**10.4 Cryolipolysis**

Cryolipolysis is a useful non-invasive adjunct for reduction of fullness in patients with spot or localized fat excess and otherwise good skin quality. Applications of cryolipolysis in the extremities is generally limited as most patients require contouring of the entire upper length of the extremities with skin quality frequently also needing to be addressed. Rivers [23] has described the use of multiple coupled cryolipolysis applicators to broaden inclusivity of patients to those with more fatty excess, but this technique can be costly for patients. We reserve cryolipolysis for

treatment of patients who seek only non-invasive treatments, are young with good skin quality and elasticity, and have mild localized areas of adipose excess in the upper arm or anterior axillary region. Remaining patients are treated according to our proposed arm contouring treatment algorithm.
