WHO AM I Cosm-Ethical & Rational Dermatology

THE FAT CONCEPT

THE SCIENCE BEHIND CRYOADIPOLYSIS

WHY COOLTECH DEFINE

THE SYSTEM OVERVIEW AND ACCESSORIES

WHAT IS IT? HOW DOES IT WORK?

THE COOLTECH DEFINE PROCEDURE, PATIENCE SELECTION, EXPECTATION AND FOLLOW UP

CLINICAL EVIDENCE

C O C O O N M E D I C A L

Agenda

RESULTS

Who I am?

C O C O O N M E D I C A L

Social media

C O C O O N M E D I C A L

campooptimage

Clínica Campo-Optimage

campo-optimage.com

Antonio Campo Voegeli

Who

we?

C O C O O N M E D I C A L

are

M.D.: UAB Excellence Certificate

Dermatology: , Hospital Clinic

Barcelona

Hospital Clinic: Oncologic Surgery Laser Unit

PhD: U.B “Cum Laude” Immunodermatology

Laclinic Montreux, Switzerland Laser and Aesthetic Medicine

Campo-Optimage: Medical Director Laser & Aesthetic Medicine

Antonio Campo Voegeli

How is My practice?

C O C O O N M E D I C A L

Excellence as the gold: Only the best staff and equipment. Exclusivity: High end environment.

Personal and close

“trato”.

Honesty

Our philosophy, our value.

Responsability

Taking care of our

patients in all

circumstances.

Cosm-Ethical Rational Dermatology

Optimal Results as the gold: Only the best staff and equipment.

Longstanding

Natural results Look better Stay the same

Persistent & accumulative

Patients go never back

Increase results with every

application

C O C O O N M E D I C A L

We do... Avoid

C O C O O N M E D I C A L

Multiple treatment protocols Mesotherapy Peelings PRP

“Flash procedures”

No cost efficient Poor cost-result Relation

No physic background

Logic and evicence

C O C O O N M E D I C A L

C O C O O N M E D I C A L

C O C O O N M E D I C A L

C O C O O N M E D I C A L

Body Treatments

Is there a Market?

C O C O O N M E D I C A L

Body Treatments In numbers

C O C O O N M E D I C A L

Constantly Growing Market 8.2 Billion US$ 2018 Expected to grow 10.5% 2019-2025

Non Surgical proportionally more than Surgical

We do... Avoid

Long experience in weight optimization Dra Arboles Specialized in Nutritional and medical control Disorders in Nutritional Behaviour

”None offered evident and persistent results in few sessions without the need of persistent repetition”

Many body-shaping technologies

RF

Cavitation

Lipolytic ligth sources

LPG

Mesotherapy...

C O C O O N M E D I C A L

Our programm Nutritional plan Psichological support Nutritional “re-education”

The fat concept

C O C O O N M E D I C A L

87%

C O C O O N M E D I C A L

The Fact of fat

Set number after adulthood

Essential fat vs excess body fat

Adipocyte: triglycerides, nucleus and general cell contents

1 pound of fat = 3500 calories

87% triglyceride In adipocyte

Triglycerides

C O C O O N M E D I C A L

Hypermetrophy, The number of that cells stays the same, but their size increases. Mainly during adulthood.

Hyperplasia The amount of adipose cells Increases. Mainly during childhood.

How does It grow

C O C O O N M E D I C A L

Childhood... Hyperplasia. Generalized Obesity

C O C O O N M E D I C A L

Adults... Hyperplasia. Central Obesity

Types of adiposity

C O C O O N M E D I C A L

Visceral fat It surrounds the organs. Can be linked to diabetes and heart disease. It disappears only with diet and excercise

Subcutaneous fat Located under the skin. It works as a reserve of energy. You can feel it by pinching it with your hand.

Viceral Fat

Fat Reserve

Subcutaneous fat

C O C O O N M E D I C A L

Localized fat Adiposity targeted by Cooltech Define

This is the target of our treatment. As fatty tissue is concentrated in certain areas and affects the body’s silhouette. It may or may not be associated with excessive weight.

