First of all who am I to say? I founded Precision Aesthetics with Lisa A Zdinak, MD 17 years ago. I researched countless technologies and even traveled the world with Dr Zdinak when she was speaking at the Monte Carlo AntiAging Congress. While there we spent 3 days researching European technologies where we not only met the President of BTL ( Emsculpt, Emface, Emtone, Exilis and Emsella) but brought their first device to New York. We later helped them research and develop their cellulite busting technology. I have also interviewed 17,000 patients at length over the past 17 years as to what treatments they have tried, what worked and what didnt as their first point of contact with our practice.
Treatments to Avoid
CoolSculpting: Google “paradoxical hyperplasia” and “Linda Evangelista.” Paradoxical hyperplasia was noted as an adverse event in 2016 when the technology was first introduced, which is why we avoided it. It causes fat cells to multiply and harden, requiring surgical removal after a year. Linda Evangelista’s case is a notable example, resulting in a $50 million lawsuit.
IUlthera: Google “Ulthera lawsuits” and make your own decision. Class action lawsuits suggest significant issues. Ultrasound on the face seems to be problematic, with claims of nerve damage.
General Advice: Always search for any technology you’re considering alongside terms like “lawsuits” or “adverse events.” Adverse events must be reported to the FDA. Avoid any practice with less than 15 years of experience and prefer a doctor’s office over a med spa, which are often franchised and may not offer the same level of care and privacy.
Safe and Favorite Treatments
Emsculpt: While widely offered, the exact placement of the paddles, temperature, and intensity are crucial. Misuse can be dangerous, as demonstrated by cases of burns and potential harm to those with pacemakers. Exilis, which only melts fat and tightens skin without adding muscle bulk, is a favorite among informed individuals for being half the price.
Emface: This treatment also has suggested protocols and positioning, but intensity and temperature can vary.
Thermage: A top favorite at our facility, people fly in from all over the world for this one-time, non-surgical, one-hour, non-invasive facelift. Performing it effectively and safely requires a high degree of expertise, knowing the vectors, number of pulses in each area, and reaching the maximal effective temperature.
Exilis: Popular for safe body shaping and skin tightening using ultrasound and radiofrequency.
Emtone: Combines acoustic wave and radiofrequency for skin tightening and cellulite reduction.
I will always talk about the truth. Society is way too obsessed with ridiculous made-up standards of beauty. It also changes as often as the styles do. Was anyone alive to witness Twiggy? She was a famous model of the seventies. Google her. What is everyone going to do with their inflated butts when the style goes back to thin?
How about “heroin chic.” That was the ’90s’. Skinny-worship was only twenty years ago. Remember Calvin Klein ads, Kate Moss? You can bet your big fat ass that it will be back. So first, get some self-confidence.
BBL or Brazilian butt lift is the deadliest procedure in plastic surgery. I made this easy for you. What a horror show. There is way more horrible information on this, then I anticipated. PS you can do emsculpt on your butt and increase the muscle in your butt for slight lift. Its only 15%. My point is not to do that, Its simply to avoid the most dangerous plastic surgery and not die. Why dont you just go to the gym? You will look and feel better overall and you might actually meet a like minded person. Unless you are obsessed with spending a ton of money to meet a superficial jerk. Think about that one?
So you are spending a boat load of money to attract a superficial jerk. Why not just put a want ad that says I want a superficial jerk? Oh right you are doing that. It is as plain as the unusually large butt that is following you around. It will probably attract an ass to follow you. It is literally a signal to what type of partner you are looking for.
Regarding other minor non-surgical procedures, not BBL. To be clear if you are in your forties to sixties and have discretionary income and getting rid of loose skin, cellulite, stretch marks or another simple procedure would make YOU happy, have fun. Do not come in and say you are doing it for someone else. A good doctor will turn you away. You can tighten skin, make collagen and even tighten the muscles on your face. I would argue, in a sense it is all natural. As you work your way down your body you can do the same to any body part. IF You have the discretionary income and it bothers you. I would also propose Emsculpt on your abs makes sense because it is your core, it protects and in some cases helps people with back issues. Its not a medical treatment but many claim it has helped their back.
I loved getting the first six pack in my life, ironically in my sixties. This is me 2018. This was with Emsculpt. Emsculpt Neo is the one with the heat that is slightly more effective. I was pretty happy with my abs after emsculpt.
So I have done Emsculpt Neo for my abs and my face with Thermage and Emface and Exilis.
In the video, I repeated my admonition then I explained all the procedures to avoid. I then explained what I believe after 17 years experience answering probably 17,000 phone calls (3 a day) and traveling the world researching technologies both in the US and in Europe, the best non surgical technologies.
