•	Discuss	post-treatment	expectations	–	specifical y	that	swel ing	and	bruising	lasting	as	much	as	several	weeks	may	occur.	Severity	of	bruising	wil depend	on	the	patient,	but	is	typical y	classified	as	mild.
PAIN MANAGEMENT•	While	Solta	Medical	cannot	recommend	any	specific	pain	mitigation	techniques,	previous	clinical	studies	and	physician	offices	have	used	a	variety	of	pain	relief	means	ranging	from	vibratory	massage	and	cold	water	spray	distraction	to	Extra	Strength	Tylenol®	or	Toradol	IM	to	narcotic	analgesics	and	anxiolytics.
•	If	using	Toradol	IM,	administer	prior	to	taking	photos	and	measurements	to	give	medication	time	to	take	effect.
MEASUREMENTS AND PHOTOS•	Take	measurements	at	the	same	time	of	day	under	as	similar	conditions	as	possible.
•	Patient	should	void	prior	to	each	measurement.
•	Schedule	women	after	their	menses	to	avoid	bloating.	This	also	minimizes	discomfort	during	treatment.	MARKING THE TREATMENT AREA•	Clean	treatment	area	with	alcohol	before	marking	to	remove	body	oils.
•	Use	"dots"	(vs.	circles)	to	mark	the	treatment	area	while	patient	is	standing,	as	the	area	may	shift	when	patient	lies	down.	Re- evaluate	treatment	area	when	patient	is	lying	down	and	adjust	as	needed	to	avoid	bony	areas	or	areas	with	inadequate	adipose	tissue	thickness.	Typical y	the	areas	surrounding	the	obliques	have	less	adipose	tissue	and	are	excluded.	•	Surgical	or	medical	grade	marking	pen	is	recommended.	Do	not	use	washable	marker	or	wax	pencil/liner	(wax	material	is	incompatible	with	HIFU	and	can	interfere	with	treatment).	•	Number	sites	while	patient	is	lying	down.	Always	number	sequential y	and	vertical y	(from	head	to	toe,	superiorly	to	inferiorly).
•	After	marking	is	complete,	spray	purified	water	over	entire	treatment	area.	Use	paper	towels	to	blot	excess	ink.
•	Patients	often	feel	soreness	similar	to	a	workout	or	a	set	of	crunches.
•	Superficial	tenderness	of	the	treated	area	may	last	up	to	several	weeks.
•	Use	of	seamless	compression	garments	may	provide	comfort	and	help	heal	possible	bruising.
settings.	Each	patient	may	react	differently	to	treatment.
The total fluence needed for a full treatment is 140 - 180 J/cm2.	Use	proper	number	of	passes	to	achieve	total	fluence	range.
Based on using grid repeat, meaning that site #1 is treated, then site #2, and so on for the entire grid.
•	Remind	patient	of	expectations	for	pain	and	sensations	before	and	during	treatment.	•	Uncertainty	of	treatment	sensations	can	increase	anxiety	and	pain	perception.	•	Understanding	the	expectations	and	safety	of	the	treatment	wil help	al eviate	anxiety.
•	Start	at	a	lower	setting	(e.g.,	40	J/cm2)	for	the	first	pass.	In	most	cases,	patients	can	tolerate	a	higher	level	on	the	next	pass,	which	may	al ow	for	3	pass	technique	and	a	shorter	treatment	time.	•	Fluence can be reduced during treatment to accommodate patient comfort.
•	Use	the	built-in	sprayer	or	a	spray	bottle	to	apply	purified	water	as	coupling	fluid.
•	Do	not	use	ultrasound	gels	or	oils.
•	Rest	the	handpiece	on	the	surface	of	the	skin	with	just	enough	pressure	to	complete	contact.	Too	light	of	pressure	can	cause	incomplete	contact	and	system	errors,	and	too	much	pressure	can	compress	the	fat	tissue	and	increase	patient	discomfort.
•	Raise	the	head	of	the	bed	to	"settle"	the	treatment	area	and	keep	it	from	being	overly	•	Mechanical y	manipulate	tissue	as	needed	to	complete	treatment	site	(push	fat	tissue	inward	toward	treatment	site	for	complete	site	contact).
•	To	avoid	system	failure,	do	not	hold	the	treatment	head	upside	down.	The	handpiece	cannot	be	inverted	more	than	90°.
•	Spray	cold	water	on	the	patient	near	treatment	area	during	an	uncomfortable	pulse.
•	Hold	an	ice	pack	on	another	part	of	the	body	during	an	uncomfortable	pulse.
•	Use	a	Zimmer	or	cooling	device	adjacent	to	the	treatment	area	(be	careful	to	not	dry	out	the	water	at	the	treatment	site).
Consult the User Manual for information on the Liposonix procedure. MK 3213A 2012 Solta Medical, Inc. Al rights reserved. Liposonix and 1 Treatment 1 Hour 1 Size Smal er are trademarks or registered trademarks of Solta Medical, Inc. or its subsidiaries.