Cheree Dunbar, MD

Both SculpSure and CoolSculpting destroy about the same amount of fat with each treatment.  However, SculpSure has a few advantages.  First, the treatment time is 25 minutes per area compared to about 1 hour with CoolSculpting.  SculpSure also has some heat spread just outside of the treatment area which gives a smoother transition from treated to untreated area. There is zero downtime with SculpSure and most people have no discomfort after the treatment where some people have lingering discomfort and/or numbness for a few weeks after CoolSculpting.  Whichever method you choose, keep in mind that you will likely need 2-3 treatments per area to get the desired results.

For loose skin, some have noticed that SculpSure may give a slight tightening but this is not a claim from SculpSure itself.  There are radiofrequency devices that can help such as Exilis Ultra.  Tightening results are subtle and take time with multiple treatments.

I suspect that the inflammation and red dots will be temporary.  Exilis has not been associated with hair loss.  

A small amount of Botox injected in the lateral brow on each side usually lifts the brows slightly which would also lift the lid.  Be sure to go to someone who has plenty of experience with Botox.  If that doesn't lift it enough, surgery would likely be the next option.

It looks like the treatment was uneven, meaning that there were areas missed in between the spots treated.  However, it is hard to tell from the picture if there is also hypopigmentation or if this is the normal pigment and redness reduction. Usually for pigment and redness reduction with IPL, several treatments are done to get the best results. It is possible that with another treatment or two you will have even looking results. If you feel it is truly hypopigmentation, you may want to consider a consultation with another provider to fully assess and give recommendations.

There are several devices that can tighten skin.  I like Exilis Ultra 360 because it combines radiofrequency (RF) and ultrasound to heat the tissues and simulate production of collagen and elastin.  This is not an immediate process.  It takes a few treatments spaced a few weeks apart.  In addition, you will probably see the best results by combining it with shock wave treatments such as Cellutone and even a skin firming cream like Nectifirm.  

For fine wrinkles and crepey skin, you will get the best results by combining procedures and using a high quality skin care product.  Crepey skin is a result of thinning of the skin and loss of collagen and elastin.  A series of fractional laser treatments will improve collagen and skin thickness.  An RF treatments such as Exilis Ultra 360 (which combines RF and ultrasound) will also help to improve elastin and tighten the skin.  Finally, there are a variety of skin care products that can also help.  My favorite is DEJ face cream by Revision Skin Care which helps the skin look younger over time.

You would likely be a good candidate for Exilis Ultra 360 which uses radiofrequency and ultrasound to heat the layers of skin and stimulate collagen and elastin production.  This results in a tightening/lifting effect.  It usually takes 4-6 treatments to get optimal results and it may continue to improve for a couple of months after you finish the series of treatments.   

Some patients do get nodules after SculpSure procedures.  We generally recommend waiting to do the next procedure until the nodules have mostly resolved.  Massaging the area may help decrease the overall amount of time it takes for them to go away but they should resolve completely with time.  

There is not a problem with doing several SculpSure treatments on the same area if the treatments are spaced about 6 weeks apart (maybe even a little closer).  However, depending on the size of the area you are treating and the exact number of treatments recommended, you may want to consult with a plastic surgeon to see if surgery would be a more cost effective option.  SculpSure is great for contouring problem areas but if you are treating a larger area where you might need 3 sets of applicators to cover the area and then multiply that times 5 sessions, you may be approaching what liposuction or another surgical option would cost.

Most patients who have had SculpSure have mild to moderate discomfort during the treatment and mild tenderness in the treated area for 1-2 weeks after.  I have had patients who experience no discomfort with the treatments and little to no tenderness after and a couple who are quite uncomfortable during treatment with more moderate tenderness after the treatment but still nothing that required any type of medication for discomfort. Swelling is very minimal and generally not noticeable. I have not had any patients who had so much tenderness that it interfered with any of their normal activities.