Patent Publication Number: US-2020297526-A1

Title: Treatment systems, small volume applicators, and methods for treating submental tissue

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application No. 62/039,213 filed Aug. 19, 2014, which is incorporated by reference in its entirety. 
    
    
     INCORPORATION BY REFERENCE OF COMMONLY-OWNED APPLICATIONS AND PATENTS 
     The following commonly assigned U.S. Patent Applications and U.S. Patents are incorporated herein by reference in their entireties: 
     U.S. Patent Publication No. 2008/0287839 entitled “METHOD OF ENHANCED REMOVAL OF HEAT FROM SUBCUTANEOUS LIPID-RICH CELLS AND TREATMENT APPARATUS HAVING AN ACTUATOR”; 
     U.S. Pat. No. 6,032,675 entitled “FREEZING METHOD FOR CONTROLLED REMOVAL OF FATTY TISSUE BY LIPOSUCTION”; 
     U.S. Patent Publication No. 2007/0255362 entitled “CRYOPROTECTANT FOR USE WITH A TREATMENT DEVICE FOR IMPROVED COOLING OF SUBCUTANEOUS LIPID-RICH CELLS”; 
     U.S. Pat. No. 7,854,754 entitled “COOLING DEVICE FOR REMOVING HEAT FROM SUBCUTANEOUS LIPID-RICH CELLS”; 
     U.S. Patent Publication No. 2011/0066216 entitled “COOLING DEVICE FOR REMOVING HEAT FROM SUBCUTANEOUS LIPID-RICH CELLS”; 
     U.S. Patent Publication No. 2008/0077201 entitled “COOLING DEVICES WITH FLEXIBLE SENSORS”; 
     U.S. Patent Publication No. 2008/0077211 entitled “COOLING DEVICE HAVING A PLURALITY OF CONTROLLABLE COOLING ELEMENTS TO PROVIDE A PREDETERMINED COOLING PROFILE”; 
     U.S. Patent Publication No. 2009/0118722, filed Oct. 31, 2007, entitled “METHOD AND APPARATUS FOR COOLING SUBCUTANEOUS LIPID-RICH CELLS OR TISSUE”; 
     U.S. Patent Publication No. 2009/0018624 entitled “LIMITING USE OF DISPOSABLE SYSTEM PATIENT PROTECTION DEVICES”; 
     U.S. Patent Publication No. 2009/0018623 entitled “SYSTEM FOR TREATING LIPID-RICH REGIONS”; 
     U.S. Patent Publication No. 2009/0018625 entitled “MANAGING SYSTEM TEMPERATURE TO REMOVE HEAT FROM LIPID-RICH REGIONS”; 
     U.S. Patent Publication No. 2009/0018627 entitled “SECURE SYSTEM FOR REMOVING HEAT FROM LIPID-RICH REGIONS”; 
     U.S. Patent Publication No. 2009/0018626 entitled “USER INTERFACES FOR A SYSTEM THAT REMOVES HEAT FROM LIPID-RICH REGIONS”; 
     U.S. Pat. No. 6,041,787 entitled “USE OF CRYOPROTECTIVE AGENT COMPOUNDS DURING CRYOSURGERY”; 
     U.S. Pat. No. 8,285,390 entitled “MONITORING THE COOLING OF SUBCUTANEOUS LIPID-RICH CELLS, SUCH AS THE COOLING OF ADIPOSE TISSUE”; 
     U.S. Pat. No. 8,275,442 entitled “TREATMENT PLANNING SYSTEMS AND METHODS FOR BODY CONTOURING APPLICATIONS”; 
     U.S. patent application Ser. No. 12/275,002 entitled “APPARATUS WITH HYDROPHILIC RESERVOIRS FOR COOLING SUBCUTANEOUS LIPID-RICH CELLS”; 
     U.S. patent application Ser. No. 12/275,014 entitled “APPARATUS WITH HYDROPHOBIC FILTERS FOR REMOVING HEAT FROM SUBCUTANEOUS LIPID-RICH CELLS”; 
     U.S. Patent Publication No. 2010/0152824 entitled “SYSTEMS AND METHODS WITH INTERRUPT/RESUME CAPABILITIES FOR COOLING SUBCUTANEOUS LIPID-RICH CELLS”; 
     U.S. Pat. No. 8,192,474 entitled “TISSUE TREATMENT METHODS”; 
     U.S. Patent Publication No. 2010/0280582 entitled “DEVICE, SYSTEM AND METHOD FOR REMOVING HEAT FROM SUBCUTANEOUS LIPID-RICH CELLS”; 
     U.S. Patent Publication No. 2012/0022518 entitled “COMBINED MODALITY TREATMENT SYSTEMS, METHODS AND APPARATUS FOR BODY CONTOURING APPLICATIONS”; 
     U.S. Publication No. 2011/0238050 entitled “HOME-USE APPLICATORS FOR NON-INVASIVELY REMOVING HEAT FROM SUBCUTANEOUS LIPID-RICH CELLS VIA PHASE CHANGE COOLANTS, AND ASSOCIATED DEVICES, SYSTEMS AND METHODS”; 
     U.S. Publication No. 2011/0238051 entitled “HOME-USE APPLICATORS FOR NON-INVASIVELY REMOVING HEAT FROM SUBCUTANEOUS LIPID-RICH CELLS VIA PHASE CHANGE COOLANTS, AND ASSOCIATED DEVICES, SYSTEMS AND METHODS”; 
     U.S. Publication No. 2012/0239123 entitled “DEVICES, APPLICATION SYSTEMS AND METHODS WITH LOCALIZED HEAT FLUX ZONES FOR REMOVING HEAT FROM SUBCUTANEOUS LIPID-RICH CELLS ”; 
     U.S. patent application Ser. No. 13/830,413 entitled “MULTI-MODALITY TREATMENT SYSTEMS, METHODS AND APPARATUS FOR ALTERING SUBCUTANEOUS LIPID-RICH TISSUE”; 
     U.S. patent application Ser. No. 13/830,027 entitled “TREATMENT SYSTEMS WITH FLUID MIXING SYSTEMS AND FLUID-COOLED APPLICATORS AND METHODS OF USING THE SAME”; 
     U.S. patent application Ser. No. 11/528,225 entitled “COOLING DEVICE HAVING A PLURALITY OF CONTROLLABLE COOLING ELEMENTS TO PROVIDE A PREDETERMINED COOLING PROFILE;” and 
     U.S. Pat. No. 8,285,390 entitled “MONITORING THE COOLING OF SUBCUTANEOUS LIPID-RICH CELLS, SUCH AS THE COOLING OF ADIPOSE TISSUE.” 
     TECHNICAL FIELD 
     The present disclosure relates generally to treatment systems for cooling and/or cooling targeted regions. Several embodiments are directed to treatment systems with non-invasive applicators that hold and cool/heat relatively small volumes of tissue. Several embodiments can also include restraint apparatuses for holding non-invasive applicators in thermal contact with patients. 
     BACKGROUND 
     Excess body fat, or adipose tissue, may be present at various locations of a subject&#39;s body and may detract from personal appearance. Excess subcutaneous fat under the chin and/or around the neck can be cosmetically unappealing and, in some instances, can produce a “double chin.” A double chin can cause stretching and/or sagging of skin and may also result in discomfort. Excess adipose tissue in superficial fat compartments can produce loose facial structures, such as loose jowls, that also cause an undesirable appearance. Excess body fat can also be located at the abdomen, thighs, buttocks, knees, and arms, as well as other locations. 
     Aesthetic improvement of the human body often involves the selective removal of adipose tissue. Invasive procedures (e.g., liposuction), however, tend to be associated with relative high costs, long recovery times, and increased risk of complications. Injection of drugs for reducing adipose tissue, such as submental or facial adipose tissue, can cause significant swelling, bruising, pain, numbness, and/or induration. Conventional non-invasive treatments for reducing adipose tissue often include regular exercise, application of topical agents, use of weight-loss drugs, dieting, or a combination of these treatments. One drawback of these non-invasive treatments is that they may not be effective or even possible under certain circumstances. For example, when a person is physically injured or ill, regular exercise may not be an option. Topical agents and orally administered weight-loss drugs are not an option if, as another example, they cause an undesirable reaction (e.g., an allergic or negative reaction). Additionally, non-invasive treatments may be ineffective for selectively reducing specific regions of adiposity. For example, localized fat loss around the neck, jaw, cheeks, etc. often cannot be achieved using general or systemic weight-loss methods. Accordingly, conventional invasive and non-invasive treatments are not suitable for many subjects and cannot effectively target certain regions of adipose tissue. 
     SUMMARY OF TECHNOLOGY 
     Systems for treating a subject&#39;s tissue can include a thermally conductive cup, a tissue-receiving cavity, and a vacuum port. The vacuum port can be in fluid communication with the tissue-receiving cavity to provide a vacuum for drawing the submental tissue, or other targeted tissue, into the tissue-receiving cavity. The system can cool and/or heat the conductive cup such that the conductive cup non-invasively controls the temperature of subcutaneous lipid-rich cells in the tissue. A restraint apparatus can hold the thermally conductive cup in thermal contact with a patient&#39;s tissue. 
     At least some embodiments are apparatuses for treating a subject&#39;s submental tissue and can include a thermally conductive cup, at least one vacuum port, and a thermal device. The thermally conductive cup can include a first sidewall, a second sidewall, and a bottom. The vacuum port can be in fluid communication with a tissue-receiving cavity of the cup to provide a vacuum for drawing the submental tissue into the tissue-receiving cavity. The tissue-receiving cavity can be sufficiently shallow to allow the subject&#39;s submental tissue to occupy substantially the entire tissue-receiving cavity when the vacuum is drawn via the vacuum port. The thermal device can be in thermal communication with the conductive cup. The thermal device can be configured to cool the conductive cup such that the first sidewall, second sidewall, and bottom together non-invasively cool subcutaneous lipid-rich cells in the submental tissue. For example, the subcutaneous lipid-rich cells can be cooled an amount sufficient to be biologically effective in damaging and/or reducing the subcutaneous lipid-rich cells or other targeted cells. 
     The first sidewall, second sidewall, and bottom can be positioned to absorb heat from the submental tissue to damage and/or reduce the lipid-rich cells, which are in a subcutaneous layer of adipose tissue, in number and/or size to an extent while non-lipid-rich cells deeper than the subcutaneous layer of adipose tissue are not reduced in number and/or size to the extent. In some embodiments, the apparatus can include a pressurization device in fluid communication with the tissue-receiving cavity via the vacuum port. A controller can include instructions for causing the apparatus to hold the submental tissue in the tissue-receiving cavity using suction provided by the pressurization device. 
     The conductive cup can be in thermal contact with most of the subject&#39;s skin at the subject&#39;s submental region when the tissue-receiving cavity is partially or completely filled with the subject&#39;s tissue. The conductive cup can include a conductive surface (e.g., metal surface) that faces the tissue-receiving cavity and has an area equal to or less than about, for example, 40 cm 2 . In some embodiments, the conductive cup can include a smooth thermally conductive surface that extends continuously along the first sidewall, second sidewall, and bottom. 
