning supplement because the faster your metabolism is running, the more fat you will burn through as a result.

L-Theanine
L-theanine is commonly found in tea leaves and is an amino acid which is beneficial for the immune system.
In terms of fitness however, its real benefits lie in its mental health boosting abilities. L-Theanine has been found to improve cognitive function, helping to improve mental focus, alertness, and concentration levels. When training, this is very important as it helps get you in the right frame of mind before you even pick up a weight or set foot on a treadmill. The more focussed you are, the more fat you will destroy as a result.

Forskohlii
Forskohlii is actually a natural herb which is found in parts of India and Asia.
It is actually related to the mint family and is renowned for its numerous health and fitness benefits.
Studies have found that concentrated dosages of Forskohlii have been found to increase natural weight loss by providing an increase in the metabolism. What’s more, numerous clinical studies have also found that the herb can actually prevent weight gain, making it harder for your body to store body fat.

L-Carnitine
L-Carnitine is another amino acid that is incredibly beneficial for when it comes to fat loss.
This is because it plays a vital role in the metabolism of fat. This basically means that it is vital for ensuring that our bodies take fat, both from our diets and from our own fat cells, and convert it into energy to provide fuel for our bodies. The body is able to produce Carnitine, yet not in dosages high enough to prove beneficial for fat loss. L-Carnitine transports fats, as well as enzymes responsible for the breakdown and metabolism of fats, to the mitochondria of our cells. The more we can supply the cell mitochondria with, the more efficient the body becomes at breaking down fat and converting it into energy.

Synephrine
Synephrine is sometimes known as bitter orange extract, and as you may have guessed, it is a natural orange extract, sourced mainly from the peel of bitter oranges. This alkaloid is very powerful and has significant fat metabolizing properties. From a molecular standpoint, Synephrine is very similar to ephedrine, which is another very powerful fat burning compound that is banned in most parts of the world. Despite being similar, it is a great deal safer than Ephedrine. It has a potent effect on the adrenal system within the body, which subsequently increases adrenalin productions, and can therefore boost your resting basal metabolic rate by as much as 70%.

5 HTP
5 HTP is naturally derived from tryptophan, which is an amino acid.
5 HTP, once consumed is actually converted into a neurotransmitter in the brain which is known as serotonin. Serotonin provides a number of roles within the human body, many of which are based upon improving your mood, and increasing your relaxation levels. In terms of weight loss however, serotonin also has an effect on your appetite. Serotonin helps to suppress your appetite and your cravings, meaning you eat less, you stay full for longer, and you crave less junk food. This is obviously very useful for somebody looking to lose body fat.

White willow bark extract
Another very powerful and important ingredient contained in C-BURN [MAX] is white willow bark extract.
Also known as Salix Alba, white willow bark extract dates back thousands of years, and has been a key ingredient in many alternative medicines for centuries upon centuries. It provides similar chemical properties to aspirin, so it functions as an anti-inflammatory, as well as a natural pain killer as well. The bark itself contains active compounds, including salicin, which has been found to have a positive effect on the metabolism.

Piper Nigrum
Piper Nigrum, better known as Black Pepper Extract, is very useful because it has been found to provide such a substantial increase in a person’s metabolism. It boosts the metabolism substantially, which means that your energy levels increase as you burn through calories and stored body fat. This, along with the caffeine, means that your body fat levels drop drastically as you are literally fuelling your workout with your own body fat. Piper Nigrum has also proved to be very effective when used to improve cognitive function, which is important for weight loss as it helps you to focus during your training sessions, and to get into a better mind set to commit to an effective diet and exercise regime in the first place.

