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Ron Shelton M.D.

#317 East 34th Street,
11th Floor, New York, NY 10016. 

Pre and Post Operative Instructions

Dear Patient,

Before your scheduled procedure, there are a few minor precautions and things about Zeltiq™(Coolsculpting™) you should know to help prepare yourself for a successful treatment and speedy recovery. By following these steps you're essentially helping your body cope with the trauma of surgery - significantly strengthening your recuperative powers - minimizing the need for any follow-up procedures - and preparing yourself to feel more comfortable on the day you're treated. So, for your own benefit, please review the attached instructions and information prior to your appointment with us.

If you think of any questions about Zeltiq™(Coolsculpting™), or remember important medical information - medications, prior surgeries - that you forgot to mention to our staff, please contact the office before your surgery.

Looking forward to providing you with excellent medical and nursing care, we remain -

Respectfully yours,
Ron Shelton, M.D. and Staff

General Information about the Zeltiq™(Coolsculpting™) Procedure

What is the Zeltiq™(Coolsculpting™) Procedure?
Zeltiq™(Coolsculpting™) is an innovative fat reduction treatment that has been proven highly effective in clinical trials, reducing fat by as much as 20%. Through the application of cold temperature, massage, and vacuum, the process of lipolysis is instigated. This cosmetic treatment is non-invasive in that only fat cells are affected by the combination of temperature and vacuum, leaving all other tissue intact and healthy.

How is the cooling delivered to the fat layer?
The Zeltiq™(Coolsculpting™) System uses a selection of non-invasive, tissue cooling applicators that are precisely controlled by an engineered monitoring system. The Medical Assistant will attach the applicator to the target procedure area (which will be discussed in depth with Dr. Shelton during your consultation) to cool the underlying fat tissue.

Who are the best candidates for the Zeltiq™(Coolsculpting™) Procedure?
This procedure is ideal for those are relatively fit, but have some modest size fat bulges that do not improve with diet and exercise. They are seeking spot reduction of specific areas of fat, but do not want anything invasive, such as Liposuction.

How much does one treatment of Zeltiq™(Coolsculpting™) cost?
A solitary zone of the abdomen, pair of love handles, or flanks is $1,500.

Is more than one session recommended?
You may require an additional treatment in the same zone to reduce the size of the area even more, but this is usually done with at least three months in between sessions. Dr. Shelton will evaluate and discuss if further treatment is needed at the time of your follow up.

What are the side effects of Zeltiq™(Coolsculpting™)?
During the procedure, you will feel a moderate amount of discomfort for the first ten minutes, which will steadily decrease as the tissue becomes numb from the cold applicator. For the remaining fifty minutes, you should not feel anything, except for occasional "twinges, tugs, and pulls" but they are very tolerable. You may also feel intense cold, stinging, cramping and aching.

After the applicator is removed and the numbness created by the machine wears off, you may experience the following side effects:

- Numb sensation over treated area, along with redness and firmness.

- Area(s) may be red, firm, and tender to the touch, and you may also feel dull, aching, or throbbing pain if the area is stretched. (For example, if you have had your abdomen treated, when you go to reach for an object in a higher place, you may feel some discomfort.)

Side effects one to two weeks after the procedure:

- Redness, bruising, and swelling.
- Tenderness, cramping, and aching.
- Itching, sensitive skin, tingling and numbness. The numbness can occur up to several weeks after the procedure.
- It also not uncommon to experience intense pain about one week after the procedure, although this is not the case for everyone. This may be more of a "shooting" pain sensation, that can usually be treated with Tylenol.

How do the results compare with other invasive procedures such as Liposuction?

The results of Zeltiq™ (Coolsculpting™) are not as rapid or dramatic as invasive Liposuction. However, for patients who wish to avoid the pain, risk, and recovery time associated with surgical procedures, this may be the preferred option.

Is Zeltiq™ recommended for cellulite?

Well controlled studies to determine whether or not Zeltiq™ (Coolsculpting™) will improve the appearance of cellulite have not been done at this time, and therefore it is not recommended for this condition.

Pre Operative Instructions

Aspirin - If you are taking any amount of aspirin on a daily basis, please notify our staff. We generally allow you to continue taking your aspirin for a medical condition. However, we may ask you to stop approximately 10 days before your procedure if it is just for prophylactic reasons. If you are currently taking Coumadin, please contact the prescribing doctor regarding whether or not you should discontinue it for Zeltiq™ (Coolsculpting™). This will help lessen your chances of bruising during the procedure.

Supplements - Do not take any Vitamin E , Ginseng, Garlic Tablets, or Gingko Biloba two days prior to you procedure.

Pain Relief - Do not take any non-steroidal anti-inflammantory agents, such as Motrin, Ibuprofen, Advil, Celebrex, Nuprin, Feldene, Clinoril, Alleve, Naroprosyn, or Anaprox for two days before Zeltiq™ (Coolsculpting™). Again, this will help limit the chances of bruising you may have. You can resume these medications the following day after your treatment.

Alcohol - Try to avoid alcoholic beverages, such as beer, wine, and liquor one day before the surgery. You may resume them the day after the procedure.

Clothing - Please be sure to wear loose, comfortable clothing the day of your Zeltiq™(Coolsculpting™) Procedure. It is not uncommon after the treatment to have swelling, and as the numbness brought on from the machine wears off, your body may become more aware of discomfort in the area. Avoid pants with tight waist bands and belts, or anything else that is restrictive.

Bring something to do - Usually, the procedure will last approximately one hour per zone. If you are getting your abdomen treated, it will be just one hour since it is one zone. Love handles are flanks are divided into two zones, so you will have a one hour treatment for each side. The Medical Assistant will be with you during the first ten minutes to ensure the applicator has a snug fit to the area, and to make sure you are comfortable. After that, you will have the opportunity to relax while the treatment progresses. There is a television, movies to download from the internet, wireless internet, and an iPod dock in the treatment room, but feel free to bring a book, laptop, magazine, etc. if you prefer.

Post Operative Instructions

For Pain - Take Extra Strength Tylenol. Avoid NSAIDS and Aspirin until the day after your Zeltiq™ (Coolsculpting™) Treatment. A compression garment may be given to you at the office, which will help reduce your discomfort. You will be slightly uncomfortable after the procedure, however, if you experience any severe discomfort that is not tolerable, call our office.

Activities - Since Zeltiq™ (Coolsculpting™) is non invasive, you may resume your normal activities right away. Generally, the first couple of days after the treatment, the area will feel as if it's been through a really intense workout regimen, "as if you were sore from doing many crunches and situps" but this is temporary. Continue to wear comfortable clothing for the first 2 days if you can, and gradually go back to form fitting bottoms and belts as your body tolerates it.

Results - Patients will see results as quickly as three weeks after their treatment, with more dramatic results in two months and this improves through four months and more. The body is still flushing out the fat cells for up to four months, so improvement will continue through that time period. During your Zeltiq™ (Cool Scuplting) Treatment, your fat cells have been eliminated. As long as you maintain your weight with diet and exercise, long term results should remain stable.