     The tissue-receiving cavity can be dimensioned to receive most of the subject&#39;s skin located at the submental region of the subject. In some embodiments, the tissue-receiving cavity has a length between opposing end walls of the conductive cup, a width between the first and second sidewalls, and a depth between an opening of the tissue-receiving cavity and the bottom of the conductive cup. The depth is substantially uniform along most of the length of the tissue-receiving cavity. 
     A liner assembly can line the conductive cup such that the liner assembly is positioned between the subject&#39;s tissue in the tissue-receiving cavity and the conductive cup. The linear assembly can be made of plastic, rubber, or other suitable material and can carry and/or include one or more sensors. 
     In some embodiments, an apparatus for treating a subject&#39;s tissue includes a submental vacuum applicator. The submental vacuum applicator can include a tissue-receiving cavity, a contoured lip, and a thermal device. The contoured lip can define a mouth of the tissue-receiving cavity and can include first and second arcuate lip portions. The contoured lip can be configured to engage a submental area of the subject such that mostly submental tissue extends through the mouth and fills substantially all of the tissue-receiving cavity while the submental vacuum applicator draws a vacuum and the first and second arcuate lip portions surround at least a portion of the subject&#39;s body. The thermal device can be positioned to be in thermal contact with the submental tissue in the tissue-receiving cavity. The thermal device is operable to non-invasively cool subcutaneous lipid-rich cells in the submental tissue an amount sufficient to be biologically effective in damaging, reducing, and/or otherwise affecting the subcutaneous lipid-rich cells. 
     The apparatus can include a controller with instructions for causing the submental vacuum applicator to cool a conductive cup such that the submental vacuum applicator non-invasively cools the subcutaneous lipid-rich cells to a temperature less than about predetermined temperature (e.g., about 0° C., about −1.8° C., etc.). The controller can include one or more processors, memory, power supplies, or other electrical components. 
     The tissue-receiving cavity can include a first end, a second end, and a central section extending between the first and second ends. The central section has a curved longitudinal axis and a substantially uniform maximum depth along most of the curved longitudinal axis. In one embodiment, the curved longitudinal axis has the same curvature as a curvature of at least one of the first and second arcuate lip portions. In one embodiment, the tissue-receiving cavity has a substantially uniform maximum depth along most of a longitudinal length of the tissue-receiving cavity. 
     The apparatus can further include a vacuum source fluidically coupled to the tissue-receiving cavity. The vacuum source can be configured to provide sufficient vacuum to draw the submental tissue toward a bottom of the tissue-receiving cavity to bring the submental tissue into thermal contact with a concave metal heat-exchanging surface of the submental vacuum applicator. 
     The submental vacuum applicator, in some embodiments, can include an applicator unit and a liner assembly removably attached to the applicator unit. In other embodiments, the applicator unit can be used without any liner assembly. 
     In further embodiments, a method of non-invasively cooling a submental region of a subject includes placing a submentum applicator on the subject. The submentum applicator includes a vacuum cup and a tissue-receiving cavity. Submental tissue can be drawn through the tissue-receiving cavity and into thermal contact with a section of the vacuum cup located at a bottom of the tissue-receiving cavity. Heat can be conductively extracted from the submental tissue by the submentum applicator so as to cool the submental tissue an amount sufficient to be biologically effective in selectively damaging and/or reducing subcutaneous submental lipid-rich cells. Heat can be repeatedly extracted from the subcutaneous submental tissue until desired tissue reduction is achieved. In some embodiments, a sufficient amount of heat can be conductively extracted from the submental tissue to visibly reduce a double chin of the subject. 
     The conductive extraction of heat can include conductively cooling an area of the subject&#39;s submental skin that is equal to or less than about 40 cm 2 . In some embodiments, a concave heat-exchanging surface of the applicator can be cooled to a temperature equal to or less than a selected temperature (e.g., 0° C.). In some embodiments, most of a heat-exchanging surface of a conductive cup of the vacuum applicator can be cooled to a temperature equal to or less than about −5° C. The submental tissue can be pulled into the tissue-receiving cavity such that the tissue-receiving cavity is filled mostly with submental tissue. In some embodiments, a vacuum can be drawn to pull the submental tissue into the tissue-receiving cavity and can result in a relatively large contact area for heat transfer with the target tissue. 
     In some embodiments, a system includes a restraint apparatus configured to hold a subject&#39;s head. The restraint apparatus can include an adjustable pillow and restraints. The pillow can include a head cradle portion operable to controllably adjust tilt of a subject&#39;s head. The restraints are coupleable to the pillow such that the restraints hold a tissue-cooling apparatus in thermal contact with the subject&#39;s submental region while the subject&#39;s head is supported at a desired tilt by the head cradle portion. 
     The system can further include a tissue-cooling apparatus configured to be connected to the pillow by the restraints. The restraints and pillow cooperate to inhibit movement of the tissue-cooling apparatus relative to the subject&#39;s submental region while the tissue-cooling apparatus non-invasively cools subcutaneous lipid-rich cells at the subject&#39;s submental region. For example, the subcutaneous lipid-rich cells can be cooled an amount sufficient to be biologically effective in damaging and/or reducing the subcutaneous lipid-rich cells. In some embodiments, the pillow and restraints can be configured to cooperate to inhibit movement of the subject&#39;s head while the tissue-cooling apparatus transcutaneously cools the subject&#39;s submental region. 
     The restraint apparatus, in some embodiments, further includes a head adjuster device and a neck adjuster device for reconfiguring the pillow. The head adjuster device is operable to reconfigure the head cradle portion of the pillow to achieve the desired tilt of the subject&#39;s head. The neck adjuster device is operable to reconfigure a neck support portion of the pillow to achieve desired neck tilt. In one embodiment, the head adjuster device has a bladder that expands to increase a slope of a tilted support surface of the head cradle portion so as to tilt the subject&#39;s head forward. In another embodiment, the head adjuster device includes a bladder located within an expandable opening of the pillow. The bladder can be inflated to expand at least a portion of the pillow to adjust head tilt of the subject. 
     The pillow, in some embodiments, can include a neck support portion which is positioned to be located under the subject&#39;s neck when the subject&#39;s head is supported by the head cradle portion. A neck adjuster device is operable to move the neck support portion against the subject&#39;s neck to adjust neck tilt of the subject. In some embodiments, the pillow includes side portions positionable on opposite sides of the subject&#39;s head. The restraint apparatus can be configured to extend across at least a portion of the subject&#39;s body to hold the tissue-cooling apparatus in thermal contact with the subject&#39;s submental region. The pillow can include a shoulder support portion and a neck support portion positioned between the shoulder support portion and the head cradle portion. The neck support portion can be moved relative to the shoulder support portion and/or head cradle portion to push against the posterior region of the subject&#39;s neck. 
     The restraint apparatus, in some embodiments, can include a cradle adjuster device and a neck adjuster device. The cradle adjuster device can have a first expandable element that can expand a sufficient amount to increase forward tilt of the subject&#39;s head. The neck adjuster device can have a second expandable element that can expand so as to cause the neck support portion to push against the subject&#39;s neck (e.g., a posterior region of the subject&#39;s neck) when the posterior region of the subject&#39;s head rests on the head cradle portion. The first and second expandable elements can be independently expanded to independently move different regions of the pillow. 
     In some embodiments, a system configured to position a subject&#39;s body includes an adjustable pillow configured to support the subject&#39;s head. The pillow can include a head cradle, a head adjuster device, and a neck adjuster device. The head cradle has side portions positioned to contact opposite sides of a subject&#39;s head received by the head cradle to inhibit movement of the subject&#39;s head. The head adjuster device is operable to tilt the head cradle portion to achieve desired tilt of the subject&#39;s head. The neck adjuster device is operable to reconfigure a neck support portion of the pillow such that the neck support portion pushes against the subject&#39;s neck to achieve desired neck tilt. 
     The system can further include one or more restraints configured to hold a tissue-cooling apparatus in thermal contact with the subject&#39;s submental region while the head cradle inhibits movement of the subject&#39;s head relative to the tissue-cooling apparatus. In one embodiment, the restraints have an open configuration for allowing the subject&#39;s head to be moved into or out of the head cradle and a closed configuration for keeping the subject&#39;s head in the head cradle. In some embodiments, the restraints can be tensioned to pull the tissue-cooling apparatus toward the subject&#39;s submental region. The restraint apparatus can include hook and loop fastener that detachably couples the restraints to the pillow. For example, the loop fastener can be part of or attached to the pillow. The hook fastener can be part of or attached to the restraints. In other embodiments, the system can include a harness, straps, fasteners (e.g., buckles, snaps, etc.), and/or other coupling means for holding the subject&#39;s body, tissue-cooling apparatus, or the like. 
     The system, in some embodiments, further includes a tissue-cooling apparatus and at least one restraint. The tissue-cooling apparatus is configured to non-invasively cool subcutaneous lipid-rich cells at the subject&#39;s submental region an amount sufficient to be biologically effective in damaging and/or reducing the subcutaneous lipid-rich cells. The restraint is detachably coupleable to the pillow and detachably coupleable to the tissue-cooling apparatus. The tissue-cooling apparatus can be a handheld device with one or more thermoelectric cooling devices (e.g., Peltier devices), cooling channels, sensors, electrical components (e.g., circuitry, controllers, etc.), and/or other components. 
     At least some treatment systems disclosed herein can include a restraint apparatus that includes an adjustable pillow and means for stabilizing a tissue-cooling apparatus. In some embodiments, the means for stabilizing the tissue-cooling apparatus can include one or more restraints. The pillow can include a head cradle portion and means for controllably adjusting tilt of the subject&#39;s head and/or neck supported by the adjustable pillow. In one embodiment, the means for controllably adjusting tilt of the subject&#39;s head and/or neck includes a bladder insertable into the adjustable pillow and a pump connected to the bladder. In one embodiment, the means for controllably adjusting tilt of the subject&#39;s head and/or neck includes a cradle adjuster device and a neck adjuster device. The cradle adjuster device is positionable in the head cradle portion and can be expanded to increase forward tilt of the subject&#39;s head. The neck adjuster device can be expanded to cause a neck support portion of the pillow to push against the subject&#39;s neck when the subject&#39;s head is supported by the head cradle portion. 
     The head cradle portion, in some embodiments, can include side portions spaced apart to be positioned on opposite sides of the subject&#39;s head. The means for stabilizing the tissue-cooling apparatus can include restraints connectable to the side portions such that the one or more of the restraints extend across the subject&#39;s body to hold the tissue-cooling apparatus in thermal contact with the subject&#39;s submental region. In some embodiments, the means for stabilizing the tissue-cooling apparatus includes a retention system with one or more restraints, straps, or other coupling features. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       In the drawings, identical reference numbers identify similar elements or acts. 
         FIG. 1  is a partially schematic, isometric view of a treatment system for non-invasively affecting target regions of a subject in accordance with an embodiment of the technology. 
         FIG. 2  is a cross-sectional view of a connector taken along line  2 - 2  of  FIG. 1 . 
         FIG. 3  is a side view of an applicator applied to a subject while the subject&#39;s head is supported by an adjustable pillow in accordance with embodiments of the technology. 
         FIG. 4  is a cross-sectional view of the applicator and the subject&#39;s tissue taken along line  4 - 4  of  FIG. 3 . 
         FIG. 5  is an isometric view of an applicator unit suitable for use with the system of  FIG. 1  in accordance with embodiments of the technology. 