C-BURN [MAX] Ingredients
Per Dose / Capsule
Medicinal Ingredients: per dose / per capsule

Caffeine (1,3,7-Trimethylxanthine) ....................................... 160 mg /  53.33 mg
L-5-HTP (5-Hydroxy-L-tryptophan, 5-HTP, Griffonia simplicifolia - Seed) .. 100 mg /  33.33 mg
L-Theanine ............................................................... 125 mg /  41.67 mg
Synephrine (4-Hydroxy-alpha-[(methylamino)methyl]benzenemethanol) ......... 20 mg /   6.67 mg
Forskohlii (Plectranthus barbatus, Root) ................................. 250 mg /  83.33 mg
White willow (Salix alba, Young branch bark) ............................. 300 mg / 100.00 mg
Black pepper (Piper nigrum, Fruit) ......................................... 7 mg /   2.33 mg
L-Carnitine (L-Carnitine tartrate) ....................................... 650 mg / 216.67 mg
Non-Medicinal Ingredients: Gelatin.

Dosage
Health Canada Recommended Dose (capsules):
Adults: 3 Capsule(s) 2 time(s) per day.
Take 2-4 hours prior to exercise, with food. Store in a cool, dry place.

Cautions and Warnings
Ensure to drink enough fluid before, during, and after exercise.

Consult a health care practitioner prior to use if you are taking lithium, carbidopa or drugs/supplements with serotonergic activity, these may include, but are not limited to, L-tryptophan, S-adenosylmethionine (SAMe), St. John's wort, antidepressants, pain killers, over the counter cough and cold medication containing dextromethorphan, anti-nausea medication and anti-migraine medication, have a liver or kidney disease, a seizure disorder, high blood pressure, glaucoma, and/or detrusor instability (overactive bladder syndrome), asthma or peptic ulcer, if you are taking anticoagulants or products containing acetylsalicylic acid (ASA) or other salicylates, if you are taking any other medications or natural health products as black pepper/piperine may alter their effectiveness or if you are of childbearing age.

Consumption with natural health products (e.g. bitter orange extract, synephrine, octopamine, ephedra) or other drugs (e.g. ephedrine) which increase blood pressure or with other caffeine-containing products (e.g. medications, coffee, tea, colas, cocoa, guarana, maté) is not recommended.

This product is not intended as a substitute for sleep.
Discontinue use and consult a health care practitioner if you show signs of weakness, oral ulcers, or abdominal pain accompanied by severe muscle pain or if you experience gastrointestinal symptoms such as nausea, vomiting, abdominal pain, dyspepsia, heartburn or diarrhea.

Do not use if you are pregnant or breastfeeding, if you have scleroderma or if you are allergic to acetylsalicylic acid (ASA) or other salicylates.

Some people may experience drowsiness.
Exercise caution if operating heavy machinery, driving a motor vehicle or involved in activities requiring mental alertness.

Hypersensitivity/allergy is known to occur, in which case, discontinue use.

Caffeine has been shown to reduce blood flow to the heart muscle during exercise which might lead to cardiovascular complications such as chest pain, and irregular heartbeat even in healthy individuals. If those symptoms occur discontinue use and consult a health care practitioner

Product: Phen375 Fat Burner Supplement. INDEX
https://birthorderplus.com/weight-loss/supplements/phen375-review/
The recommended dosage is 2 tabs a day .... yet, 1 bottle is 30 tabs only.

Packages And Prices (+ Shipping)

Regular: USA $449.95 
    1 BOTTLE: $ 65.95 (+ $15.95) --- SAVINGS: $24.04 (30 tablets) 
    2 BOTTLES + 1 FREE: $131.90 (+ $15.95) | --- SAVINGS: $138.07 (60 tablets) 
    BEST DEAL! 4 BOTTLES + 1 FREE: $187.96 (+ $15.95) --- SAVINGS: $261.99 (150 tablets) 
USA $3.80 per day  --- LINK: https://birthorderplus.com/phen375 

As a new customer you can get a discount of $24.04 on your first purchase. 
 Existing customer coupons:
   $40 OFF repeat purchases coupon code: mfgr_rebate_40
   $20 OFF repeat purchases discount: mfgr_rebate_20 
Each Code is Valid only for a Limited Time after you enter the website. 