When I went to Monte Carlo in 2009, there was only one other New York doctor there. There was only lasers and the first non surgical device for skin tightening, Thermage. This industry did not exist. In fact the reason we went, was Dr Lisa was lecturing on the new Thermage face tip called the CPT. There was no Coolsculpting. That was 2016 and it is a disaster, still the most dangerous treatment. There was no Emsculpt. That was 2018.
So all of the geniuses that you have been speaking to or taking advice from, even Doctors, have no clue about all of the technologies. In fact any time you hear a doctor speaking about a technology, its not even that they believe in it or know anything about it. They are being paid by the manufacturer to read a slide show prepared by the manufacturer. They dont even know what they are talking about.
The Monte Carlo Anti Aging Congress, accepts studies provided by doctors about technologies that were just released that year. The study is made by the doctor. Thermage didnt even know Dr Lisa had submitted the study.
So that is real research, not a doctor being paid to narrate a slide show.
Again to be clear, If you have discretionary income and it would make you happy to see a few less wrinkles, a bit more collagen and tighter muscles, less sag on your face when you look in the mirror I am all for it, and I do it. Want a tone tummy? Great. I know women absolutely love getting rid of stratch marks even thirty years later ( Carboxytherapy works on any color stretch mark on any color skin at any age). Cellulite is also a bummer. People love getting rid of that. Its all good. I am advocating against making young ladies and girls feel bad about looking normal. If you are under thirty go to the gym, lose weight your skin will bounce back.
PS I probably havent moved to florida yet because it scares me. All the women look alien, with inflated lips and butts and boobs. There are natural approaches to all of this. Even Botox, a good doctor will never freeze everything. They will soften the lines. They will not make you look like a deer in the headlights, if you really want Botox. Although, check out my forehead no Botox for probably 20 years, Just emface and thermage, making collagen and tightening muscles, not freezing them.
Ill end with this story told by Wayne Dyer. A 40 year old woman goes to her doctor for her annual physical. She comes home all excited and tells her husband, ” the doctor told me I have the breasts of a 20 year old, the legs of a thirty year old, and the face of a twenty year old” her husband replies, “What did he say about your forty year old ass?” ” “Oh she replies your name didnt come up”. Thats what I am talking about. Do what makes you happy go to the gym, work out at home. Always happy to help even if its just a pep talk.
OUTLINE OF VIDEO
Non-surgical beauty treatments, including CoolSculpting and radio frequency devices. (0:00)
Emphasize the importance of self-confidence
Criticizes the industry for promoting unnecessary treatments and pushing financing options on clients.
Discussion of CoolSculpting and radio frequency devices; recommendation against CoolSculpting due to potential for paradoxical hyperplasia and loose skin.
The speaker highlights the benefits of radio frequency devices, including increased collagen production, muscle tightening, and wrinkle reduction.
Non-invasive beauty treatments for face and body, including Ulthera, Excellus, and carboxytherapy. (4:30)
My experience with Thermage treatments, highlighting my expertise and success with the procedure.
Exilis and Emculpt treatments, are effective for body shaping and abs development.
Compare the effectiveness of different fat-melting treatments, including Emsculpt and Exilis, and notes that Exilis is half the price but only melts fat.
The potential risks of using ultrasound on the face, citing lawsuits against Ulthera and the close proximity of nerves to the skin.
Carboxytherapy is the most effective treatment for stretch marks, as it breaks down the marks at a deep level.
Cellulite treatment with acoustic wave technology. (10:23)
Company brought first Exilis device to US in 2009, 8 years before Emsculpt.
Rebranding of a cellulite treatment device as Emtone and its FDA approval in 2020.
Cosmetic treatments and their effectiveness. (13:34)
Silkpeel offers non-invasive alternatives to traditional microdermabrasion and laser treatments.
Here is an example you can probably relate to. We have all had a pimple at least once in our life. Where does our focus go? It’s literally just to the pimple. We know with absolute certainty that every single person we see that day is only going to see that pimple and nothing else.
When someone sees you walking down the street they see your whole body. You do have a lot of control over that. They will make a judgment about your body, what you are wearing, the way you hold yourself, the way your walk, the smile on your face, and your mood. When you speak, they will hear the tone of your voice, the energy, and how you make them feel. It’s only the pimple that they see, right?
Everyone wants to feel seen, heard and understood. Just ask Oprah. Applying that principle earned her over a billion dollars and worldwide fame.
Take it from me. I should be put in jail for what I have done most of my life. We retouched the most beautiful women in the world to take away any speck of imperfection, or reality, and made generations of women feel insecure and neurotic. I wasnt the evil genius that came up with the idea, but we did do retouching for Ralph Lauren, Chanel, Revlon, Estee Lauder, Cover Girl, L’oreal, Donna Karan, Calvin Klein, to name a few.