         FIG. 6  is an exploded isometric view of the applicator unit of  FIG. 5 . 
         FIG. 7  is a top view of the applicator unit of  FIG. 5  in accordance with embodiments of the technology. 
         FIG. 8  is a cross-sectional view of the applicator unit taken along line  8 - 8  of  FIG. 7 . 
         FIG. 9  is a cross-sectional view of the applicator unit taken along line  9 - 9  of  FIG. 7 . 
         FIGS. 9A and 9B  are cross-sectional views of vacuum cups in accordance with embodiments of the technology. 
         FIG. 10  is an isometric view of a liner assembly in accordance with embodiments of the technology. 
         FIG. 11  is a top view of the liner assembly of  FIG. 10 . 
         FIG. 12  is a cross-sectional view of the liner assembly taken along line  12 - 12  of  FIG. 11 . 
         FIG. 13  shows an applicator ready to be placed against a subject&#39;s skin in accordance with embodiments of the technology. 
         FIG. 14  shows the applicator contacting the subject&#39;s skin. 
         FIG. 15  is a cross-sectional view of the applicator before tissue has been drawn into a tissue-receiving cavity of the applicator. 
         FIG. 16  is a cross-sectional view of the applicator after tissue has been drawn into the tissue-receiving cavity. 
         FIG. 17  shows the subject after cryotherapy has been performed. 
         FIGS. 18-21  are isometric views of vacuum cups in accordance with embodiments of the present technology. 
         FIG. 22  is an isometric view of an applicator unit in accordance with embodiments of the technology. 
         FIG. 23A  is an isometric view of an applicator in accordance with embodiments of the technology. 
         FIG. 23B  is a side view of the applicator and connector of  FIG. 23A . 
         FIG. 23C  is an exploded isometric view of the applicator and connector of  FIG. 23A  in accordance with embodiments of the technology. 
         FIG. 23D  is a cross-section view of the applicator of  FIG. 23A . 
         FIG. 24  is an isometric view of a head support assembly in accordance with embodiments of the present technology. 
         FIG. 25  is a cross-sectional view of the head support assembly taken along line  25 - 25  of  FIG. 27  when a pillow is in an unexpanded lowered configuration. 
         FIG. 26  is a cross-sectional view of the head support assembly taken along line  26 - 26  of  FIG. 27  when the pillow is in an expanded raised configuration. 
         FIG. 27  is a top view of a pillow in accordance with embodiments of the present technology. 
         FIG. 28  is a front view of the pillow of  FIG. 27 . 
         FIG. 29  is a side view of the pillow of  FIG. 27 . 
         FIGS. 30 and 31  are top views of adjuster devices in accordance with embodiments of the present technology. 
         FIG. 32  is a top view of an adjustable pillow supporting the subject&#39;s head and restraints ready to be coupled to the pillow. 
         FIG. 33  is a top view of the restraint apparatus holding the applicator in thermal contact with the subject. 
         FIG. 34  is a side view of the restraint apparatus holding the applicator in thermal contact with the subject. 
         FIG. 35  is a schematic block diagram illustrating subcomponents of a controller in accordance with embodiments of the technology. 
     
    
    
     DETAILED DESCRIPTION 
     A. Overview 
     The present disclosure describes treatment systems, applicators, and methods for affecting targeted sites. Several embodiments are directed to non-invasive systems that cool/heat relatively small regions or volumes of tissue, including submental tissue, neck tissue, etc. The systems can help position the patient&#39;s body to enhance treatment. Several of the details set forth below are provided to describe the following examples and methods in a manner sufficient to enable a person skilled in the relevant art to practice, make, and use them. Several of the details and advantages described below, however, may not be necessary to practice certain examples and methods of the technology. Additionally, the technology may include other examples and methods that are within the scope of the technology but are not described in detail. 
     At least some embodiments are systems for treating a subject&#39;s tissue and can include a thermally conductive cup, a tissue-receiving cavity, and a vacuum port. The vacuum port is in fluid communication with the tissue-receiving cavity to provide a vacuum for drawing the submental tissue into the tissue-receiving cavity. The thermal device can cool or heat the conductive cup such that the conductive cup non-invasively cools subcutaneous lipid-rich cells in the submental tissue an amount sufficient to affect targeted tissue. A restraint system can hold the conductive cup at the treatment site to enhance treatment. 
     In some embodiments, an apparatus for treating a subject&#39;s tissue includes a thermally conductive element, a vacuum port, and a thermal device for heating/cooling the conductive element. The conductive element can be a metal cup with sidewalls and a bottom. The vacuum port can be in fluid communication with a tissue-receiving cavity defined by the metal cup to provide a vacuum for drawing tissue into the tissue-receiving cavity. When the thermal device heats or cools the conductive cup, the heated/cooled sidewalls and/or bottom can non-invasively heat/cool subcutaneous lipid-rich cells in the submental tissue, which is located in the tissue-receiving cavity, an amount sufficient to be biologically effective in altering the subcutaneous lipid-rich cells. The thermal device can include one or more cooling/heating elements (e.g., resistive heaters, fluid-cooled elements, Peltier devices, etc.), controllers, sensors, or combinations thereof. 
     The term “treatment system”, as used generally herein, refers to cosmetic or medical treatment systems, as well as any treatment regimens or medical device usage. Several embodiments of treatment system disclosed herein can reduce or eliminate excess adipose tissue or other undesirable tissue treatable using cryotherapy. The treatment systems can be used at various locations, including, for example, a subject&#39;s face, neck, abdomen, thighs, buttocks, knees, back, arms, ankles, and other areas. For example, a submental region can be treated to visibly reduce or eliminate a double chin or other unwanted tissue. 
     Some of the embodiments disclosed herein can be for cosmetically beneficial alterations of target regions. Some cosmetic procedures may be for the sole purpose of altering the target region to conform to a cosmetically desirable look, feel, size, shape and/or other desirable cosmetic characteristic or feature. Accordingly, at least some embodiments of the cosmetic procedures can be performed without providing an appreciable therapeutic effect (e.g., no therapeutic effect). For example, some cosmetic procedures may not include restoration of health, physical integrity, or the physical well-being of a subject. The cosmetic methods can target subcutaneous regions to change a subject&#39;s appearance and can include, for example, procedures performed on subject&#39;s submental region, face, neck, ankle region, or the like. In other embodiments, however, cosmetically desirable treatments may have therapeutic outcomes (whether intended or not), such as psychological benefits, alteration of body hormones levels (by the reduction of adipose tissue), etc. 
     Reference throughout this specification to “one example,” “an example,” “one embodiment,” or “an embodiment” means that a particular feature, structure, or characteristic described in connection with the example is included in at least one example of the present technology. Thus, the occurrences of the phrases “in one example,” “in an example,” “one embodiment,” or “an embodiment” in various places throughout this specification are not necessarily all referring to the same example. Furthermore, the particular features, structures, routines, stages, or characteristics may be combined in any suitable manner in one or more examples of the technology. The headings provided herein are for convenience only and are not intended to limit or interpret the scope or meaning of the technology. 
     B. Cryotherapy 
       FIG. 1  and the following discussion provide a brief, general description of a treatment system  100  in accordance with some embodiments of the technology. The treatment system  100  can be a temperature-controlled system for exchanging heat with a subject  101  and can include a non-invasive tissue-cooling apparatus in the form of an applicator  102  (“applicator  102 ”) configured to selectively cool/heat tissue to reduce and/or eliminate targeted tissue to achieve a desired overall appearance. The illustrated treatment system  100  includes a restraint apparatus  107  configured to hold the applicator  102  generally under the subject&#39;s chin to reduce or eliminate submental lipid-rich fat cells so as to reduce or eliminate, for example, a double chin. Skin, muscle, connective tissue of the neck and/or face, or other non-targeted tissue can be generally unaffected. The applicator  102  can also treat relatively small volumes of tissue at other locations. 
     The treatment system  100  can perform medical treatments to provide therapeutic effects and/or cosmetic procedures for cosmetically beneficial effect. Without being bound by theory, the selective effect of cooling is believed to result in, for example, membrane disruption, cell shrinkage, disabling, disrupting, damaging, destroying, removing, killing and/or other methods of lipid-rich cell alteration. Such alteration is believed to stem from one or more mechanisms acting alone or in combination. It is thought that such mechanism(s) trigger an apoptotic cascade, which is believed to be the dominant form of lipid-rich cell death by non-invasive cooling. In any of these embodiments, the effect of tissue cooling can be the selectively reduction of lipid-rich cells by a desired mechanism of action, such as apoptosis, lipolysis, or the like. In some procedures, the applicator  102  can cool the tissue of the subject  101  to a temperature in a range of from about −25° C. to about 20° C. In other embodiments, the cooling temperatures can be from about −20° C. to about 10° C., from about −18° C. to about 5° C., from about −15° C. to about 5° C., or from about −15° C. to about 0° C. In further embodiments, the cooling temperatures can be equal to or less than −5° C., −10° C., −15° C., or in yet another embodiment, from about −15° C. to about −25° C. Other cooling temperatures and temperature ranges can be used. 
     Apoptosis, also referred to as “programmed cell death”, is a genetically-induced death mechanism by which cells self-destruct without incurring damage to surrounding tissues. An ordered series of biochemical events induce cells to morphologically change. These changes include cellular blebbing, loss of cell membrane asymmetry and attachment, cell shrinkage, chromatin condensation and chromosomal DNA fragmentation. Injury via an external stimulus, such as cold exposure, is one mechanism that can induce cellular apoptosis in cells. Nagle, W. A., Soloff, B. L., Moss, A. J. Jr., Henle, K. J. “Cultured Chinese Hamster Cells Undergo Apoptosis After Exposure to Cold but Nonfreezing Temperatures” Cryobiology 27, 439-451 (1990). 
     One aspect of apoptosis, in contrast to cellular necrosis (a traumatic form of cell death causing local inflammation), is that apoptotic cells express and display phagocytic markers on the surface of the cell membrane, thus marking the cells for phagocytosis by macrophages. As a result, phagocytes can engulf and remove the dying cells (e.g., the lipid-rich cells) without eliciting an immune response. Temperatures that elicit these apoptotic events in lipid-rich cells may contribute to long-lasting and/or permanent reduction and reshaping of subcutaneous adipose tissue. 
