What a fitting title. Because sometimes cosmetic procedures do come out ugly. We all have seen bad surgeries and overfilled Donald Duck lips but did you know that what might seem to be a simple safe trip to the local med spa for a “non surgical” treatment can turn out like this? Linda Evangelista, super model, once considered one of the most beautiful in the world was completely disfigured by Coolsculpting, probably the most popular procedure to this day.

Check out the whole article in People Magazine. I didnt even know that that the adverse event (Paradoxical Hyperplasia) is sometimes no longer “fixable” or amenable by liposuction, which it would have been if they had never done Coolsculpting. I dont care if it only happens 1% of the time. What horrible person or doctor, would offer a procedure that he or she knows could permanently disfigure you? That was known before they bought the technology. We chose not to offer the treatment because of that risk. Dr Lisa was mortified by the possibility that any of her patients she loves would be subjected to that risk, no matter how tiny that risk might be.

I even built 2 websites in 2016 to warn people because I was so upset. I called one, Fatfreezing.info and the other Coolsculpting.nyc. I even show a screen shot of Coolsculpting’s own website and their original warning in 2016, (which every doctor was well aware of). How can you call yourself a doctor and offer a treatment that will disfigure at least a dozen people every year, if you treat 100 patients a month. You know you are destroying their lives, their self confidence, potentially permanently disfiguring them, and you call yourself a doctor, or a really cool med spa?

To explain paradoxical hyperplasia, what happens is a “paradox.” Rather than get destroyed, the fat cells multiply like crazy and get hard as a rock. You have to wait a year for it to soften, then you can surgically remove it. Hopefully without leaving a lot of lumpiness. But I doubt that is even possible. You dont have to be a doctor to imagine if you suck out what looks like a bar of butter, you will leave behind, lumpiness and loose skin. Worse yet, Coolsculpting at its best, leaves behind loose skin. So when it works, the loose skin created by a successful Coolsculpting, is treated by a $5000 radio frequency procedure, to tighten the loose skin created by Coolsculpting. Its the least effective, problematic procedure that costs the most, with at least a 1% chance of disfigurement.

The crazy part of all of this is there are dozens of radio frequency devices that can “melt” fat with the side effect of smoother tighter skin. Go back and read that sentence. To add insult to injury, literally, when Coolsculpting is “successful” you get more loose skin. So its the worst choice when it works.

I know this from our research. Every doctor does extensive research before they invest hundreds of thousands of dollars and their reputation, on a new technology. I also know from the patients I speak to. I answer at least 3 phone calls a day; translation 1000 a year and over 17,000 phone calls. My first question is “what treatments have you done, what did you like, what worked, and what didnt work?” So I know more than a doctor who is busy treating people. They dont have time for up to a one hour conversation with each prospective patient. I am also speaking to people he or she will never even see or meet.

I also go to the manufacturers, conferences and seminars. I have attended the world wide Anti Aging Aesthetic Congress in Monte Carlo and Paris, where Dr Lisa was lecturing on the latest and greatest technology we introduced that year. I have attended multiple seminars in California, Miami, Chicago, countless in New York, to research the latest technologies. And I take every call from manufacturers representatives to learn about every new technology. I always ask for the research and studies. Together with Dr Lisa, we always need to see if there is something new that we should be looking at. Plus our friends/best clients from Europe only come to see us because we have the latest and greatest technologies. We cant maintain that clientele unless we have the latest most effective technologies. That is a challenge in a small private office. But we do it.

I even go to the Coolsculpting seminars to see what is new. The last one I went to, their own salesman whipped out his phone and googled bad coolsculpting, in an effort to sell me. He showed me what looked like a shark bite. He said “see you can now sell them 8 areas, four on the front of the tummy and 2 on each side and charge 8x more. I guess he didnt know I am not motivated by taking advantage of patients. I was repulsed. So now I am going to give them 8 shark bites vs smoother tighter skin while melting fat ( which is what we do with Exilis)? Are you kidding me?