C O C O O N M E D I C A L

Patient selection Good candidate Pinchable distinct bulges

with minimal skin laxity

C O C O O N M E D I C A L

Patient selection Bad candidate

Too much fat

C O C O O N M E D I C A L

Patient selection Bad candidate

Visceral fat

C O C O O N M E D I C A L

Patient selection Bad candidate

Laxity

C O C O O N M E D I C A L

Patient selection Bad candidate

Not enough fat

C O C O O N M E D I C A L

Patient selection Bad candidate

Laxity

C O C O O N M E D I C A L

Patient selection Bad candidate

Laxity

Skin disease

C O C O O N M E D I C A L

Fresh scar

Cellulite

Patient selection Bad candidate

C O C O O N M E D I C A L

Stretch marks

Patient selection Bad candidate

Hernia

Why Cooltech?

C O C O O N M E D I C A L

C O C O O N M E D I C A L

My Previous Experience

Laclinic (2013-2017)

Montreux Switzerland

Coolsculpting (Zeltiq)

Results

Economical Analysis

Cost of device

100.000€

Cost consumables

150-350€/treatment area

700-1000€ cost for patient

Treatment area/session

1

Average area/patient

3

Percentage of non responders

15%

C O C O O N M E D I C A L

C O C O O N M E D I C A L

The System

C O C O O N M E D I C A L

Overview & Accessories

4

Simultaneous

applicators

Up to 8 body

areas

Can be treated

on the same day

2

Couplers specially

Developed to improve

access to hard

or very small fat folds

Patented RFID

Cool Gel Pad

to guarantee maximum

safety of the patient

FULL BODY

CONTOURING

Save time / Save cost

Cool faster / Better comfort

Greater result

360º Power cooling plate

C O C O O N M E D I C A L

C O C O O N M E D I C A L

Homogenous cooling to all treatment areas.

Power cooling

C O C O O N M E D I C A L

Cool faster

Leads to Better

comfort

Greater result

Optimized design and internal shape ensure the perfect contact with treated area.

Economical Analysis

C O C O O N M E D I C A L

Cost of device

70.000€

Cost consumables

15€/treatment area

200-300€ cost for patient

Treatment area/session

Average area/patient

Percentage of non responders

4

3

15%

70.000 €

Cost patient 600-1200€

15% non responders

(Free treatments at 15€)

C O C O O N M E D I C A L

C O C O O N M E D I C A L

But...I wanted to try it myself...

Control

18 months After 1 treatment

What is it? How does it work?

C O C O O N M E D I C A L

Mechanism of action:

1

The treatment begins by creating a

vacuum so the fatty tissue is in total

contact with the applicator.

2

The temperature

decreases in the treatment

area.

3

The adipose cells are

damaged by exposure at

low temperature.

4

The nucleus of the fatty

cells crystallizes (the injury

begins from 4 to 10 ºC).

5

Inflammatory

response.

6

Macrophage recruitment (48

hours post treatment).

7

Phagocytosis.

8

Lower immune response

(30 days post treatment).

9

Lower thickness of

interlobular septa (90 days

post treatment).

C O C O O N M E D I C A L

C O C O O N M E D I C A L

-10ºC 70 mins

50/ Procedure

Low risk of necrosis

The perfect balance of safety and efficacy

High efficacy of fat reduction

Ave

rag

e f

at

tem

pe

ratu

re (

de

gC

)

Time (min)

The Procedure

C O C O O N M E D I C A L

The patient process

C O C O O N M E D I C A L

Consultation

And patient

expectation

Before

Photo

Assessment

Personalized

Treatment plan

CoolTech

Define

Procedure

Patient

Follow up

After Photo

(8 weeks after)

Repeat on

the area or each

Out to other

potential area

Clinical History Important diseases (DM, tyrhoid gland...) Contraindications Patient’s concerns and expectations

C O C O O N M E D I C A L

Consultation Day Patient education

and expectation

Physical Examination BMI Weight Heigth

Specific Localized Fat Deposits Analyze usual areas of localized fat deposits.