     One mechanism of apoptotic lipid-rich cell death by cooling is believed to involve localized crystallization of lipids within the adipocytes at temperatures that do not induce crystallization in non-lipid-rich cells. The crystallized lipids selectively may injure these cells, inducing apoptosis (and may also induce necrotic death if the crystallized lipids damage or rupture the bi-lipid membrane of the adipocyte). Another mechanism of injury involves the lipid phase transition of those lipids within the cell&#39;s bi-lipid membrane, which results in membrane disruption or dysfunction, thereby inducing apoptosis. This mechanism is well-documented for many cell types and may be active when adipocytes, or lipid-rich cells, are cooled. Mazur, P., “Cryobiology: the Freezing of Biological Systems” Science, 68: 939-949 (1970); Quinn, P. J., “A Lipid Phase Separation Model of Low Temperature Damage to Biological Membranes” Cryobiology, 22: 128-147 (1985); Rubinsky, B., “Principles of Low Temperature Preservation” Heart Failure Reviews, 8, 277-284 (2003). Other possible mechanisms of adipocyte damage, described in U.S. Pat. No. 8,192,474, relate to ischemia/reperfusion injury that may occur under certain conditions when such cells are cooled as described herein. For instance, during treatment by cooling as described herein, the targeted adipose tissue may experience a restriction in blood supply and thus be starved of oxygen due to isolation as a result of applied pressure, cooling which may affect vasoconstriction in the cooled tissue, or the like. In addition to the ischemic damage caused by oxygen starvation and the buildup of metabolic waste products in the tissue during the period of restricted blood flow, restoration of blood flow after cooling treatment may additionally produce reperfusion injury to the adipocytes due to inflammation and oxidative damage that is known to occur when oxygenated blood is restored to tissue that has undergone a period of ischemia. This type of injury may be accelerated by exposing the adipocytes to an energy source (via, e.g., thermal, electrical, chemical, mechanical, acoustic, or other means) or otherwise increasing the blood flow rate in connection with or after cooling treatment as described herein. Increasing vasoconstriction in such adipose tissue by, e.g., various mechanical means (e.g., application of pressure or massage), chemical means or certain cooling conditions, as well as the local introduction of oxygen radical-forming compounds to stimulate inflammation and/or leukocyte activity in adipose tissue may also contribute to accelerating injury to such cells. Other yet-to-be understood mechanisms of injury may exist. 
     In addition to the apoptotic mechanisms involved in lipid-rich cell death, local cold exposure is also believed to induce lipolysis (i.e., fat metabolism) of lipid-rich cells and has been shown to enhance existing lipolysis which serves to further increase the reduction in subcutaneous lipid-rich cells. Vallerand, A. L., Zamecnik. J., Jones, P. J. H., Jacobs, I. “Cold Stress Increases Lipolysis, FFA Ra and TG/FFA Cycling in Humans” Aviation, Space and Environmental Medicine 70, 42-50 (1999). 
     One expected advantage of the foregoing techniques is that the subcutaneous lipid-rich cells in the target region can be reduced generally without collateral damage to non-lipid-rich cells in the same region. In general, lipid-rich cells can be affected at low temperatures that do not affect non-lipid-rich cells. As a result, lipid-rich cells, such as those associated with highly localized adiposity (e.g., submental adiposity, submandibular adiposity, facial adiposity, etc.), can be affected while non-lipid-rich cells (e.g., myocytes) in the same generally region are not damaged. The unaffected non-lipid-rich cells can be located underneath lipid-rich cells (e.g., cells deeper than a subcutaneous layer of fat), in the dermis, in the epidermis, and/or at other locations. 
     In some procedures, the treatment system  100  can remove heat from underlying tissue through the upper layers of tissue and create a thermal gradient with the coldest temperatures near the cooling surface, or surfaces, of the applicator  102  (i.e., the temperature of the upper layer(s) of the skin can be lower than that of the targeted underlying target cells). It may be challenging to reduce the temperature of the targeted cells low enough to be destructive to these target cells (e.g., induce apoptosis, cell death, etc.) while also maintaining the temperature of the upper and surface skin cells high enough so as to be protective (e.g., non-destructive). The temperature difference between these two thresholds can be small (e.g., approximately, 5° C. to about 10° C., less than 10° C., less than 15° C., etc.). Protection of the overlying cells (e.g., typically water-rich dermal and epidermal skin cells) from freeze damage during dermatological and related aesthetic procedures that involve sustained exposure to cold temperatures may include improving the freeze tolerance and/or freeze avoidance of these skin cells by using, for example, cryoprotectants for inhibiting or preventing such freeze damage. 
     C. Treatment Systems 
       FIG. 1  shows the treatment system  100  that can include the applicator  102 , the restraint apparatus  107 , a connector  104 , and a control module  106  for controlling operation of the applicator  102 . The applicator  102  can conform closely to the contours of the subject&#39;s body. The restraint apparatus  107  can include a head support assembly  108  for holding the subject&#39;s head  109  and restraints  111   a,    111   b  (collectively “restraints  111 ”) for connecting the applicator  102  to the head support assembly  108 . The head support assembly  108  can include an adjustable pillow  130  with independently movable features capable of positioning different regions of the subject&#39;s body any number of times. After completing a cryotherapy procedure, the restraints  111  can be detached from the pillow  130  to release the subject  101 . 
       FIG. 1  shows the head support assembly  108  holding the subject&#39;s head  109  at a preferred position for treating submental tissue, reducing the likelihood of unintentional movement of the applicator  102  relative to the treatment site, to enhance a treatment. In some embodiments, the head support assembly  108  can include a head adjuster device  113  and a neck adjuster device  115 . The head adjuster device  113  can be operated to adjust the forward tilt of the subject&#39;s head  109 , and the neck adjuster device  115  can be operated to adjust the position of the subject&#39;s neck. The restraints  111  can be tensioned to pull the applicator  102  toward the subject&#39;s submental region and hold the subject&#39;s shoulders against side portions  125   a,    125   b  (collectively “side portions  125 ”). The restraints  111  can be sufficiently tensioned to inhibit movement of the applicator  102  relative to the treatment site while the applicator  102  non-invasively cools the treatment site. 
     The connector  104  extends from the control module  106  to the applicator  102 .  FIG. 2  is a cross-sectional view of the connector  104  taken along line  2 - 2  of  FIG. 1 . Referring to  FIG. 1 , the connector  104  can provide suction for drawing tissue into the applicator  102  and energy (e.g., electrical energy) and fluid (e.g., coolant) from the control module  106  to the applicator  102 . Referring now to  FIG. 2 , the connector  104  can include a main body  179 , a supply fluid line or lumen  180   a  (“supply fluid line  180   a ”), and a return fluid line or lumen  180   b  (“return fluid line  180   b ”). The main body  179  may be configured (via one or more adjustable joints) to “set” in place for the treatment of the subject  101 . The supply and return fluid lines  180   a,    180   b  can be conduits comprising, in whole or in part, polyethylene, polyvinyl chloride, polyurethane, and/or other materials that can accommodate circulating coolant, such as water, glycol, synthetic heat transfer fluid, oil, a refrigerant, and/or any other suitable heat conducting fluid. In one embodiment, each fluid line  180   a,    180   b  can be a flexible hose surrounded by the main body  179 . The connector  104  can also include one or more electrical lines  112  for providing power to the applicator  102  and one or more control lines  116  for providing communication between the control module  106  ( FIG. 1 ) and the applicator  102  ( FIG. 1 ). To provide suction, the connector  104  can include one or more vacuum lines  119 . In various embodiments, the connector  104  can include a bundle of fluid conduits, a bundle of power lines, wired connections, vacuum lines, and other bundled and/or unbundled components selected to provide ergonomic comfort, minimize unwanted motion (and thus potential inefficient removal of heat from the subject  101 ), and/or to provide an aesthetic appearance to the treatment system  100 . 
     Referring again to  FIG. 1 , the control module  106  can include a fluid system  105  (illustrated in phantom line), a power supply  110  (illustrated in phantom line), and a controller  114  carried by a housing  124  with wheels  126 . The fluid system  105  can include a fluid chamber and a refrigeration unit, a cooling tower, a thermoelectric chiller, heaters, or any other device capable of controlling the temperature of coolant in the fluid chamber. The coolant can be continuously or intermittently delivered to the applicator  102  via the supply fluid line  180   a  ( FIG. 2 ) and can circulate through the applicator  102  to absorb heat. The coolant, which has absorbed heat, can flow from the applicator  102  back to the control module  106  via the return fluid line  180   b  ( FIG. 2 ). For warming periods, the control module  106  can heat the coolant such that warm coolant is circulated through the applicator  102 . Alternatively, a municipal water supply (e.g., tap water) can be used in place of or in conjunction with the control module  106 . 
     A pressurization device  117  can provide suction to the applicator  102  via the vacuum line  119  ( FIG. 2 ) and can include one or more pumps, vacuum sources, or the like. Air pressure can be controlled by a regulator located between the pressurization device  117  and the applicator  102 . If the vacuum level is too low, tissue may not be drawn adequately (or at all) into the applicator  102 . If the vacuum level is too high, undesirable discomfort to the patient  101  and/or tissue damage could occur. The control module  106  can control the vacuum level to draw tissue into the applicator  102  while maintaining a desired level of comfort. According to certain embodiments, approximately 0.5 inch Hg, 1 inch Hg, 2 inches Hg, 3 inches Hg, or 5 inches Hg vacuum is applied to draw facial or neck tissue into the applicator  102 . Other vacuum levels can be selected based on the characteristics of the tissue and desired level of comfort. 
     The power supply  110  can provide a direct current voltage for powering electrical elements (e.g., thermal devices) of the applicator  102  via the line  112  ( FIG. 2 ). An operator can use an input/output device in the form of a screen  118  (“input/output device  118 ”) of the controller  114  to control operation of the treatment system  100 , and the input/output device  118  can display the state of operation of the treatment system  100  and/or progress of a treatment protocol. In some embodiments, the controller  114  can exchange data with the applicator  102  via the line  116  ( FIG. 2 ), a wireless communication link, or an optical communication link and can monitor and adjust treatment based on, without limitation, one or more treatment profiles and/or patient-specific treatment plans, such as those described, for example, in commonly assigned U.S. Pat. No. 8,275,442. Each treatment profile and treatment plan can include one or more segments, and each segment can include temperature profiles, vacuum levels, and/or specified durations (e.g., 1 minute, 5 minutes, 10 minutes, 20 minutes, 30 minutes, 1 hour, 2 hours, etc.). Additionally, if the treatment system  100  includes multiple applicators, a treatment profile can include specific profiles for each applicator to concurrently or sequentially treat multiple treatment sites, including, but not limited to, sites along the subject&#39;s face and/or neck (e.g., submental sites, submandibular sites, etc.), abdomen, thighs, buttocks, knees, back, arms, ankle region, or other treatment sites. In some embodiments, the controller  114  can be incorporated into the applicator  102  or another component of the treatment system  100 . 
       FIG. 3  is a side view of the applicator  102  applied to the subject  101  while the pillow  130  (shown in cross section) supports the subject in accordance with embodiments of the technology. The pillow  130  can position the subject&#39;s body such that the submental region is at a suitable position for treatment by the applicator  102 . An expandable member  121  of the head adjuster device  113  ( FIG. 1 ) can be expanded to tilt (indicated by arrow  122 ) the subject&#39;s head  109 . An expandable member  123  of the neck adjuster device  115  ( FIG. 1 ) can be expanded such that the pillow  130  pushes against and moves the subject&#39;s neck  127  (indicated by arrow  128 ). The expandable members  121 ,  123  can be independently inflated/deflated any number of times in a treatment session. 
     D. Applicators 
       FIG. 4  is a cross-sectional view of the applicator  102  taken along line  4 - 4  of  FIG. 3 . The applicator  102  can include an applicator unit  202  and a liner assembly  204 . Tissue can be drawn into a tissue-receiving cavity  230  (“cavity  230 ”) and against a patient-contact surface  237  of the liner assembly  204 . The applicator unit  202  can extract heat from tissue  211  located in the tissue-receiving cavity  230 . Heat (represented by arrows) from the tissue  211  can be conductively transferred through the liner assembly  204  to temperature-controlled heat-exchanging surfaces  239  of the applicator unit  202  such that heat flows across substantially all of the applicator/skin interface. 