Benefits:
These diet pills can make you lose more than 25 lbs within 6 weeks.

Ingredients:

1. 1,3 – Dimethylpentylamine hydrochloride
   This ingredient is considered natural because it is found in the nature although it is of synthetic origin in Phen375. It is a powerful boosting agent for the energy levels and it also increases thermogenic action in the body, thus leading to improved burning of the calories.
   
   

2. 1,3,7 Trimethylxanthine
   1,3,7 Trimethylxanthine is another ingredient that enhances the functioning of cyclic AMP, thus further increasing the energy levels and facilitating the burning of fats.
   
   

3. L. Carnitine
   L. Carnitine is also found in this supplement and its role is to break down the fat chains found in the accumulated fats around the body.
   It also leads to conversion of these fats into pure energy that the body can utilize.
   In addition to the burning of fats and conversion into energy, this leads to appetite suppression.
   
   

4. Capsicum
   Capsicum is utilized in the formula due to its potential to burn calories.
   It is the ingredient that gives chili peppers the hotness and spiciness and it is known to increase thermogenesis in the human body, thus leading to burning of the calories.
   
   

5. Long Jack tongkat ali
   Long Jack tongkat ali is another natural ingredient found in this best fat burner which is used because of its ability to prevent the storing of fats that are ingested in food.
   This means that the amount of fats accumulated due to ingesting them is decreased, further aiding in the weight loss process.
   
   

6. Chromium Picolinate
   You will also find chromium Picolinate in the Phentemine375 formula and the main action of this ingredient is on the appetite.
   More precisely, this ingredient has been found to severely reduce food cravings and to also elevate the mood of the person using a product containing it.
   
   

7. Caffeine Powder Anhydrous
   May reduce hunger pangs preventing you to crave food.
   
   

8. Coleus Forskolii Root PE (10% Forskolin)
   May activate adenylyl cyclase and raise cyclic AMP levels in a wide variety of cell types.
   --- If you are any kind of blood thinner, this product is not safe.
   The Forskolin in it will interact at your Warfarin/Coumadin and send your INR through the roof.
   
   

9. Citrus Aurantium
   May increase the body’s metabolism and fat mobilization.
   
   

   Cayenne Pepper
   May increase your body temperature so you can burn more calories.
   
   

10. Dendrobium Nobile Extract (from orchids)
    Commonly used to improve digestion.

Cautions:
... should not be taken if the person has medical conditions such as heart problems and diabetes.

• mild dizziness at first.
• Some inconsistency in sleep patterns.
• Bit of a loose stool now and then.
• Higher blood pressure levels.
• Increased heart rate.

Feedback:

In late June I ordered a month’s package. I told myself, if I’m going to spend USA $140 a month on this I’m going to follow their diet plan and get back to at least a size 10-12; I’m going to succeed. The first month I lost 18 lbs and I when realized their product worked I stayed with it for the next five months, I have lost about 55 pounds in six months and I feel so much better! – Isabella, Miami.

Disclaimer:
Birthorderplus.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Additionally, Birthorderplus.com participates in various other affiliate programs, and we sometimes get a commission through purchases made after clicking our links.

Product: Belt, Cold Lipolysis Body Shaping. INDEX
https://www.hammacher.com/product/
cold-lipolysis-body-shaping-belt?promo=search&query=RL-92486
Item: RL-92486 --- Price USA $99.95 --- July 22, 2018
Item: RL-92504 --- Price $14.95 ---Replacement Pads
July 2018 catalog, Source Code: 683000
Lifetime Guarantee --- White. One size.
Brand: fatFreezer

This is the device that lets you perform fat freezing treatments at home.
Safer than liposuction or surgical solutions, the extreme cold temperature stimulates lipolysis, the natural breakdown of stored fats, destroying fat cells and eliminating them from the body.