One more point on our first “ugly” Coolsculpting. I recently spoke to a lady, and in my questioning, she said, “no results from Coolsculpting”. Most people say no results. I said “well at least you didnt get paradoxical hyperplasia.” She replied, ” I did, and it was more painful than childbirth, I had to wait a year to get it removed and it was the worst pain of my life, for a whole year”

By the way you know those numbers are certainly low balled. I am certain the number is a lot higher. I called a doctor in Maryland to ask him about this, and how often it happens. He said “yea no big deal, they (Allergan the multibillion dollar company that bought Cooslculpting) pay for the surgery to fix it”. Maybe not to you my Doctor friend, who forgot the Hippocratic Oath “First do No Harm” I am sure the people he disfigured by it have a different opinion, having to live with that trauma for a year and perhaps disfigured for life. I know, no big deal, they signed a waiver, really?

Why do people do it? Greed and advertising. I dont believe any doctor is that stupid that he cant read the side effects, which you can read yourself on the screen shot I took from their own website and put on my website fatfreezing.info and Coolsculpting.nyc at its peak was spending 100 million a year advertising directly to the consumer. BTL and most of the others advertise to doctors. So literally there is not a person in America who hadnt heard of Coolsculpting. For perspective, 100 million dollars was the entire GM budget at one time. Chevrolet, Pontiac, Cadillac, Buick, Hummer. Back in the day when they dominated the airwaves. PS not only do you bring in at least a million in revenue from Coolsculpting, you dont have to spend upwards of $100,000 a year on advertising.

Coolsculpting still draws thousands of phone calls a month. I know, because I talk to other doctor’s offices all over the country to get the best information I can from those I dont compete with. Unfortunately for us, we do such a good job, our clients dont need to return for at least a few years, in some cases, depending on their age, so we have to advertise.

Maybe I should retitle this blog the dark side of “non surgical cosmetic procedures” 

How about the fact that everyone offers multi year financing for a procedure they know, you are going to want to repeat, once every few years and perhaps, even twice a year, if they are a lot older? Again, not the providers problem. The “good” doctor is simply hooking you up with an outside company that is going to put you into as long as a 7 year contract. That is between you and your new bill collector to insure you pay them every month. How does that sound for integrity or lack there of?

How come every seminar I go to, the doctors tell me I could make 30% more revenue if we offered financing? Answer me that? Want to hear one even more ugly? The biggest provider of Med Spa communication programs, which integrates incentives, a phone app, a program to connect with your patients and financing said this at a recent seminar. “If you use our system and you propose a treatment plan or procedure that might cost $7000 or more, you can put it in their shopping cart. When they get home later, after a few drinks, when they are drunk, they can go to their shopping cart, and not only buy it but finance it.”

Does that sound anywhere within a million miles of integrity? It actually sounds like they should be reported to the medical board. These are medical procedures. Even a Med Spa has a “medical director’ Pehaps he or she is 90 years old and is at an old age home. But they signed off on the equipment and are technically “supervising” the procedures from wherever they are.

Are you starting to get the picture? Its like the Movie, the Good the Bad and the Ugly, with a lot of ugly, and a lot of bad. But there is good, for starters, just go to a doctors office. And turn on your common sense. Do they have at least 15 years experience? Do they offer Coolsculpting, in my opinion that is a red flag. If we offered it I would probably have 20 million in the bank and I dont even know if I would be writing this. But we would also have disfigured at least a few hundred people in the past 17 years. We have never even given one person the equivalent of a sunburn, even though we have probably delivered upwards of 20,000 treatments. And we also offer medical treatments like Thermage, Exilis, and Emtone, which are delivered at very high temperatures in order to deliver the greatest efficacy. Do they offer financing? Does everyone there have experience? How many years experience does the person who is actually going to treat you have? Do they have at least 12 different technologies to choose from? Common sense if the only they have is Emsculpt (the popular one on social media, 6 pack abs) Duh, of course they will say its perfect for you, But did you know if its just loose skin, Thermage is much better, If its fat and loose skin, Exilis is better and cheaper than Emsculpt. If its a little bit of celulite and loose skin Emtone is better. Every one of these are $250 to $350,000 machines. Worse yet Emtone and Exilis need to be operated by a very experienced technician at a very high temperature. Do you think they local med spa hires hundred thousand dollar a year techs? PS, neither I or any of the top doctors would ever let go of their best technicians by not paying them top dollar and a plethora of benefits.