     To effectively cool relatively shallow targeted submental tissue without adversely effecting deeper non-targeted tissue, the tissue  211  can be drawn against the bottom  233  of the relatively shallow tissue-receiving cavity  230 . Subcutaneous lipid-rich cells in a subcutaneous layer  213  can be cooled an amount sufficient to be biologically effective in affecting (e.g., damaging and/or reducing) such lipid-rich cells without affecting non-target cells to the same or greater extent. In some procedures, platysma muscle  221 , digastric muscle  223 , mylohyoid muscle  225 , geniohyoid muscle  227 , and/or other non-targeted tissues can be generally unaffected by the treatment. In some procedures, adipose tissue in the subcutaneous layer  213  can be selectively cooled/heated without significantly affecting non-targeted tissue. Although the illustrated applicator  102  is positioned to treat mostly submental tissue, it can also be positioned to treat tissue at the submandibular region, neck region, or other target regions. Straps, harnesses, or other retaining apparatuses can secure the applicator  102  to the subject throughout therapy. 
       FIG. 5  is an isometric view of the applicator unit  202  in accordance with embodiments of the technology. The applicator unit  202  can include a cup assembly  228  for cooling/heating tissue and a housing  240  for protecting the cup assembly  228 . The cup assembly  228  can include a cup  231  and a contoured lip  232 . The cup  231  can be contoured to accommodate tissue pulled into the cavity  230  and can serve as a heat sink to provide effective cooling/heating of tissue. The contoured lip  232  can define a mouth  242  of the cavity  230  and can sealingly engage, for example, a liner assembly (e.g., liner assembly  204  of  FIG. 3 ), the subject&#39;s skin (e.g., if the contoured lip  232  is placed directly against skin), a cryoprotectant gel pad, or other surface. The contoured lip  232  can include two spaced apart arcuate lip portions  290   a,    290   b  and side lip portions  292   a,    292   b  connecting the lip portions  290   a,    290   b.  Fasteners  241  (e.g., hook or loop fastener) can be coupled to or part of the housing  240 . Various features of the applicator unit  202  are discussed in detail in connection with  FIGS. 6-9 . 
       FIG. 6  is an exploded isometric view of the applicator unit  202  in accordance with embodiments of the technology. In some embodiments, including the illustrated embodiment, the housing  240  includes two housing sections  244   a,    244   b  that cooperate to surround internal components, but the housing  240  can have a wide range of multi-piece or one-piece constructions selected based on the configuration of cooling unit  246  and/or the cup assembly  228 . The cooling unit  246  can be in thermal communication with a base  245  of the cup assembly  228 . In a cooling mode, the cooling unit  246  cools the cup assembly  228 , and in a heating mode, the cooling unit  246  heats the cup assembly  228 . 
       FIG. 7  is a top view of the applicator unit  202  in accordance with embodiments of the technology. The cup  231  can include spaced apart sidewalls  260   a,    260   b,  a bottom  270 , and end portions  272   a,    272   b.  The sidewalls  260   a,    260   b  can be curved, flat, or combinations thereof and can extend between the end portions  272   a,    272   b.  The bottom  270  can extend between the sidewalls  260   a,    260   b  and can extend between the end portions  272   a,    272   b.    
     The cup  231  can be a thermally conductive cup made, in whole or in part, of a thermally conductive material for rapid cooling and/or heating to, for example, reduce treatment times and/or produce generally flat temperature profiles over the heat-exchanging surface  239  or a portion thereof. Because the subject&#39;s body heat can be rapidly conducted to the cup  231 , the cooled skin can be kept at a generally flat temperature profile (e.g., ±3° C. of a target temperature) even though regions of the skin, or underlying tissue, may experience different amounts of blood flow. The thermally conductive materials can include, without limitation, metal/metal alloys (e.g., stainless steel, copper alloys, etc.), pure metal (e.g., pure copper), or other rigid or flexible high heat transfer materials such as thermally conductive plastics. In some embodiments, the thermally conductive material at room temperature can have a thermal conductivity equal to or greater than about 13 W/(mK), 50 W/(mK), 100 W/(mK), 200 W/(mK), 300 W/(mK), 350 W/(mK), and ranges encompassing such thermal conductivities. In some embodiments, the cup  231  can have a multi-piece construction with different pieces made of different materials to provide different amounts of heat flow at different locations. In other embodiments, the cup  231  has a unitary construction and is made of a single material, such as metal. The surface  239  can be a smooth surface that extends continuously along at least most of the cavity  230 . When tissue is drawn against the surface  239 , the skin can be slightly stretched to reduce the thickness of the skin to increase heat transfer between target tissue and the surface  239 . Thus, the mechanical properties, thermal properties, shape, and/or dimensions of the cup  231  can be selected based on, for example, target treatment temperatures and/or desired volume of tissue to be drawn into the cavity  230 . 
     One or more vacuum ports  250  can be in fluid communication with the cavity  230 . The number and locations of the vacuum ports  250  can be selected based on, for example, desired tissue draw, considerations of patient comfort, and the desired vacuum level. If the vacuum level is too low, tissue will not be drawn adequately (or at all) into the cavity  230 . If the vacuum level is too high, undesirable discomfort to the patient and/or tissue damage could occur. The vacuum ports  250  can be positioned near the bottom of the cavity  230  to comfortably draw the tissue deep into the cavity  230 . 
     Vacuum ports  280   a,    280   b,    280   c  (collectively, “vacuum ports  280 ”) can be positioned along the sidewall  260   a,  and vacuum ports  291   a,    291   b,    291   c  (collectively, “vacuum ports  291 ”) can be positioned along the sidewall  260   b.  The vacuum ports  280 ,  291  can be used to draw a liner assembly, cryoprotectant gel pad, and/or tissue against the respective sidewalls  260   a,    260   b.  In other embodiments, adhesive (e.g., pressure-sensitive adhesive), snaps, or hook and loop type fasteners can be positioned at various locations along the surface  239  and can couple a liner assembly to the applicator unit  202 . In yet other embodiments, a cinching device (not shown) can couple liner assemblies to the applicator unit  202 . 
       FIG. 8  is a cross-sectional view of the applicator unit  202  taken along line  8 - 8  of  FIG. 7 .  FIG. 9  is a cross-sectional view of the applicator unit  202  taken along line  9 - 9  of  FIG. 7 . Referring now to  FIG. 8 , cavity  230  can include a first end  300 , a second end  302 , and a central section  304  extending between the first and second ends  300 ,  302 . The central section  304  can have a curved longitudinal axis  310  extending along a substantially circular path, an elliptical path, or other desired nonlinear or linear path. In some embodiments, the longitudinal axis  310  has a curvature generally equal to the curvature of at least one of the arcuate lip portions  290   a,    290   b  (as viewed from the side). In other embodiments, the longitudinal axis  310  can have a curvature that is different than the curvature of one or both lip portions  290   a,    290   b  and can be selected based on the shape of the subject&#39;s body. 
     The cavity  230  can have substantially uniform depth along most of curved longitudinal axis  310 . Embodiments of the applicator unit  202  for treating submental tissue can have a maximum depth  312  equal to or less than about 0.5 cm, 2 cm, 2.5 cm, 3 cm, or 5 cm, for example. Embodiments of the applicator unit  202  for treating facial tissue can have a maximum depth  312  equal to or less than about 0.5 cm, 2 cm, or 3 cm, for example. The maximum depth  312  can be selected based on, for example, the volume of targeted tissue, characteristics of the targeted tissue, and/or desired level of patient comfort. 
       FIG. 9  shows the sidewalls  260   a,    260   b  splayed out to facilitate conformably drawing tissue into the tissue-receiving cavity  230 . The positive draft angle of the sidewalls  260   a,    260   b  can be increased or decreased to decrease or increase, respectively, the vacuum level needed to fill the cavity  230  with tissue. Referring to  FIGS. 8 and 9  together, the bottom of the cavity  230  can define a curved longitudinal profile shape in a longitudinal direction (e.g., a direction parallel to the axis  310  in  FIG. 8 ), and the bottom of the cavity  230  can define a curved transverse profile shape in a transverse direction. In one embodiment, a radius of curvature of the longitudinal curve profile shape of  FIG. 8  can be greater than a radius of curvature of the transverse curved profile of  FIG. 9 . The tissue-receiving cavities disclosed herein can have substantially U-shaped cross sections (see cavity  230  of  FIG. 9 ), V-shaped cross sections (see tissue-receiving cavity  230 ′ of  FIG. 9A ), or partially circular/elliptical cross-sections (see tissue-receiving cavity  230 ″ of  FIG. 9B ), as well as or other cross sections suitable for receiving tissue. 
       FIG. 9  shows the contoured lip  232  connected to an upper edge  333  of the cup  231 . The contoured lip  232  can be made, in whole or in part, of silicon, rubber, soft plastic, or other suitable highly compliant materials. The mechanical properties, thermal properties, shape, and/or dimensions of the contoured lip  232  can be selected based on, for example, whether the contoured lip  232  contacts a liner assembly, a surface of a cryoprotectant gel pad, or the subject&#39;s skin. 
     Sensors  470  can be coupled to the surface  239 , embedded in the cup  231 , or located at other suitable positions (e.g., carried by a film applied to the cup  231 ). The sensors  470  can be temperature sensors, such as thermistors, positioned to detect temperature changes associated with warm tissue being drawn into the cup  231 . A control module (e.g., control module  106  of  FIG. 1 ) can interpret the detected temperature increase associated with skin contact and can monitor, for example, the depth of tissue draw and tissue contact based on the locations and amount of temperature increase. In some embodiments, the sensors  470  measure heat flux and/or pressure (e.g., contact pressure) with the skin of the patient. In yet further embodiments, the sensors  470  can be tissue impedance sensors or other sensors capable of detecting the presence and/or characteristics of tissue. Feedback from the sensors  470  can be collected in real-time and used in concert with treatment administration to efficaciously target specific tissue. The sensor measurements can also indicate other changes or anomalies that can occur during treatment administration. For example, an increase in temperature detected by the sensors  470  can indicate either a freezing event at the skin or movement of the applicator  102 . An operator can inspect the subject&#39;s skin and/or applicator  102  in response to a detected increase in temperature. Methods and systems for collection of feedback data and monitoring of temperature measurements are described in commonly assigned U.S. Pat. No. 8,285,390. 
     Referring again to  FIG. 6 , the cooling unit  246  can be mounted directly to the cup assembly  228  and can include a thermal device  350  and a connection assembly  353 . The thermal device  350  can include, without limitation, one or more thermoelectric elements (e.g., Peltier-type elements), fluid-cooled elements, heat-exchanging units, or combinations thereof. In some embodiments, the thermal device  350  includes thermoelectric elements  352  for cooling/heating the base  245  and a fluid-cooled element  354  for cooling/heating the thermoelectric elements  352 . In a cooling mode, the fluid-cooled element  354  can cool the backside of the thermoelectric elements  352  to keep the thermoelectric elements  352  at or below a target temperature. In a heating mode, the fluid-cooled element  354  can heat the backside of the thermoelectric elements  352  to keep the thermoelectric elements  352  at or above a target temperature. Although the illustrated thermal device  350  has two thermoelectric elements  352 , it can have any desired number of thermoelectric elements  352  at various locations about the cup  231 . In other embodiments, the thermal device  350  has only fluid-cooled elements or only non-fluid cooled thermoelectric elements. The configurations and components of the thermal device  350  can be selected based on the desired power consumption and targeted temperatures. The connection assembly  353  can include circuitry, a circuit board, fittings (e.g., inlet ports, outlet ports, etc.), or the like. The cooling unit  246  can also be incorporated into part of the cup assembly  228 . In such embodiments, the thermoelectric elements  352  can be embedded or otherwise disposed in the cup  231  to reduce the distance from the tissue to the thermoelectric elements  352 . 
