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Some users add the upper arm as a fifth site

"Calorie restriction induces mitochondrial biogenesis and bioenergetic efficiency." Proceedings of the National Academy of Sciences , 103(6), 17681773

ThermiSmooth is a very comfortable and safe procedure, in the hands of a skilled physician, but others may lack the knowledge of facial anatomy to perform the procedure safely and effectively

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Backup cooling solutions, including insulated containers with ice packs, provide protection during outages

They are not illegal to buy or own - and widely available online - but they are not approved for human use, so are not subject to the quality controls that govern pharmaceutical manufacturing