Personalized Treatment Protocol Diet Exercise Psichological support

Select Cryolipolisis Areas Standing in front mirror Ask for patient’s concern areas. Biomeasurements Contour measurements. Fat thickness. Standarized photos. 3D volume analizing pictures. Marking Asses bulge by “⊂ ⊃” shape pinching. Identify natural orientation of the bulge. Treatment plan Establish number of treatment sessions and zones. Start by most efficient ones. Add additional according to patients concern’s and budget.

Assessment & Personalize

Treatment Plan Assessment &

Marking

C O C O O N M E D I C A L

x

1. Peak

3. Applicator boarder

2. Fat boarder

Establish target areas Important diseases (DM, tyrhoid gland...) Contraindications Patient’s concerns and expectations

Suction level Determine how much tissue

can be drawn in applicator.

Selection of applicators Use templates to establish which

applicator in every area.

Establish number of applicators for

each treatment session.

Marking Mark peak, fat boarder

and applicater border.

Assure the bulge is completely

covered.

Prepare the patient before every step with the right expectation is key

Placement lasts 70 mins or 50 mins. Perfect balance of safety and efficacy.

The patient will feel

Cold of the Cool Gel Pad application. Seep pulling, tugging, pinching, cold and stinging when the vacuum is being applied. Numb due to the coldness.

C O C O O N M E D I C A L

Cooltech define procedure

Patient Expectation/ During Treatment

In rare case, patient may experience nausea or dizziness which usually resolve within minutes. Ensure the patient is comfortable for the entire treatment time.

2-minute semi-auto massage by Cooltech Define Massager.

C O C O O N M E D I C A L

Cooltech define procedure

Post-procedure Massage

Explain massage is for maximize the outcome of the procedure.

Prepare patient May experience uncomfortable sensation.

Suggest to clean and comfort the treated area by warm towel.

○ Deep itching

○ Tingling

○ Numbness

○ Tenderness to the touch

○ Strong cramping

○ Muscle spasms

○ Aching and/or soreness

Patient Post Care

● . Compression garments

● . Cold compress

● . Warm pad

● . Stretching

Solutions

Most patients Resume daily activity, no limitations First 2 weeks May experience:

Start to see results As early as 3-4 weeks, Most dramatice 1-3 months Will process injured fat cells up to 4 months after.

Optional combinations Pressotheraphy: immediately after, twice a week x 4 weeks. RF: immediately after, twice a week mantained. Others: shockwaves, mesotherapy.

C O C O O N M E D I C A L

Patient Follow up

& Repeat Treatment

C O C O O N M E D I C A L

Recommended follow up call Days 1, 7, 14 and 45 after treatment.

First outcome evaluation 6-8 weeks Discuss outcomes and fullfillment of expectations. Establish next areas to be treated.

First clinical control 2-4 weeks Evaluate secondary reactions, pain and results, remember may take 1-3 months.

Final evaluation 12-16 weeks Biometry: comparison with previous measures. After pictures Establish future treatment areas (progressive body sculpting (every 3-4 months)).

Growing Market Of “Body Sculpting” Increasing Demand for

Non-Surgical solutions

Other Technologies Have not shown sustainable and consistent results.

Fat is not as selectively sensitive to heat than to cold.

Cryolipolisis Strong evidence in the efficacy of removing localized fat.

“The one that diet or exercise does not remove”.

Original Technology Out of the market:

PRICE OF DEVICE

COST OF CONSUMABLES

Conclusion

C O C O O N M E D I C A L

Same Physical Principles Shows equal efficiency

if not higher.

Lower Cost Of Device

Minimal Consumable Cost

Makes affordable retreating areas without

cost if no response

Multiple Area Treatment Per Session Up to 8 per day

Maximize results Precise patient selection

Associate Diet and Nutritional education +

exercise

Complement with other EBD (RF,

Pressotherapy).

C O C O O N M E D I C A L

Thanks

Thanks