       FIG. 10  is an isometric view of the liner assembly  204  in accordance with one embodiment.  FIG. 11  is a top view of the liner assembly  204  of  FIG. 10 .  FIG. 12  is a cross-sectional view of the liner assembly  204  taken along line  12 - 12  of  FIG. 11 . When the liner assembly  204  is positioned on an applicator unit, the liner assembly  204  can provide a sanitary surface for contacting a patient and can also effectively transfer heat between the subject and the applicator unit. After treatment, the liner assembly  204  can be discarded or sanitized and reused. 
     The liner assembly  204  can include a cup liner  400  for overlaying the heat transfer surface of an applicator unit and attachment members  404   a,    404   b  for securing the liner assembly  204  to the applicator unit. The cup liner  400  can include a lip portion  410  and a main body  420 . When the applicator unit is inserted into the main body  420 , the lip portion  410  can surround the mouth of a tissue receiving cavity and an elongated opening  450  can be aligned with a trench (see trench  451  of  FIG. 8 ) of the applicator unit, and openings  460  can be aligned with the vacuum ports of the applicator unit. In highly compliant embodiments, the liner assembly  204  can be made, in whole or in part, of rubber, soft plastic, or other compliant material. 
     Liner assemblies can also be a film, a sheet, a sleeve, or other component suitable for defining an interface surface to prevent direct contact between the applicator unit and the subject&#39;s skin to reduce the likelihood of cross-contamination between patients, minimize cleaning requirements, etc. Exemplary protective liners can be sheets, sleeves, or other components constructed from latex, rubber, nylon, Kevlar®, or other substantially impermeable or semi-permeable material. Further details regarding a patient protection device may be found in U.S. Patent Publication No. 2008/0077201. A liner or protective sleeve may be positioned between the absorbent and the applicator to shield the applicator and to provide a sanitary barrier that is, in some embodiments, inexpensive and thus disposable. 
     E. Treatment Methods 
       FIGS. 13-17  are a series of views of a method of performing cryotherapy in accordance with various embodiments of the present technology. Generally, targeted tissue can be drawn into the applicator  102  until the tissue is in thermal contact a region of the cup assembly  228  located at a bottom of the cavity  230 . The cup assembly  228  can be cooled to extract heat from the tissue so as to cool/heat targeted tissue an amount sufficient to be biologically effective in damaging and/or reducing targeted cells.  FIG. 17  shows a pretreatment tissue profile of a double chin in phantom line and the post treatment tissue profile in solid line. Various details of operation are discussed in detail below. 
       FIG. 13  shows the applicator  102  ready to be placed at a treatment site  502 . In procedures for reducing a double chin, the applicator  102  can be aligned with and placed generally at the submental region (i.e., the submental triangle). Although the subject&#39;s head is shown at a generally horizontal orientation, the subject&#39;s head can be held at other orientations. For example, a pillow (e.g., pillow  130  of  FIG. 1 ) or other support device can be used to elevate, tilt, or otherwise position the subject&#39;s head, neck, shoulders, and/or other body parts. The applicator  102  can be placed against the subject such that it extends laterally across the submental triangle or a portion thereof. It will be appreciated that the applicator  102  can be placed at other locations along the patient&#39;s body and the orientation of the applicator  102  can be selected to facilitate a relatively close fit. 
       FIG. 14  shows the applicator  102  placed against the subject&#39;s skin.  FIG. 15  is a cross-sectional view of the applicator  102  contacting the subject&#39;s skin  500  before drawing tissue.  FIG. 16  is a cross-sectional view of the applicator  102  after tissue has been drawn into the cavity  230 . Although not shown in  FIGS. 13-16  for ease of illustration, other elements, materials, components (e.g., gel pads, absorbents, etc.) can be located between the skin  500  and the applicator 102. U.S. Pub. No. 2007/0255362 and U.S. Patent Publication No. 2008/0077201 and U.S. application Ser. No. 14/610,807 disclose components, materials (e.g., coupling gels, cryoprotectants, compositions, etc.), and elements (e.g., coupling devices, liners/protective sleeves, absorbents, etc.) that can be placed between the skin  500  and the applicator  102 . 
     Referring to  FIGS. 15 and 16 , when a vacuum is applied, the skin  500  can be moved (indicated by arrows in  FIG. 15 ) towards the bottom of the cavity  230 . The vacuum level can be selected to comfortably pull the tissue into contact with the desired area of the applicator  102 , and the skin  500  and underlying tissue can be pulled away from the subject&#39;s body which can assist in cooling underlying tissue by, e.g., lengthening the distance between targeted subcutaneous fat and the muscle tissue. After a sufficient amount of tissue fills most or all of the cavity  230 , the tissue is cooled/heated.  FIG. 16  shows mostly submental tissue located in the cavity  230 . For example, substantially all the tissue  514  can be submental tissue to alter only the submental region. In other procedures, tissue at the submandibular region can be drawn into the cavity  230  to reduce, for example, jowl fat. 
     Because a target volume of fat may be relatively small and localized, the applicator  102  can provide well-defined margins of the treatment area. In some embodiments, the applicator  102  can conductively cool an area equal to or less than about 20 cm 2 , 30 cm 2 , or 40 cm 2  to avoid damaging non-targeted tissue (e.g., tissue adjacent to the submental region). In some embodiments, the patient-contact surface  237  can have a surface area equal to or less than about 20 cm 2 , 30 cm 2 , or  40  cm 2 . An operator can have an array of applicators with different dimensions so that the operator can select an applicator to match a patient&#39;s anatomy. 
     The control module  106  ( FIG. 1 ) can automatically begin heating/cooling the tissue. In other embodiments, the control module  106  ( FIG. 1 ) can notify the operator that the applicator  102  is ready for treatment. The operator can inspect the applicator  102  and can begin treatment using the control module  106 . Heat (represented by arrows in  FIG. 16 ) can be transferred from targeted tissue to the thermoelectric elements  352 . Coolant can flow through an inlet port  550  connected to the fluid line  180   a.  The coolant can circulate through passages  552  to absorb heat from the thermoelectric elements  352  and can exit the passages  552  via the outlet port  560  connected to the fluid line  180   b.  The heated coolant can flow back to the control module  106  ( FIG. 1 ) for cooling. 
     In contrast to invasive procedures in which coolant is injected directly into targeted tissue, each of the sidewalls  260   a,    260   b  and bottom  270  ( FIG. 7 ) can conductively cool tissue to produce a desired temperature in target tissue without bruising, pain, or other problems caused by injections and perfusion of injected fluid. For example, perfusion of injected fluid can affect the thermal characteristics of the treatment site and result in undesired temperature profiles. As such, the non-invasive conductive cooling provided by the applicator  102  can be more accurate than invasive procedures that rely on injecting fluids. The illustrated targeted tissue of  FIG. 16  can be cooled to a temperature range from about −20° C. to about 10° C., from about 0° C. to about 20° C., from about −15° C. to about 5° C., from about −5° C. to about 15° C., or from about −10° C. to about 0° C. In one embodiment, the patient-contact surface  237  can be kept at a temperature less than about 5° C. to extract heat from subcutaneous lipid-rich cells such that those cells are selectively reduced or damaged. Because non-lipid-rich cells usually can withstand colder temperatures better than lipid-rich cells, the subcutaneous lipid-rich cells can be injured selectively while maintaining the non-lipid-rich cells (e.g., non-lipid-rich cells in the dermis and epidermis). 
     Lines  119  of  FIG. 16  can provide sufficient vacuum to hold the skin  500  against the patient-contact surface  237 . The tissue  514  can fill substantially the entire cavity  230 . For example, the tissue  514  can occupy at least 70%, 80%, 90%, or 90% of the volume of the cavity  230  to avoid or minimize air pockets that may impair heat transfer. The restraint apparatus  107  of  FIG. 1  can be adjusted such that the applicator  102  applies sufficient pressure to reduce, limit, or eliminate blood flow to deeper tissue to improve cooling efficiency because blood circulation is one mechanism for maintaining a constant body temperature of about 37° C. Blood flow through the dermis and subcutaneous layer of the tissue is a heat source that counteracts the cooling of the targeted tissue (e.g., sub-dermal fat). If the blood flow is not reduced, cooling the subcutaneous tissues would require not only removing the specific heat of the tissues but also that of the blood circulating through the tissues. Thus, reducing or eliminating blood flow through the tissue  514  can improve the efficiency of cooling and avoid excessive heat loss from the dermis and epidermis. 
     It will be appreciated that while a region of the body has been cooled or heated to the target temperature, in actuality that region of the body may be close but not equal to the target temperature, e.g., because of the body&#39;s natural heating and cooling variations. Thus, although the applicator  102  may attempt to heat or cool the target tissue to the target temperature or to provide a target heat flux, the sensors  470  ( FIG. 9 ) may measure a sufficiently close temperature or heat flux. If the target temperature or heat flux has not been reached, operation of the cooling unit can be adjusted to change the heat flux to maintain the target temperature or “set-point” selectively to affect targeted tissue. When the prescribed segment duration expires, the next treatment profile segment can be performed. 
       FIG. 17  shows subject after completing cryotherapy with the pretreatment tissue profile of a double chin (shown in phantom line) and the post treatment tissue profile without the double chin (shown in solid line). It may take a few days to a few weeks, or longer, for the adipocytes to break down and be absorbed. A significant decrease in fat thickness may occur gradually over 1-3 months following treatment. Additional treatments can be performed until a desired result is achieved. For example, one or more treatments can be performed to substantially reduce (e.g., visibly reduce) or eliminate a double chin. 
     The treatment procedure of  FIGS. 13-17  can also involve use of cryoprotectant between the applicator  102  and the skin. The cryoprotectant can be a freezing point temperature depressant that may additionally include a thickening agent, a pH buffer, a humectant, a surfactant, and/or other additives. The temperature depressant may include, for example, polypropylene glycol (PPG), polyethylene glycol (PEG), dimethyl sulfoxide (DMSO), or other suitable alcohol compounds. In a particular embodiment, a cryoprotectant may include about 30% polypropylene glycol, about 30% glycerin (a humectant), and about 40% ethanol. In another embodiment, a cryoprotectant may include about 40% propylene glycol, about 0.8% hydroxyethylcellulose (a thickening agent), and about 59.2% water. In a further embodiment, a cryoprotectant may include about 50% polypropylene glycol, about 40% glycerin, and about 10% ethanol. Other cryoprotectants or agents can also be used and can be carried by a cotton pad or other element. U.S. application Ser. No. 14/610,807 is incorporated by reference in its entirety and discloses various compositions that can be used as cryoprotectants. 