I imagined one day I would publish a book of before-and-afters. But all the media back then were archaic items long gone in the garbage, like Zip drives, 9-track tape, and other obsolete media. I can tell you with absolute certainty that every one was extensively retouched.
Think about what you are comparing yourself to. The “model” is already preselected from millions to be a genetic abnormality. Long legs, no hips, big eyes, high cheek bones, and a big square face. Ironically, some of them look weird in person. But then lets get to work. A $2000 a day make up artist, who knows exactly how to bring out the best features of anyone is on set. A photographer who charges $10,000, who knows exactly how to use lighting and angles to get the best shot, thousands of dollars of lighting, an assistant to manage the additional lights, to fill any natural shadows from your face itself. Yet they still need at least 100 shots to get one good one, and you expect that the one you just took with your phone to be perfect LOL.
After hours of shooting, the hundreds of shots go to the creative director to choose the best one. At this point it is retouched. So even with tens of thousands of dollars spent up to this point, our genetically deformed model still needs retouching. Forgot to mention the stylist. Of course they have clothed the person, chosen the perfect color and flattering style, and even altered the attire on the spot to perfection. So when we finally find the best shot, the real magic begins, and gobs more money is spent to make you feel even worse.
We start the retouching. I can tell you for a fact that we were paid around $40,000 to create and separate just the eyelashes for a certain cosmetic company selling an eyelash curler. I can also tell you we took cellulite, loose skin, stretch marks off of many butts of famous models in their twenties! And everyone also gets fat trimmed off of arms and legs. Havent you ever noticed the straight lines around the legs, hips and arms? In fact if it wasnt done perfectly, you might even see a halo where they shaved inches off arms and legs to make everyone look like Barbie.
These women are constantly in make up and have the worst skin. Yet with a mere ten or twenty thousand dollars of retouching for countless hours, going over every millimeter of their skin, we can smooth out all of the imperfections. We can even throw in a quick nose job or excess skin removal under the chin or neck. By the way, ever notice that most of them have no pores? Of course they dont, when you do that much retouching it becomes literally painted over or airbrushed.
So this is what you are comparing yourself too? What is wrong with you? By the way I have seen the budgets. We only did the ads. The media buy for the many pages in magazines is over a million dollars. Ads were often sent to magazines like Vogue, Cosmo, Glamour, Elle, Allure, Bazaar, French Vogue. Who cares if the photography, makeup, and retouching cost $50,000. They were selling the new shade of lipstick, they needed us to make it perfect, and then send perfect digital copies to where all the major magazines were being printed, all over the world.
So that was my professional experience, from my first career. Now for my personal perspective as a male (sorry forgot the weirdo term, is it straight?). I have dated a few women. I was single for some 30 odd years. I can tell you what I was attracted to and what was the most memorable.
I have three basic types. I absolutely love confident, funny and smart women. If you have all three thats sexy too. I cant even think of anything else that I was attracted to. And that was even at a young age. Because even in your twenties, the talking is a lot longer than the sex. Even if you are 24 years old and you are having sex for five hours, yea right. What are you going to do the other 19 hours? Do you think you might actually talk a little bit? How long can you talk to someone that is not interesting? Sorry if your husband only knows baseball stats.
So what else? Lets start with big boobs. The sexiest stunt anyone ever pulled was by a woman I knew that was almost flat. We went to a black tie for our client, Saks Fifth Avenue. She wore a black skirt, and a man tailored shirt practically unbuttoned to her navel, because she could, she was almost flat. She looked elegant and sexy. You could never get away with that with big boobs. Every man in the room managed to negotiate his way near her at a 30 degree angle to get a glimpse. She owned the room. It was at the Waldorf with more than 1000 people. That is what I am talking about for sexy. That was the sexiest stunt anyone ever pulled off in my life. We barely made it home in the cab. Point being sexy is how you carry yourself as well as your humor, confidence, and your accomplishments in life.
Hair? I remember when I was around 30, a sixty year old woman, our office manager, walked in to the office and I was completely mesmerized. I had no idea what had hijacked my brain. I remember it like it was yesterday. She exuded sexuality. I even said “you look great today I dont know what it is.” She replied she got caught in the rain and her hair was all messed up. And then of course it all clicked what was connected in my brain to a woman with hair all messed up? When have I seen that before? I was a bit embarrassed when I made the connection. By the way so far for me, the theme here is natural. The point of this anecdote is sexy is natural.
Clothing? I love contrast. Seeing a woman in a simple T shirt and jeans means you get to see her. She is the highlight and focus. The contrast of her beauty and femininity to the plain clothing makes her stand out. Probably why it looks cute when you see a young lady wearing construction boots vs high heels. The contrast is stunning.