The belt secures around a waist, stomach, thigh, or buttock with hook-and-loop fasteners, and targets a 4" x 4" area.

Provide a 30- or 60-minute session, and can be used on men or women.

Includes 10 disposable pads for placement between the device and skin.

Recommended for use in conjunction with exercise and diet.

Charges via AC.

Fits waists up to 50" in circumference. (2 1/4 lbs.)

Comment:
... Once you put it on, you can feel it starting to work because it's a little painful but not too bad.
It's because it gets really cold. It's non invasive ....
You have to remember to massage your area after you are through.
Also, keep a journal of dates of when you use it and on what body part because you can only use it in the same area after four weeks.

Alternate SOURCE and Reviews:
Product: Belt, Cold Lipolysis Body Shaping. INDEX
LINK: https://www.amazon.ca/Patented-FatFreezer-Reduction-Equipment-Machine/dp/B06XSSCBZV...
Date first available at Amazon.ca: April 16 2017
CDN $149.08

• FatFreezer is a non-invasive alternative to conventional liposuction.
  Results from fat Lipolysis can be seen within 4-8 weeks after treatment.

• How It Works:
  Cold helps in breaking down fat cells without damaging other tissues.
  Use for 30 minutes a day to tone and 60 minutes a day to remove bulges. (on different areas)

• LARGE areas like the stomach should be split into sections, treating each section with a 60 min treatment.
  Wait 2 hours before treating other areas.

• You MUST apply a new' glycerin sheet between the skin & machine at every application.

• Rub the Area:
  After each treatment, gently rub the treated area for 3-5 mins, to help break down dead fat cells in the area.

• Fat Freezer Body Sculpting:
  Fat cells are cooled into a negative temperature which causes them to break up and be disposed of through the body's own lymphatic system. Proven not to damage skin or neighboring tissues. Our patented freeze fat system helps with both shrinking fat cells and MAKING SURE THEY DON'T COME BACK. Fat freezing is a new technology and is one of the most popular methods used in Europe

• What You get:
  We provide all the right tools and transparent instructions as well as dieting guidance.
  Kit includes Shape N Freeze, Velcro belt, Instruction Manual, Diet Plan, Power adapter, fat measuring device, 5 protective pads.

• Operating Instructions -
  1. Loop one end of the Velcro belt around the handle of one end of the device.
  2. Apply a protective pad on the desired area of body.
  3. Carefully place the device (metal plate) over the protective membrane.
  4. Wrap the Velcro belt firmly around the body and apply the other end around the opposite loop attach the device firmly.

• Safety Warning -
  If you feel numbness on your body, please remove device. Don't not use device in same area twice within 4-6 weeks.

2nd Alternate SOURCE and Reviews:
Product: Belt, Cold Lipolysis Body Shaping. INDEX
LINK: https://www.ebay.com/itm/
Cryolipolysis-Lipo-Cold-Freeze-Fat-Body-Slim-Slimming-Weight-Loss-Machine-Belt-H/232842919830
Supplier: zhengzheng2011 (Hong Kong)
has been an eBay member since Aug 11, 2009
Free International Shipping
60-day Returns (at customer expense)
US $106.89 --- July 22, 2018

Power: 65W
Input Voltage: AC 12V

LINK: PayPal Credit: https://creditapply.paypal.com/apply
No Interest if paid in full in 6 months on $99+.
For New Accounts: Variable Purchase APR is 25.49%.

The APR is accurate as of 7/2/2018 and will vary with the market based on the Prime Rate
(as defined in your credit card agreement).
Minimum interest charge is $2.00.

Individual items that are less than $99 qualify for special financing when combined for a total of $99 or more in a single transaction.

Multiple separate transactions of less than $99 per transaction cannot be combined to meet the minimum purchase amount.

If you miss a payment your late fee could be up to $38, even less if it's your first time.

If approved, we start you off with a minimum credit line of at least $250.

INDEX