     F. Applicator Units 
       FIGS. 18-22  are isometric views of applicators in accordance with embodiments of the present technology. The description of the applicator  102  ( FIGS. 1-17 ) applies equally to the applicators of  FIGS. 18-21  unless indicated otherwise.  FIG. 18  shows an applicator  600  that includes a cup  601  defining a tissue-receiving cavity  610 . The cup  601  has sidewalls  602 , end portions  603 , and a bottom  604 . A thermally conductive edge  616  (e.g., a rounded edge or a blunt edge) can be made of metal or other thermally conductive material capable of cooling/heating margins of the treatment site. An array of vacuum ports  612  (one labeled in  FIG. 18 ) are in fluid communication with the tissue-receiving cavity  610 . A base  624  can be in thermal communication with the cup  601  and can include, without limitation, one or more thermal elements, controllers, or the like. 
       FIG. 19  shows an applicator  630  that includes a cup  631  and a base  656 . The cup  631  has sidewalls  632 , end portions  633 , and a bottom  634  and defines a tissue-receiving cavity  640 . A lip portion  642  is coupled to the cup  631  and flares outwardly. The cavity  640  (as viewed from above) can have an elongate shape (e.g., generally elliptical shape, rounded rectangle shape, etc.), a circular shape, or other suitable shape for receiving tissue. A vacuum port  652  is in fluid communication with the tissue-receiving cavity  640 . 
       FIG. 20  shows an applicator  660  that includes a cup  661  with sidewalls  662 , end portions  663 , and a bottom  664  and can define a tissue-receiving cavity  670 . A lip portion  672  can be a bladder seal or other sealing member. A vacuum port  675  can provide a vacuum for drawing the submental tissue into the cup  661 , and vacuum ports  677  can provide a vacuum for drawing a liner assembly or skin against the cup  661 .  FIG. 21  shows the applicator  660  with a base  680  that serves as a heat spreader to increase heat flows. 
     Exemplary components and features that can be incorporated into the applicators disclosed herein are described in, e.g., commonly assigned U.S. Pat. No. 7,854,754 and U.S. Patent Publication Nos. 2008/0077201, 2008/0077211, 2008/0287839, 2011/0238050 and 2011/0238051. The patient protection devices (e.g., liners or liner assemblies) may also include or incorporate various storage, computing, and communications devices, such as a radio frequency identification (RFID) component, allowing for example, use to be monitored and/or metered. Additionally, restraint apparatuses or components disclosed herein can be used to perform the method discussed in connection with  FIGS. 13-16 . For example, the restraint apparatus  107  can be used to hold the applicators disclosed herein to perform the cryotherapy of  FIGS. 13-16 . 
       FIG. 22  is an isometric view of an applicator  682  in accordance with embodiments of the technology. The applicator  682  is generally similar to the applicator  102  discussed in connection with  FIGS. 1-17 . The applicator  682  of  FIG. 22  includes a housing  684  with coupling features in the form of loops  692  configured to receive restraints, such as flexible straps, belts, etc. 
       FIG. 23A  is an isometric view of an applicator  695  suitable for use with treatment systems disclosed herein. The applicator  695  can be generally similar to the applicators discussed in connection with  FIGS. 1-23 . The applicator  695  is connected to a connector  104  via a flexible joint  696 .  FIG. 23B  shows the flexible joint  696  extending from a side of the applicator  695  or from any other suitable location along the applicator  695 . 
       FIG. 23C  is an exploded isometric view of the applicator  695  in accordance with embodiments of the technology, and  FIG. 23D  is a cross-sectional view of the applicator of  FIG. 23A . Referring to these figures, a housing  693  of the applicator  695  can include multiple housing sections  697  that cooperate to surround and protect internal components, such as a cooling unit  694 . The cooling unit  694  can heat or cool a conductive cup  698 . A manifold system  699  can include lines  701  in fluid communication with ports  703  (one identified in  FIG. 23C ) of the cup  698 . The manifold system  699  can also include coolant lines  705  ( FIG. 23D ) that provide coolant to and take away coolant from the cooling unit  694 . The applicator  695  can have other components, including liner assemblies, sensors, manifolds, vibrators, massage devices, or combinations thereof. Additionally, the manifold system  699  can include vacuum lines  687  that can be fluid communication with vacuum ports  688  (two identified in  FIG. 23C ) of the cup  698 . The vacuum lines  687  can be used to draw a vacuum to hold a liner assembly against the conductive cup  698 . 
     Although noninvasive applicators are illustrated and discussed with respect to  FIGS. 1-23D , minimally invasive applicators may also be employed. As an example, a cryoprobe, an electrode, an injector (e.g., a needle), and/or other invasive component may be incorporated into the applicators disclosed herein and can be inserted directly into the targeted tissue (e.g., subcutaneous adipose tissue) to cool, freeze, or otherwise thermally process targeted tissue. Treatment systems and applicators disclosed herein can also include elements (e.g., electrodes, vibrators, etc.) for delivering energy, such as radiofrequency energy, ultrasound energy (e.g., low frequency ultrasound, high frequency ultrasound, etc.), mechanical massage, and/or electric fields. The energy can be selected to affect treatment by, for example, heating tissue. Additionally or alternatively, energy can be used to affect the crystal formation in non-targeted tissues while allowing cooling of the targeted tissue. In non-targeted cells or structures, non-thermal energy parameters may be selected to reduce ice crystal size and/or length, reduce freezing lethality, or the like. In targeted cells or structures, non-thermal energy parameters may be selected to enhance crystal nucleation. Thus, energy can be selectively applied to control therapy. The treatment systems disclosed herein may be used with a substance that may provide a thermal coupling between the subject&#39;s skin and the thermal element(s) to improve heat transfer therebetween. The substance may be a fluid, e.g., a liquid, a gel, or a paste, which may be hygroscopic, thermally conductive, and biocompatible. 
     G. Restraint Systems 
       FIG. 24  is an isometric view of the head support assembly  108  in accordance with embodiments of the present technology. The pillow  130  can include a deployable head cradle portion  702 , a neck support portion  704 , and a shoulder support portion  736 . The head cradle portion  702  can include the vertical side portions  125   a,    125   b  and a central region  721  therebetween. The side portions  125   a,    125   b  are positioned to contact opposite sides of a subject&#39;s head located in a concave head-receiving region  711 . Movement of the head cradle portion  702  and the neck support portion  704  for positioning the patient&#39;s body is discussed in connection with  FIGS. 25 and 26 . 
     The head adjuster device  113  can include a pressurization device in the form of a pump  724  and a conduit  722 . The conduit  722  fluidically couples the pump  724  to an expandable member (not shown) positioned within the pillow  130 . For example, the expandable member can be positioned between the head cradle portion  702  and the base  709 . The pump  724  can be manually pumped to move the head cradle portion  702  to achieve desired tilt of the subject&#39;s head. The neck adjuster device  115  includes a pressurization device in the form of a pump  734  and a conduit  732 . The conduit  732  can extend through the side portion  125   b  and to an expandable member located generally underneath the neck support portion  704 . The pump  734  can be manually pumped to move the neck support portion  704  to achieve desired neck tilt of the subject. In various embodiments, the adjuster devices disclosed herein can include, without limitation, one or more motorized pumps, valves, pressure regulators, pneumatic drive devices, mechanical drive devices, or other suitable components. 
       FIG. 25  is a cross-sectional view of the pillow  130  taken along line  25 - 25  of  FIG. 27  when the pillow  130  is in an undeployed lowered configuration.  FIG. 26  is a cross-sectional view of the pillow  130  taken along line  26 - 26  of  FIG. 27  when the pillow  130  is in a deployed raised configuration. Referring now to  FIG. 25 , the pillow  130  includes an expandable opening  744  positioned generally under a region of a head-support surface  742  of the head cradle portion  702 . A deployable member  121  can be positioned in the expandable opening  744  and can be deployed (e.g., expanded, inflated, etc.) to move the head cradle portion  702 . A flexible region or joint  743  can connect the head cradle portion  702  to the base  709 . In some embodiments, the head cradle portion  702  can be rotated an angle ? when the expandable member  121  moves from an unexpanded configuration ( FIG. 25 ) to an expanded configuration ( FIG. 26 ). The angle ? can be greater than or equal to about 5 degrees, about 10 degrees, about 20 degrees, about 30 degrees, about 40 degrees, about 50 degrees, or about 60 degrees to rotate the support surface  742  a corresponding angle. The amount of movement of the head cradle portion  702  can be selected based on the desired amount of head tilt. 
       FIG. 25  shows the neck support portion  704  positioned generally between the head cradle portion  702  and the shoulder support region  736 . When the subject&#39;s head is supported by the head cradle portion  702 , the neck support portion  704  is located under the subject&#39;s neck. A flexible portion or joint  747  can connect the neck support portion  704  to the base  709 . An expandable opening  754  is located under the neck support portion  704 . In some embodiments, an expandable member  123  can be inflated to push the neck support portion  704  upwardly to define an angle ? that is greater than or equal to about 5 degrees, about 10 degrees, about 15 degrees, about 20 degrees, about 25 degrees, about 30 degrees, about 35 degrees, about 40 degrees, or about 45 degrees to rotate the neck support portion  704  a corresponding angle. The amount of movement of the neck support portion  704  can be selected based on the desired support for the subject&#39;s neck. 
     The pillow  130  can include other types of movable features, such as movable panels (e.g., rotatable panels, linearly movable panels, etc.) or other features capable of being moved (e.g., translated, rotated, or both) to support, move, and/or otherwise interact with the subject&#39;s body. By way of example, the side portions  125  ( FIG. 24 ) can include surfaces or features that move inward firmly to hold the patient&#39;s head. The number, locations, and properties (e.g., cushioning properties, breathability, etc.) of the movable features can be selected based on, for example, desired patient comfort, body positioning, and/or treatment parameters. 
       FIG. 27  is a top view of the pillow  130 . The neck support portion  704  extends between shoulder-engagement ends  748   a,    748   b  of the side portions  125   a,    125   b,  respectively. The shoulder support region  736  is positioned to support the subject&#39;s shoulders when the shoulder-engagement ends  748   a,    748   b  bear against the subject&#39;s right and left shoulders, respectively. The side portions  125   a,    125   b  can include fasteners or other components for coupling to restraints (e.g., restraints  111   a,    111   b  of  FIG. 1 ). In some embodiments, the side portions  125   a,    125   b  include hook or loop fasteners  763  (illustrated in dash-dot lines) for coupling to loop or hook fasteners of the restraints  111 . For example, the fastener  763  can be sections of hook Velcro® closure. In other embodiments, the fastener  763  can include, without limitation, one or more snaps, buttons, ties, or other attachment features. Other regions of the pillow  130  can be made of breathable material and can have one-way or two-way stretchability. 
       FIG. 28  is a front view of the pillow  130  with the head cradle portion  702  having a substantially U-shaped profile (including V-shaped). The head cradle portion  702  can also have a semi-circular shape profile or other suitable shape for accommodating the subject&#39;s head. The heights of the side portions  125   a,    125   b  can be selected such that the side portions  125   a,    125   b  extend upwardly along opposite sides of the subject&#39;s head sufficient distances to reduce or limit side-to-side rotation of the subject&#39;s head. 
