How Patients Deal with Discomfort after CoolSculpting

Popsicle panniculitis became the inspiration for the non-surgical CoolSculpting procedure. This phenomenon was observed when excessive exposure to cold popsicles result in the reduction of fats in cheeks.

CoolSculpting usually works on patients who have fats in certain areas of their body that can be "pinched" by doctors. This procedure will not work with obese patients. It specifically targets fat cells and doesn't harm any muscle tissue or skin.

Patients undergoing this procedure often complain of discomfort, most often in the abdomen area, after the non-surgical treatment. Itching is associated with the body digesting the dead fat cells. A patient who has experienced such itchiness after the CoolSculpting noted that the doctor prescribed Neurontin to ease the discomfort felt while the nerves in the affected area are still recovering. Others also use compression garments or lightly massage the area to lessen the itch. Redness, bruising, and swelling may also develop for some patients but these are only temporary.

One patient took Motrin every five hours to treat the pain and inflammation in the area. With CoolSculpting, patients' level of discomfort is lower compared to those performed after a tummy tuck or liposuction. There are even patients who immediately go back to work the day after the non-surgical treatment, claiming that the discomfort they feel is tolerable.

Most patients are actually looking forward to the results and wouldn't mind the little discomfort. It is very important for those who administer CoolSculpting procedures to assess whether a patient can have this treatment. Also, they must be briefed and informed about the after-effects of the procedure and the discomforts they might feel.

Popsicle Panniculitis?

"Popsicle Panniculitis" can be caused by a number of conditions, most often exposure to cold that affects some infants 6 to 72 hours after they suck on a popsicle or ice cube. Popsicle panniculitis causes swelling and redness in the cheeks near the corners of the mouth. It's a rare condition that usually only affects infants and young children, possibly because infants have a higher concentration of fatty acids in their subcutaneous tissue than adults do. The only treatment required for popsicle panniculitis is to remove the source of cold or limit the child's exposure to cold.

Dr. Brett Kotlus, Cosmetic Surgeon At Allure Medical Spa In Michigan

Dr. Brett Kotlus; from gene mapping to plastic surgery.

Physician:  Brett Kotlus, M.D., M.S.
Location Update: Dr. Kotlus has recently moved to NYC. His new practice webesite is at DrKotlus.com

That's interesting: Dr. Kotlus has traveled to Mongolia on a humanitarian medical mission to instruct local doctors. He also had the opportunity to travel to Malaysia and Thailand to conduct a peer-to-peer laser training. In 2007, he was the first recipient of two Cosmetic Surgery Foundation research grants.

About: I went to Penn State for my undergraduate education and I stayed on to finish a Master’s program in genetics. My thesis involved gene mapping in mice. I then decided I wanted to work with people, and I went to medical school at Tel Aviv University. After a residency in ophthalmology in New York, I completed two fellowships, one in oculofacial plastic surgery accredited by ASOPRS and a two-year cosmetic surgery fellowship accredited by the American Academy of Cosmetic Surgery. I then joined a cosmetic practice in Michigan.

How did you fell in love with cosmetic medicine? What was your training like?

My AACS-accredited fellowship in general cosmetic surgery was a major influence on my career. I had the opportunity to train with fantastic oculofacial surgeons, ENT/facial plastic surgeons, general plastic surgeons, and general surgeons to round out my aesthetic knowledge.  The exposure to a growing field involving new technology was an attraction early on.

Who runs your plastic surgery center an medical spa and what services do you offer?

The office is an hour north of Detroit. There are 2 full-time physicians, 2 part-time physicians, and 2 physician assistants. The scope of the practice includes non-surgical and surgical cosmetic procedures including functional oculoplastic surgery, varicose vein treatments, medical weight management, and hormone replacement. The office has an accredited operating suite.  

Are you using new technologies in your clinic? Can you share your experience using these?

We are strongly involved in new technology. There is a lot of excitement in the practice right now for the nonsurgical fat reduction devices. We are using CoolSculpting and Liposonix and both have shown better results than any previous non-surgical fat reduction modality. With CoolSculpting for example, we have found an average of 25% subcutaneous thickness reduction after a single treatment, as measured by diagnostic ultrasound. The market for body contouring is huge, especially when it can be done with minimally-invasive means.  

For skin resurfacing I generally use the erbium Fraxel or the fractional CO2 (Lumenis ActiveFX and DeepFX) depending on the client’s tolerance for downtime. Ulthera is a new addition to the practice and I think it will supplant Thermage for non-surgical firming.     

How are you driving new patient traffic?

Obviously, we put a good deal of focus on the internet with our website and adwords campaigns. This is an ongoing project, and we work with an SEO firm as the ranking rules continue to evolve. We did a Groupon campaign that was very successful in the sense that it introduced our practice to clients that may not have known about us. It was definitely worthwhile.

Internal marketing to our existing patientsis our most valuable form of advertising. We rely on referrals from happy clients and we regularly schedule seminars and events to generate excitement and offer education about the procedures we offer.

Many surgeons are less than enthusiastic about nonsurgical treatments. What's your on using nonsurgical treatments alongside surgery.

Injectables continue to amaze me in terms of being able to achieve great results in a short period of time with minimal downtime.  Neuromodulators and fillers are often downplayed by cosmetic surgeons because they want to be in the OR, but they should embrace the minimally-invasive advances in our field. I find injectables to be just as professionally rewarding as surgery. 

One of my favorite stories about appearances comes from my own family. My grandmother underwent cataract surgery a few years ago. She called me afterward because she thought the surgery gave her more wrinkles and made her face look older. To me, she looked the same, but her vision was dramatically better, so she was able to see the wrinkles. From her perspective, she aged 10 years in an instant. She couldn’t believe that she had been walking around like that for all these years. She still imagines herself as a youthful person. Some of the time in cosmetic medicine we are focusing on a wrinkle when we should be focusing on a perspective. 

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be interviewed, just contact us.

Update on 2015-02-05 14:45 by Medical Spa MD

Update: Dr. Kotlus has recently moved to NYC. His new practice webesite is at DrKotlus.com