I remember a very wise beyond her years Willa Holland telling me when she was probably around 12 or thirteen years old. You dont want the clothes to wear you, you want to wear the clothes. Meaning if the clothes are that bright and showy the person is lost. The clothes are wearing the person vs the person is wearing the clothes. She was in NY as a very young person attending a red carpet event many years ago. She wore an extremely plain skirt and shirt and was trying to coach her chaperone who was accompanying her and had no idea what to wear. Her chaperone was probably 20 years older than her.
Confidence works for both, or all 37 sexes. People are attracted to confident people. We want to be close to that power. Maybe its another survival hard wired thing. Oh oh maybe the next blog. Sure we know women are attracted primitively to men that look like they can protect them, or have the money to protect them and their offspring in today’s world. But maybe it is just the appearance, meaning the way they carry themselves.
There is a lot to think about. But I can guarantee you one thing we can all agree on. Too much makeup and too much fillers, and too much surgery is not only ugly, its gross.
One more thing stop comparing yourself to the one in a million genetic abnormality with $50,000 invested in makeup, stylist, photography and retouching. You just might be too stupid for anyone to want to date for that reason alone.
Ok one more. Do you really want a superficial jerk. There are guys that seem to gravitate to overblown fake weird looking people. In fact just this week I saw one inappropriately dressed at the White House. I think her husband sells books. I would have died if I was the man accompanying this facsimile of a woman dressed like a slut for a state dinner at the White House. I would never date someone that looked that gross and had no taste and I actually have a few less dollars then her date does. In fact I wouldnt be caught dead even talking to someone that looks like that.
PS even in retrospect, I walked the walk. I didnt do it intentionally, but I dated the working models, no interest. One practically proposed to me. I chose the brilliant smart funny surgeon, who could put me in my place, handle me, and make me laugh, and have fun. She is the sexiest woman I know. I am literally just noticing this as I wrote this and did a “fact check” on myself. And neither one of us needed the other person. Its also sexy to know that you were chosen out of want, not need.
I need to acknowledge Paulina Porizkova. Because I did not know she was an anti retouching advocate. But she was unusually perfect. She was literally the only person we did not retouch when we did Estee Lauder ads. Absolutely everyone else got a ton of retouching. And here is something else for you to ponder before you call the plastic surgeon or even come to us.
In my opinion she could have easily stopped at six minutes. I think she looked better.
I do proudly manage a non surgical cosmetic doctor’s office. We have people flying in from all over the world to do a “non surgical facelift” So I dont need or want the wrong person. If you are under thirty, just dont drink, dont smoke, stay out of the sun. For your body, lose weight, your skin will bounce back. If your grandmother has a ton of disposable income and she wants to do a treatment to make HER happy she can call us. And I am not even putting in a link because that is not what this is about. Its simply not right for most people. You dont borrow money to do treatments, its for discretionary income, for something that bothers you. Shame on pretty much every doctor in New York. When I go to the seminars, they all tell me I could make 30% more money if we took financing. If you cant even afford to put it on your credit card and you have to take out a loan, thats just wrong.
Worse yet shame on RepeatMD. They suggested to not only take financing, but put your proposal that costs many thousands, in a shopping cart for them, so when they get home, after a few drinks, they can purchase it AND finance it. Seriously? How is it even legal to promote drunk purchasing of a medical procedure, let alone finance it?
Society has gone crazy. And there is way too much pressure inappropriately placed on looks. There is way too much emphasis on unnatural large boobs, butts and lips. Dont do any of that. I would rather spend my time educating young women to just not do it. “Just Dont Do it”.
And you can bet your ass, or big fake ass and big fake boobs that the styles will change. I just googled and found a bunch of doctors offering to remove butt implants.
Anyone remember Kate Moss Calvin Klein ads a mere twenty years ago, skinny heroin chic? Or Twiggy from the sixties?
Heck we might even be on the precipice of that now. Anyone heard of Ozempic? All the new weight loss drugs?
The good news is there are a dozen technologies that can non surgically transform your body from head to toe. We can now get rid of cellulite, loose skin, fat and stretch marks. We can also add or restore muscle to your biceps, and triceps to help get rid of the dreaded bat wings, calves and thighs. We can literally add muscle, reduce fat, and tighten skin, on the front of your thighs the back of your thighs, inner thighs and outer thighs. There is almost nothing that we cannot do. We can even restore 30% of the muscles on your face as well as tighten the skin and restore collagen. So that’s the good news.
The bad news is that there are still dangerous procedures out there and Med Spas are getting more prolific than Starbucks. So you can imagine there is a preponderance of inexperienced people working there. There’s a small handful of doctor’s offices that have been around for 20 years. None of us are giving up our 20 year technician to a Med Spa. Nor would a Med Spa pay 100 grand a year plus benefits to a technician. Their business model is just to do a few things that are popular that are relatively low risk of hurting the patient with the lowest paid people who do not really know what they’re doing. They simply can not choose the best technology for the issue at hand. Actually they wouldnt even have all of the most effective technologies since the most effective technologies reuquire an extremely skilled technician. That is not their business model.