Do they have at least a dozen options? I can think of 5 different ones we would choose from for your tummy. That depends on what combination of issues are present like loose skin, fat, cellulite, stretch marks, muscle laxity, which can only be determined in person. Then of course which ones in which order. Its laughable that Med Spas advertise combination treatments. They think that puts them in our league. Absolutely not. There is no way of knowing which treatments would be the most effective, efficient, give you the greatest results and be cost effective.

That can only happen, when you are seen in person by a person who has delivered tens of thousands of treatments on people with every combination of, loose skin, fat, cellulite, muscle laxity, plus or minus, stretch marks.

About financing. We let people pay as they go. I am sure you have credit cards, with a credit line. We will not assist or encourage you in putting yourself into a multiyear debt for a procedure that you will like so much, you will want to repeat in a few years because you lose collagen every day of your life. And you also lose muscle and gain fat

My tummy got phenomenal, literally unbelievable results in 2018. But after 6 years it back to square one. The point is with non surgical skin tightening or muscle building, of course, the results dont last forever. If you are human, you lose collagen every day, so you get more loose skin. You also lose muscle and gain fat every day. Just look at your grandparents if they are still alive.

Dont get me wrong, people love their results. It looked like I knocked off 5 years after my first facial Thermage in my fifties. And if you are younger you might get away with doing one of these procedures merely once every 3 to 5 years. But the point of this blog is point out the ugly the bad and the good.

So lets get back to the Good. Go to a doctor’s office. Med Spas are a completely different business model. It is the least experienced people for the lowest salary delivering the least effective treatments to hopefully not injure too many people. How does that sound? How about making a few calls? Does anyone who works there know anything about what they offer? Its your face and body. Do you want to look your best, knock off a few years? Use your common sense. Read the website. You will know right away how much experience they have. I always brag which technologies we were first to offer going back to 2007, 2008, 2009, as well as the ones we were first to offer just now, like the chin applicator for Emface, and Emface itself. Sorry I dont want to be self referential. I just wanted to give an example of how easy it is to read between the lines when you are trying to find the best provider in your city. Its safe to assume the provider with the most experience it likely to deliver the best outcomes. Also massive reviews just means they have a system or incentive for reviews or maybe fake ones.

I cant tell you how many people bring us gifts, theatre tickets, tickets to their performances, offer weekends at their homes in the Hamptons, Miami, hotels and or casinos they own, they are so grateful for their results. But they would never leave a review or give us a before and after. Its private, personal. No one wants to show their cellulite, stretch marks or saggy face to the world wide web forever? And literally put their saggy ass in to the public domain, especially if they are famous and known for how great they look from head to toe. Again common sense. Do you think a model who made over $4 million in one year because she is so perfect gave us a review or a before and after photo?

I know I got a little bit too much into the weeds on all of the different technologies. At least I am not a doctor, so you didnt get the technical details. Just remember common sense. Lots of different technologies to choose from guarantees you that you are not being told the only one they have, is coincidentally the best. I once told this to a client who was torn between two radio frequency/ultrasound technologies. “We dont have that particular one, why dont you call someone who has both of the ones you are considering, there would be no reason why they would pick one over the other if they have both.” See common sense. How many years, common sense, how many years does the person who is going to be treating you? common sense. Go visit at least 2 places. You will see, hear and feel comfortable or not. Is privacy important to you? What are your priorities? Do you just want to book yourself, because you think you know everything and hang out in the waiting room with a bunch of “twenty somethings” taking selfies? Sorry we cant offer that. There is a plethora of choices. You get to choose what you want. I might be wrong, but I think people want the most private office, with the most effective treatments and latest technologies delivered by the most experienced person. Sorry that was a plug. But the advice makes sense.