       FIG. 29  is a side view of the pillow  130 . The expandable opening  744  can be a slot or a slit extending inwardly and generally parallel to a bottom surface  745  of the pillow  130 . An access feature  760  in the form of a through-hole extends from an exterior surface  766  of the side portion  125   a  to the expandable opening  754  ( FIGS. 25 and 26 ). The bottom surface  745  can comprise non-skid material for inhibiting movement of the pillow  130  along a support surface. 
     The pillow  130  can be made, in whole or in part, of a compressible material, including without limitation open-cell foam, closed-cell foam, or other compliant material. In some embodiments, the pillow  130  can be made of open-cell polyurethane foam. In some embodiments, the pillow  130  can include a cover for surrounding the foam main body. The cover can be removed and washed to provide a clean surface, and the cover can include fasteners (e.g., loop fastener, snaps, etc.) for coupling to restraints or other components. 
       FIG. 30  is a top view of the head adjuster device  113 . The pump  724  can be a bulb pump, a squeeze pump, or other manual pump and may include a button for releasing air. In other embodiments, the pump  724  is a motorized pump. The conduit  722  can be flexible tubing that fluidically couples the pump  724  to the expandable member  121 . The expandable member  121  can comprise, in whole or in part, urethane, silicon, rubber, or other suitable material. Referring now to  FIG. 27 , the expandable member  121  (shown in phantom line) can be an inflatable bladder that extends across most of the width of the pillow  130 . 
       FIG. 31  is a top view of the neck adjuster device  115  generally similar to the head adjuster device  113  of  FIG. 30  except as detailed below. The expandable member  123  can comprise urethane, silicon, rubber, or other suitable material and can be dimensioned to be located under the neck support portion  704 . Referring now to  FIG. 27 , the expandable member  123  (shown in phantom line) is located generally between the side portions  125 . 
       FIGS. 32-34  are a series of views of a method of performing cryotherapy using the restraint apparatus  107  in accordance with various embodiments of the present technology. Generally, the subject&#39;s head  109  can be positioned in the head cradle portion  702 . An applicator  787  can then be aligned with the treatment site. The restraints  111   a,    111   b  can be coupled to the side portions  125   a,    125   b  and tensioned to pull the applicator  787  against the subject&#39;s submental region. After completing the treatment session, the restraints  111   a,    111   b  can be detached from the respective side portions  125   a,    125   b  to release the subject. Various details of operation are discussed in detail below. 
       FIG. 32  is a top view of the pillow  130  supporting the subject&#39;s head and restraints  111   a,    111   b  ready to be coupled to the pillow. The restraints  111   a,    111   b  can be straps permanently or detachably coupled to an applicator  787 . For example, ends  770   a,    770   b  of the respective restraints  111   a,    111   b  can include hook or loop fasteners, snaps, ties, and/or other features for coupling to the applicator  787 . In other embodiments, the restraints  111   a,    111   b  can be part of a harness system with a harness body holding the applicator  787 . The number, lengths, and configurations of the restraints  111   a,    111   b  can be selected based on the location of the treatment site, desired force for holding the applicator  787 , or other treatment parameters. 
       FIG. 33  is a top view of the restraint apparatus  107  holding the applicator  787  in thermal contact with the subject after fasteners  780   a,    780   b  (illustrated in phantom line) of the restraints  111   a,    111   b  have been applied to the pillow  130 . The fasteners  780   a,    780   b  can be loop fasteners located at or proximate to respective restraint ends  782   a,    782   b.  Tensioning of the restraints  111 , illustrated in a V arrangement, can be adjusted to inhibit or limit side-to-side movement of the applicator  787  and to stabilize the applicator  787  even if the subject&#39;s head moves slightly. During a single treatment session, the ends  782   a,    782   b  can be coupled at various locations along the pillow  130  at different times, thus providing treatment flexibility. 
       FIG. 34  is a left side view of the restraint apparatus  107  holding the applicator  787  in thermal contact with the subject. Referring to  FIGS. 33 and 34 , the restraint ends  770   a,    770   b  can be permanently or detachably coupled to the applicator  787 . For example, the restraint end  770   a  can include a fastener  787   a  (e.g., a loop fastener shown in phantom line in  FIG. 34 ) coupled to hook fastener of the applicator  787 . The restraint ends  770  can be repositioned any number of times along the applicator  787 . In other embodiments, the restraint ends  770  can be integrated into or part of the applicator  787 , which can be similar or identical to the any of the applicators disclosed herein. The connection between the restraints  111  and the applicator  787  can be selected based on the design of the applicator. 
     H. Computing Environments 
       FIG. 35  is a schematic block diagram illustrating subcomponents of a controller in accordance with an embodiment of the disclosure. The controller can be part of the control module  106  ( FIG. 1 ). For example, the controller  790  can be the controller  114  of  FIG. 1  or can be incorporated into the applicators or other components disclosed herein. The controller  790  can include a computing device  800  having a processor  801 , a memory  802 , input/output devices  803 , and/or subsystems and other components  804 . The computing device  800  can perform any of a wide variety of computing processing, storage, sensing, imaging, and/or other functions. Components of the computing device  800  may be housed in a single unit or distributed over multiple, interconnected units (e.g., though a communications network). The components of the computing device  800  can accordingly include local and/or remote memory storage devices and any of a wide variety of computer-readable media. 
     As illustrated in  FIG. 35 , the processor  801  can include a plurality of functional modules  806 , such as software modules, for execution by the processor  801 . The various implementations of source code (i.e., in a conventional programming language) can be stored on a computer-readable storage medium or can be embodied on a transmission medium in a carrier wave. The modules  806  of the processor can include an input module  808 , a database module  810 , a process module  812 , an output module  814 , and, optionally, a display module  816 . 
     In operation, the input module  808  accepts an operator input  819  via the one or more input devices, and communicates the accepted information or selections to other components for further processing. The database module  810  organizes records, including patient records, treatment data sets, treatment profiles and operating records and other operator activities, and facilitates storing and retrieving of these records to and from a data storage device (e.g., internal memory  802 , an external database, etc.). Any type of database organization can be utilized, including a flat file system, hierarchical database, relational database, distributed database, etc. 
     In the illustrated example, the process module  812  can generate control variables based on sensor readings  818  from sensors and/or other data sources, and the output module  814  can communicate operator input to external computing devices and control variables to the controller. The display module  816  can be configured to convert and transmit processing parameters, sensor readings  818 , output signals  820 , input data, treatment profiles and prescribed operational parameters through one or more connected display devices, such as a display screen  118  ( FIG. 1 ), printer, speaker system, etc. 
     In various embodiments, the processor  801  can be a standard central processing unit or a secure processor. Secure processors can be special-purpose processors (e.g., reduced instruction set processor) that can withstand sophisticated attacks that attempt to extract data or programming logic. The secure processors may not have debugging pins that enable an external debugger to monitor the secure processor&#39;s execution or registers. In other embodiments, the system may employ a secure field programmable gate array, a smartcard, or other secure devices. 
     The memory  802  can be standard memory, secure memory, or a combination of both memory types. By employing a secure processor and/or secure memory, the system can ensure that data and instructions are both highly secure and sensitive operations such as decryption are shielded from observation. In various embodiments, the memory  802  can be flash memory, secure serial EEPROM, secure field programmable gate array, or secure application-specific integrated circuit. The memory  802  can store instructions for causing the applicators to cool/heat tissue, pressurization devices to draw a vacuum, or other acts disclosed herein. In one embodiment, the memory  802  stores instructions executable by the controller  790  for the thermal device to sufficiently cool conductive cups disclosed herein such that submental vacuum applicators non-invasively cool the subcutaneous lipid-rich cells to a desired temperature, such as a temperature less than about 0° C. 
     The input/output device  118  can include, without limitation, a touchscreen, a keyboard, a mouse, a stylus, a push button, a switch, a potentiometer, a scanner, an audio component such as a microphone, or any other device suitable for accepting user input and can also include one or more video monitor, a medium reader, an audio device such as a speaker, any combination thereof, and any other device or devices suitable for providing user feedback. For example, if an applicator moves an undesirable amount during a treatment session, the input/output device  803  can alert the subject and/or operator via an audible alarm. The input/output device  118  can be a touch screen that functions as both an input device and an output device. The control panel can include visual indicator devices or controls (e.g., indicator lights, numerical displays, etc.) and/or audio indicator devices or controls. The control panel may be a component separate from the input/output device  118  and/or output device  120 , may be integrated applicators, may be partially integrated with one or more of the devices, may be in another location, and so on. In alternative embodiments, the controller  114  can be contained in, attached to, or integrated with the applicators. Further details with respect to components and/or operation of applicators, control modules (e.g., treatment units), and other components may be found in commonly-assigned U.S. Patent Publication No. 2008/0287839. 
     The controller  790  can include any processor, Programmable Logic Controller, Distributed Control System, secure processor, and the like. A secure processor can be implemented as an integrated circuit with access-controlled physical interfaces; tamper resistant containment; means of detecting and responding to physical tampering; secure storage; and shielded execution of computer-executable instructions. Some secure processors also provide cryptographic accelerator circuitry. Suitable computing environments and other computing devices and user interfaces are described in commonly assigned U.S. Pat. No. 8,275,442, entitled “TREATMENT PLANNING SYSTEMS AND METHODS FOR BODY CONTOURING APPLICATIONS,” which is incorporated herein in its entirety by reference. 
     I. Conclusion 
     Various embodiments of the technology are described above. It will be appreciated that details set forth above are provided to describe the embodiments in a manner sufficient to enable a person skilled in the relevant art to make and use the disclosed embodiments. Several of the details and advantages, however, may not be necessary to practice some embodiments. Additionally, some well-known structures or functions may not be shown or described in detail, so as to avoid unnecessarily obscuring the relevant description of the various embodiments. Although some embodiments may be within the scope of the technology, they may not be described in detail with respect to the Figures. Furthermore, features, structures, or characteristics of various embodiments may be combined in any suitable manner. Moreover, one skilled in the art will recognize that there are a number of other technologies that could be used to perform functions similar to those described above. While processes or acts are presented in a given order, alternative embodiments may perform the processes or acts in a different order, and some processes or acts may be modified, deleted, and/or moved. The headings provided herein are for convenience only and do not interpret the scope or meaning of the described technology. 
     Unless the context clearly requires otherwise, throughout the description, the words “comprise,” “comprising,” and the like are to be construed in an inclusive sense as opposed to an exclusive or exhaustive sense; that is to say, in a sense of “including, but not limited to.” Words using the singular or plural number also include the plural or singular number, respectively. Use of the word “or” in reference to a list of two or more items covers all of the following interpretations of the word: any of the items in the list, all of the items in the list, and any combination of the items in the list. Furthermore, the phrase “at least one of A, B, and C, etc.” is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). 
     Any patents, applications and other references, including any that may be listed in accompanying filing papers, are incorporated herein by reference. Aspects of the described technology can be modified, if necessary, to employ the systems, functions, and concepts of the various references described above to provide yet further embodiments. These and other changes can be made in light of the above Detailed Description. While the above description details certain embodiments and describes the best mode contemplated, no matter how detailed, various changes can be made. Implementation details may vary considerably, while still being encompassed by the technology disclosed herein. As noted above, particular terminology used when describing certain features or aspects of the technology should not be taken to imply that the terminology is being redefined herein to be restricted to any specific characteristics, features, or aspects of the technology with which that terminology is associated.