For example, I can literally rattle off a half a dozen different technologies just for your tummy. We don’t even know if you’re dealing with loose skin, fat or a combination until we touch your skin. So you would come for a consult. The technician, who has delivered 20,000 treatments, will determine if your best solution is a thermage skin tightening, or emtone for tightening skin and perhaps a little bit of dimpling a.k.a. cellulite, or Exilis which uses ultrasound and radio frequency to get rid of fat and tighten the skin, or Carboxytherapy which would not only get rid of fat but stretch marks. By the way, I use this as an example just to show you how many different technologies we might use in one area. Ironically I forgot to mention the one that med spas do have, emsculpt. Emsculpt makes muscles and reduces fat in the area. But you may not want to add muscle bulk in your tummy area. I’ve done quite a few emsculpt treatments since 2018. I probably will never have a 32 inch waist again because I’ve added muscle in the area. By the way, Exilis reduces fat and tightens skin and is less expensive than emsculpt. It’s already getting complicated. It is complicated. Even a doctor who dont spend full time researching non surgical technologies would not have my experience. Your surgeon might be the best at a few different surgeries but he or she is not going to know all of the non surgical options, even though he launched a Med Spa. He or she would not even have an Emtone, Thermage or Exilis. These machines need to be run at a very high temperature. You need someone extremely experienced to run those machines. Anyway this already got way too long I kind of repeated the same things in a video on my YouTube channel if that’s easier for you. PS I met one of the most famous Beverly Hills Surgeons at a conference. I did my due diligence and studied his website so I could have an intelligent conversation with him. I said “I see you do Thermage.” He said no, not really, I dont trust my technician to run that device at the very high effective temperature to get great results. So this is what you are facing.
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.
Transform your appearance and rejuvenate your vitality at Precision Aesthetics
Precision Aesthetics: The Ultimate Total Transformation for Rejuvenated Appearance and Vitality
THE PINNACLE OF PRIVACY AND EXCLUSIVITY
Embark on a highly exclusive and private journey for all your non-surgical cosmetic enhancements at Precision Aesthetics.
TRANSFORMATIONS FROM HEAD TO TOE
Unleash the potential for total transformation.
Commencing at your forehead, we employ non-invasive techniques to tighten muscles and stimulate collagen, sidestepping the temporary paralysis associated with traditional Botox. Progressing downwards, we deploy cutting-edge technologies such as Thermage, Exilis, and Emface to tighten skin, sculpt jawlines, and address concerns beneath the chin and neck. Age spots and sun spots effortlessly vanish following skin-tightening procedures.
Transitioning to the body, we combat undesirable “bat wings” through a synergistic approach involving fat reduction, skin tightening, and muscle enhancement, utilizing three distinct technologies. Additionally, ongoing muscular enhancement of biceps and triceps is available for both men and women.
Achieving a sculpted six-pack becomes reality by tightening abs, reducing loose skin, melting fat, and minimizing stretch marks or cellulite with five advanced technologies. Similar transformative treatments extend to flanks and buttocks. Finally, pelvic floor muscles are strengthened, benefiting the sex life of both men and women and averting potential future issues.
Continuing the journey, we comprehensively sculpt thighs—front, back, inner, and outer—addressing skin tightening, fat reduction, muscle enhancement, and cellulite or stretch mark removal.
Culminating the transformation, allow us to enhance your calves for irresistibly sculpted legs, meeting the desires of both men and women.
Step out as a revitalized individual, with no downtime, ready to embrace any evening plans, including glamorous black-tie events.
WHAT TO EAGERLY ANTICIPATE
From the moment you engage with us, expect an unparalleled, exclusive journey. Our concierge service, available seven days a week, ensures seamless scheduling tailored to your preferences. Navigate with ease; we are here to address your queries and accommodate appointments that align with your busy schedule.
Upon arrival, you’ll notice the deliberate absence of signage, catering to the discretion valued by our high-profile clientele. For those seeking absolute privacy, inquire about reserving the entire office exclusively for your use, ensuring complete anonymity, regardless of your status.
Warmly welcomed by our limited staff (maximum two individuals), you’ll find a waiting area free from onlookers. Enjoy a selection of beverages as you’re escorted into your private sanctuary, complete with customizable amenities such as temperature control, phone charging, and spa-like beds adorned with freshly laundered linens.
Its not that complicated. A friend asked yesterday, what was that thing or energy for cellulite?
