I have done hundreds of Ultherapy procedures and never found a need to ice before or after the procedure.Ultherapy uses HIFU (high frequency ultrasound energy) which is focused 1.5 mm to 4.5 mm from the outer layer of the skin. There is no need to ice or cool the skin as in some types of LPD lasers, for example. Hopefully, your provider has upgraded his device as the new upgrades are as efficacious, if not more efficacious than the initial model and achieve the same end goal using less energy (power, intensity), which translates into LESS PAIN.I recommend a product called Swell-X for a week after the procedure and ibuprofen. Read the Ultherapy book provided on the link below.