One of the most exciting recent developments in aesthetic medicine has been the introduction of cryolipolysis. This technology triggers the breakdown of fat via lowering the patient’s body temperature, in order to change the fat from a liquid to a solid. It does so without damaging other tissue, such as skin.

The production of cryolipolysis has taken shape in the form of the Zeltiq device, from Zeltiq Inc of Pleasanton, Calif.

In changing the fat from a liquid to a solid, the fat cells are slowly destroyed so that they can safely be processed by the liver. Some have voiced concern about other technologies that destroy fat internally and that the body can’t handle the large quantity of fat introduced into the lymphatic system.

The Zeltiq system allows this process to occur over several months. The Zeltiq procedure is based on work originally done by R. Rox Anderson, MD, of the Wellman Center for Photomedicine at Massachusetts General Hospital.

Regarding the use of cryolipolysis by Zeltiq, David J. Goldberg, MD, JD, a board-certified dermatologist and director of Skin Laser & Surgery Specialists of New York & New Jersey, wrote, “Initial work was done on animals, but data was recently presented at the American Society for Dermatologic Surgery meeting, showing that dramatic results can be seen in humans. Patients sit and read the newspaper while their fat is frozen away.”

The Zeltiq procedure can be performed in a physician’s office and requires no anesthetic. After the procedure, the patient can go about his or her day as usual. Apoptosis begins a day after the procedure. Good candidates for the procedure are those who are in good shape with fat bulges here and there.

The Zeltiq device is cleared by the FDA in the United States for various applications related to skin cooling during dermatologic treatments. The Zeltiq noninvasive cooling device is not cleared by the FDA for lipolysis, yet units have been installed in the United States for research purposes.

To provide insight on this new technology, PSP spoke with Neil Sadick, MD, FAAD, FAACS, FACP, FACPh, founder of the Sadick Research Group of Great Neck, NY, and vice chairman of the Dermatology Foundation and clinical professor of dermatology at Weill Medical College of Cornell University.

PSP: Please explain Cryolipolysis.

Sadick: It is the application of polled cooling technology to induce program filled fat reduction.

PSP: How long did the development of the device take?

Sadick: For the past 3 years plus, the device has been worked with. The reason being is that the company wanted to understand the science of how the cold is leading to the reduction, in terms of the number, in volume in fat cells. They did a lot of excellent scientific research. They wanted good controlled studies showing both the safety and efficacy of the technology before they released it.

PSP: Have there been any reported adverse side effects to the liver?

Sadick: No. The FDA is looking at all of the fat reduction technologies. The fat cells are prepared by the liver supposedly and the lymphatic system, articula, and the patellae system of the liver and the lymphatic. There has not been any adverse side effects seen with this procedure

PSP: Have there been any negative effects at all?

Sadick: Nothing major. A little bit of prolonged redness or numbing for a few days, but there is nothing-long term.

See also the PSP Body Contouring Podcast Series at

PSP: What are the pros and cons to this procedure?

Sadick: It is a way to noninvasively reduce localized fat deposits without going inside the body with liposuction and through [a] surgical procedure. Other than that, the patient feels a little numbing, parasitic feeling but there is not a significant discomfort. There is no downtime associated with the procedure. You can go right back to work. Like all remodeling technology, at least I believe the initial results show some variability in terms of who responds best and who would not respond at all.

PSP: Who is the ideal patient to receive this procedure?

Sadick: The ideal patient for this procedure would be someone that has localized love handles, for example. Alternatively, it is a choice for someone who has localized fat deposits and does not want liposuction—and who cannot reduce these despite appropriate weight loss regimens and exercise programs.

Shae Waddell is a contributing writer for PSP. She can be reached at .

Simple Marketing

Marketing isn’t complicated; it is actually quite simple. The challenge for most physicians is time—the limited time you have is most profitable when spent with patients, not creating flyers or planning an open house. In addition to the amount of time it takes to generate and implement effective promotions, there isn’t one complete source, one absolute answer, or even a clear list of “do’s and don’ts” for getting busy.

Until now. Simple marketing is also simple to explain, and over the next several months PSP will publish a series of articles that will describe tested concepts that have proven to increase business for practices.


Randomly and haphazardly spending money on marketing is a quick way to systematically deplete your funds. In marketing circles, the phrase “shotgunning” refers to sporadically “shooting” into the masses and hoping to hit your target or a qualified lead.

The more preferred method, known as the “rifle approach,” entails taking calculated shots strategically aimed at a specific segment of your audience. Don’t shotgun it.

Most physicians don’t realize they have an advantage when it comes to marketing. You are trained to listen to your patients. Listening is a magical word in marketing. To effectively promote your services, you have to listen to your market and think from their perspective.

In marketing, every time your patient hears from or about you it is called a “touch.” Your goal is to maintain frequent touches with your patients so you stay current in their minds, schedule, and budget. It is a common marketing maxim that it takes at least eight touches before a person will respond to your efforts. Planning only one method of outreach means you are planning to waste your money. You should consider the expense of each effort an investment toward gaining a new patient.

1) Go green.

Do you use promotional materials such as brochures, newsletters, or even business cards? Increase the return on your investment by increasing the number of people who see your literature. Simply add a sentence encouraging your recipients to “Help us be green and share this newsletter with a friend before throwing it away.” With this one sentence, you can double the amount of people that see your materials without any additional costs and show your patients that you are environmentally conscious.

2) Keep them loyal with a reward.

It costs six to seven times more to gain a new patient then to retain one. Keep those patients coming back with an easy-to-use and inexpensive loyalty card. Initial or mark on the card every time a patient spends a certain dollar amount and reward them with a credit, a facial, or some other product or service when the card is filled.

3) Make it interactive.

Do you sell Latisse? If so, for less than $10 you can show patients before-and-afters using an interactive, 3D demo station. Simply purchase a pair of false eyelashes from a local drug store. Trim the left set of lashes and label it “Before.” Leave the right set of lashes as is and label it as “After.” Next, set out applicators alongside a used bottle of Latisse that has been refilled with water. Display these lifelike virtual lashes with a sign that invites curious patients to try it for themselves.

This is just one example. Use your imagination and even go as far as create a contest among your staff people to help you come up with similar interactive displays that revolve around other products or services you offer.

4) Let patients refer on your behalf.

Many practices regularly mail their patients a birthday or holiday gift card that includes a gift certificate for the practice. This type of a promotion can warrant a strong return, as many patients view the gift card as having cash value. As you are already spending the postage to mail to these patients, empower this qualified market to refer on your behalf by providing them a secondary gift card clearly labeled as a “Gift for a Friend.”

5) Sell gift cards? If so, sweeten the deal.

Gift cards for your practice can provide patients a convenient birthday, Valentine’s Day, or Mother’s Day gift while bringing new patients through your doors. Why not encourage patients to buy their gifts from your office by offering a little something back? Provide a complimentary gift card to the practice or offer, say, skin care services with any gift purchased. Now the patient has an incentive to purchase presents from you as opposed to a local department store.

If you convert just two new filler patients per week, it will mean an additional $34,000 in annual revenue for your practice.

I thought that would get your attention. Now, go back to the beginning of this article and read it again. This time, take notes and brainstorm some ideas to get people moving through the doors. Good luck!

Tracy L. Drumm is vice president of If Marketing, a Chicago-based firm specializing in aesthetic medicine. She can be reached at .