So from the top
1 Lasers been around forever get rid of superficial red spots, age spots goes by names like IPL anything with the name laser attached to it lots of different frequencies
2 Radio frequency. Creates heat and can be delivered past the surface of the skin to the collagen layer for skin tightening or to the fat layer for fat melting
3 Acoustic Wave. Awesome for cellulite its a pulsing or pounding that literally is used for physical therapy. It forces the muscles to heal more quickly and it also hits the fibers that should be holding back the cellulite to tighten. The latest iteration Emtone acoustic wave plus radio frequency
4 Ultra Sound great for deeper work Often used for the body Exilis combines Ultrasound and radio frequency for body shaping there are others like liposonix. We do not offer ultrasound on face like Ulthera.
5 Coolsculpting Not recommended google search paradoxical hyperplasia and for fun throw in Linda Evangelista with your search
6 Carboxytherapy Introduction of Carbon dioxide great for stretch marks
I have a ton I can say about all of these, which I did say in the other posts and videos. But of the hundreds of devices you will see out there its one of the above and or a combination of them. With radio frequency, Thermage, Ultrashape, Velashape, Its the experience of the operator. And there are slight differences in the machines.
Actually I can elaborate for hours on these devices. But I know sometimes you just want it short and sweet.
Feel free to listen to the youtube sometimes reading it and hearing it is even more helpful. Plus there is a lot more detail in the video since its 26 minutes compared to a 2 minute read. Plus you can see my beautiful face from every angle.
Please excuse the self referential stories. I dont know how else to explain actual events and dates and the significance without telling the actual story. I am trying to give the best advice I can based on my learning over the past 20 years my personal experiences with the technologies and researching the technologies. My tens of thousands of phone calls with new patient inquiries (each call beginning with me asking and surveying what treatments they have done, what worked and what didnt)
Funny when I made the video I remembered that after my first Thermage treatment my skin got so much tighter that I didnt have to pull on it to shave. I completely forgot that. To this day I dont have to pull my skin taut because it is taut. Men know what I am talking about and probably so do some of you women who have watched a man shave.
Ill have to make a video of me shaving LOL
DONT GET FOOLED AGAIN.
Especially by med spas that dont even offer the most effective treatments stronger medical grade devices that absolutely must be operated by someone with at least 15 years experience. They havent been around that long LOL.
The most effective medical grade devices have to be operated at a very high temperature by a highly qualified and experienced person. PS that is not the doctor. The doctor doesnt operate a machine every day. That is absurd. That is not why they went to medical school. Often when a patient insists the doctor operate the machine the first question out of the doctor’s mouth is how do I turn this on? Do you think that is the most experienced person?
IN THE BEGINNING First there were lasers. They were used in cosmetics for getting rid of superficial red spots. You can even get rid of tiny superficial veins. Not bigger veins like on the body. Those veins require being surgically removed. It is called vein stripping. Even small veins that are removed by lasers sometimes grow back.
The first technology to revolutionize the “non surgical” market was Thermage. It utilizes radio frequency to tighten the skin. If you tried to turn up a laser to do this you would burn the skin before you reached the collagen layer to tighten the skin. The genius behind Thermage who holds the patent for this technology is the same principle you see every day in your microwave oven. In the sense that the skin on your chicken will never brown. It can bypass it and go straight to the middle. In the same manner Thermage is calibrated to go to the collagen layer. There is an immediate tightening and then for the next three to six months the stimulated collagen grows for even greater results after the original tightening. The result for many, including myself is maintaining a smooth lower face and jaw. One could even refer to it, as a non surgical face lift. Lets just call it a quarter of an inch to give you an idea. There are many before and afters on the internet to give you an idea of great results from Thermage.
There are so many other technologies that now utilize radio frequency, profound, velashape, ultrashape. Actually I think there are over 50 of them. You need the person who has the most experience. You need to operate these devices at a very high temperature to get the best possible treatment. That will never happen at a med spa. In fact most med spas do not even have devices like these that are truly medical grade devices. Since we were the first in 2007 with Thermage NXT in New York we actually have the most experience. We also delivered the most treatments in New York multiple years. Apologies that it is about us, but it also explains the experience with which I speak.
Then came Exilis. Ironically made by BTL who later became famous for Emsculpt the ab machine everyone happily shares on videos. Exilis utilizes radio frequency as well but it is calibrated to go to the fat layer to melt fat, for body shaping. It also has another handpiece that is calibrated to tighten the skin but not as deep as Thermage. To be accurate the body shaping hand piece actually incorporates ultrasound and radio frequency for greater results. Dr Lisa explained to me fat cells look like a cluster of grapes so the ultrasound, shakes them loose and makes it more effective.
