18 March 2016 March 2016 19 Expert guide: Aesthetics & Cosmetology 2016 Introduction The global demand for aesthetic procedures continues to grow considerably each year. The ageing “baby boomer” generation and the ro-bust economy has led to ongoing growth in the aesthetic industry. In the US, more than $13.5bn was spent in cosmetic procedures in 2015, a $1.5bn increase from the previous years.1 Pa-tients cite a desire to appear more youthful, healthier, and need to remain competitive in the workplace as reasons for their surgical and non-surgical cosmetic expenditures. While the majority of aesthetic procedures are surgical, non-surgical procedures accounted for 42% of the total expenditures.1 With 22% in-crease in non-surgical expenditures compared to the previous year and 44% increase over the past five years, the demand for non-surgical al-ternatives is growing rapidly. Injectables, hair removal, and skincare are the most popular non-surgical procedures, but there is growing interest in non-surgical body contouring pro-cedures. Liposuction remains the most popular surgical procedure and patients are increasing-ly asking for non-invasive options to avoid the surgical risks and downtime associated with surgery. Non-surgical fat reduction procedures body contouring procedure available. Patients come to my practice asking for the CoolSculpt-ing procedure by name. CoolSculpting The potential for cryolipolysis, controlled cool-ing to selectively target undesirable subcutane-ous fat, was first recognized by researchers R. Rox Anderson, MD, and Dieter Manstein, MD, PhD, from the Wellman Center for Photomedi-cine at Massachusetts General Hospital, a teach-ing affiliate of Harvard Medical School. Based upon case reports of cold-induced panniculitis, they investigated controlled cooling and real-ized that lipid-rich fat cells are more susceptible to cold injury than surrounding water-rich cells. The cryolipolysis technology was exclusively li-censed to ZELTIQ Aesthetics in 2005 and the CoolSculpting system was developed to non-invasively reduce subcutaneous fat. CoolSculpting received FDA clearance in the increased 18.7% year over year and the demand is anticipated to increase.1 At Kazem Aesthet-ica, I provide both surgical and non-surgical procedures to help patients achieve their aes-thetic goals.Non-Surgical Body Contouring There is a wide array of methods for non-in-vasive body contouring. These energy-based methods include radiofrequency heating, non-thermal focused ultrasound, high intensity fo-cused ultrasound, low level laser therapy, and external laser lipolysis. None provide the re-peatable, reliable, dramatic results achieved by liposuction, but most patients don’t want to un-dergo elective surgery. Some lack clinical stud-ies and proven efficacy, some have moderate efficacy but poor patient tolerability, and some show occasional efficacy but poor reliability.I’ve explored many innovative techniques at my practice and my chosen non-surgical body contouring procedure is cryolipolysis, which utilises controlled cooling to selectively tar-get undesirable subcutaneous fat. Commonly known as CoolSculpting by ZELTIQ Aesthet-ics, the cryolipolysis procedure is the only safe, tolerable, effective, and reliable non-invasive US for non-surgical reduction of fat in the flank area in 2010. FDA clearance followed for the abdomen in 2012, for the thighs in 2014, the submental area in 2015, and back fat, bra fat, and underneath the buttocks in 2016. CoolS-culpting is approved for fat reduction in over 70 countries worldwide, throughout Europe, and including Canada, Brazil, and Australia.The CoolSculpting System consists of a control module and an array of applicators for contour-ing different areas of the body. There are several vacuum applicators which pull the targeted tis-sue into a cup and apply surface cooling from parallel panels. The vacuum applicator sizes and cup curvature accommodate a range of patient sizes and treatment areas, such as ab-domens and inner thighs. A non-vacuum con-formable surface cryolipolysis applicator allows treatment of fibrous, non-pinchable fat in areas such as the lateral thigh bulges. An example of one of my patients following CoolSculpting of the abdomen and flanks is shown in Figure 1. Dr. Farid Kazem www.kazem.nl info@kazem.nl +31 172 50 90 75 Non-Invasive Body Contouring By Dr. Farid Kazem Netherlands Figure 1: CoolSculpting abdomen and flank treatment demonstrating the Treatment to Transformation protocol for dramatic fat reduction. Pre-treatment (top row) and post-treatment (bottom row). Procedure by Dr. Farid Kazem. With the 3-in-1 CoolAdvantage applicator, CoolSculpting secures its position as the leader in non-surgical fat reduction