We brought the first BTL Exilis device to NY in 2009. So literally no one has more experience than we do. Dr Lisa was lecturing at the Monte Carlo Anti Aging Congress, because we just introduced tne Thermage CPT in 2009 and did a study on it. At that conference we met the President of BTL Jan Zarksky who gave us the Exilis to bring to New York, recognizing our expertise. It doesnt get better than that for experience. And we are the same team 17 years later.
In 2010 we got a call from Jan Zarsky of BTL he explained that the women who were doing acoustic wave therapy for physical therapy were swearing their cellulite was disappearing. Who ever heard of that? Can you imagine that the unexpected side effect was that obvious, that women wanted to continue treatment? Usually the opposite happens. Most of our new patients came to us because they did not get the promised effect some place else. In life in every profession always underpromise.
So the President of BTL sent us the acosutic wave device to do a study. Sure enough it was more effective than the Thermage we were doing at that time which was a much more expensive treatment. But the acoustic wave required many more treatments. But the acoustic wave didnt have consumables So we dropped the price by 80% and offered acoustic wave therapy. Just FYI acoustic wave didnt require expensive consumables. So even though the results were better we fairly dropped the price and passed on the savings to our grateful clients.
Fast forward 2020 BTL added radio frequency to the acoustic wave for skin tightening as well as cellulite reduction and called it Emtone. We happily took the first one in New York in 2019 and were crowned the doctor’s training facility due to our extensive contribution to the research and development of the technology. Sadly it was only a month before we were shut down for the pandemic and they never really marketed it much. They were having too much fun with Emsculpt the ab machine, since everyone was happy to share their abs on social media vs showing off their before and after cellulite? Who would have thought. LOL?
I skipped Emsculpt because I was telling the continuous story of the best cellulite treatment which started with our research in 2010 and culminated in Emtone in 2020. BTL actually released Emsculpt in 2018. That is the device everyone brags about and shows off their abs. It is muscle stimulation. But to be clear this is not stick on skin. Its electro magnetic and engages the whole muscle group with 20,000 crunches. After four or six treatments ( we immediately went to six) Do the math 50% better results. Actually probably more we didnt do a study before and afters but its cumulative. Their reported results after only four treatments was plus 16% muscle and minus 19% fat in the area. And if you heard of Emsculpt Neo they added radio frequency to it for even better results. You may have heard of Cutera TruFlex. I was interested in that machine and got a demo. So there are a dozen pads that are stuck on the skin. I thought it made sense but you cant go that strong and engaging the whole muscle group is better. I even spoke to an orthopedic surgeon at a seminar and asked him if it would be better to heal muscles in legs or backs. He said, “no its better to engage the muscle group” He had used emsculpt to help a girl avoid knee replacement. A big aside but it is relevant as to which technology is more effective.
In 2022 BTL offered a few Emface machines to New York. We happily signed up to be the first. To make it short and sweet is emsculpt for the face. What better way to lift your face then to restore your muscles. After 75,000 muscle contractions six times, as we offer. You can really see the lift in your lower face. I dont own an MRI or an ultrasound but by their research even four treatments offer 37% restoration of muscle, 23% lift and 37% wrinkle reduction. for our best clients we also combine Emface with Thermage for the kind of results I got.
Sorry backwards again in time. Back in 2005 Dr Lisa also did the United States research on Carboxytherapy before we opened Precision Aesthetics. It was being used extensively in Europe and South America. It is simply magic for stretch marks of any color on any color skin. For those of you who are familiar with microneedling. Imagine microneedling on steroids. The needle is approximately the same as used for taking blood. It is used to break up the stretch mark, then a drop of Co2 gas is inserted. As you might remember from High School biology, every cell in your body is excreting Co2 and bringing in Oxygen. That is what makes it magical. Because the body now rushes oxygenated blood to the area. The increase in circulation really multiplies the effect of the treatment for truly great results. We have people fly in from all over the country to get treated by us. Using a laser for stretch marks is pretty much malpractice in my opinion. You are merely striping the body to camouflage the stretch mark. Worse yet you could get hypo or hyperpigmented. Its a total no no for dark skin. A stretch mark is like a scar. The skin has ripped at a deep level. Carboxy is also great for scars.
Its that simple. If there was anything else that would give our clients great results with little to no down time, we would have bought it yesterday, we have many thousands of clients.
PS lets talk about No Nos. Coolsculpting just google paradoxical hyperplasia and google paradoxical hyperplasia and Linda Evangelista. You dont have to take my word for it. PS why are there 5 law firms doing class action law suits against Coolsculpting? Lawyers dont waste their time. They will take on a case if you were run over by a Fedex truck and they will sue Coolsculpting. Do the math.
In an ultimate act of selfishness, I’ve been holding back. I was worried—worried that someone might criticize me, that someone might not like me. Protecting my feelings took priority. I haven’t shared the magic I’ve learned about beauty over the past 20 years. Plus, I needed to see 17 years of results to be positive about what the treatments have done for me. Our thousands of clients will never tell. They are too high profile. Let me tell you what’s really going on in the world of non-surgical beauty, and why so many are getting disfigured, overfilled with fillers, or over-paralyzed with Botox.
Non-surgical skin tightening is magical, and we’ve mastered it. Over the years, we’ve achieved results that others can only dream of—results backed by objective proof.
Conversations with Legends
A few years ago, I was chatting with Dr. Brian Kinney, one of the most famous Beverly Hills plastic surgeons (may he rest in peace). During our small talk, I mentioned how many Thermage treatments we perform and shared our little secret: we give patients a painkiller so we can safely reach the highest, most effective temperature. This ensures the best results for a one-time treatment. He admitted something surprising: he’d never trust his technician to do that.
But that’s where we’re different. Danielle, our technician, has delivered more Thermage treatments than anyone in New York for multiple years. We’ve invested over $150,000 annually for years just on the treatment tips. Why? Because every patient deserves great results with zero downtime. Our treatments don’t even cause a slight sunburn. I have videos of myself driving home after my sessions, ready to attend a party if I wanted to. That’s how confident I am in our process.
Innovating Thermage Treatments
Let’s talk numbers: With the NXT device we used 1200-pulse tips for full face and neck treatments. While most others used 600 pulses—not even half a treatment! You dont have to be a geek to understand half a treatment isnt worth much, especially since the results are additive. PS in case any geeks are looking to find fault, the numbers are different with the Newer FlX which we do offer. We’ve gone further, offering two treatments a year (a protocol the company doesn’t officially recommend but that has proven results). The results speak for themselves. Ask the folks at Thermage—Danielle’s track record is unmatched.
Carboxytherapy: Magic for Stretch Marks
While we’re on the subject of Beverly Hills plastic surgeons, let me address a comment from a particularly famous one who’s on not on one but two TV shows. He claimed Carboxytherapy isn’t safe. Want to laugh? Carbon dioxide (CO2) is the most commonly used gas for insufflation during laparoscopic surgeries. Quarts of CO2 are used daily on each patient in operating rooms. We use barely a drop for Carboxytherapy to treat stretch marks. And while you were reading this you exhaled Co2, thats known as breathing. It is something we all learned in grade school. I dont comment on things I dont know.
Here’s how it works: the stretch mark is broken up with a needle, which also delivers a tiny drop of CO2. This encourages circulation and stimulates the area for healing. It’s pure magic. Clearly, our TV celebrity physician has never stepped into an operating room. So yes, in this instance, I’ll confidently say I know better.
Why Expertise Matters
Both Thermage and Carboxytherapy are powerful tools, but they absolutely require expertise. Look up reviews on Thermage, and you’ll see the difference between good and bad practitioners. It’s all too easy to deliver the wrong number of pulses to the wrong areas. Do any of us have perfectly symmetrical faces? Does everyone have the same needs under their chin, on their cheeks, or around their jawline? No.
Now here’s a funny one for you: I’ve had callers ask if we use the grid. The grid! This is something painted on the face on day one of training—20 years ago. It suggests evenly distributing pulses: 200 along the jawline, 200 mid-cheek, 200 upper cheek. That approach? A disaster waiting to happen. Everyone’s face is unique, and a one-size-fits-all approach simply doesn’t work.
Years of Listening
Or that I have answered three calls a day for 17 years—around 17,000 phone calls—and have asked each person what treatments they’ve done and what their results were. So yes, I know better than literally anyone what works and what doesn’t. Take, for instance, the last CoolSculpting seminar I attended. The salesman whipped out his phone, Googled “bad CoolSculpting,” and showed me an image that looked like a shark bite. He explained that you’d need at least eight treatments for the stomach area: four on the front and two on each flank. Even then, you’d have eight shark bites, not a smooth result.
Or consider the Cutera seminar, where their fat-melting treatment involves a dozen pads stuck in place. I asked the doctor lecturing about the difference between that and handheld treatments like Exilis. With a wand, you can keep moving, allowing higher temperatures and smoother results. His response? “I’ve never operated one; I have no idea.”
The Apology
So here I am, finally shouting from the rooftops what thousands of our patients already know. These treatments, when done right, are transformative. But they must be done by someone skilled, someone who knows how to customize every pulse, every injection, every treatment to the individual. I’m sorry for holding back, for not sharing sooner. It’s time to change that.
If you’re ready to experience beauty treatments done right—by someone who truly knows what they’re doing—you know where to find us. Let’s do this the right way.
PS: It is your choice if you want lips, tits, and butt too big and completely frozen faces and want to take out a mortgage for it. Just not what we do.
Happiness Health and Beauty Secrets 