CoolSculpting PAH: The Paradoxical Adipose Hyperplasia Side Effect

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Published on Mar 19, 2022 By: WIFH Staff

Paradoxical Adipose Hyperplasia as a Side Effect of Coolsculpting

Since the FDA’s clearance of CoolSculpting, a non-invasive form of cryolipolysis (destruction of fat cells with freezing), to get rid of unwanted fat, some patients have experienced a condition known as paradoxical adipose hyperplasia, or PAH. Find out what PAH is, why it occurs, how to prevent it, and what to do about it if it happened to you after CoolSculpting.

What is the Paradoxical Adipose Hyperplasia Side Effect of CoolSculpting?

coolsculp sculpsure
Figure 1: Photo of Treatment Area Affected by PAH (courtesy of the JAMA Network)

Paradoxical adipose hyperplasia is a previously unreported adverse effect of cryolipolysis.

Cryolipolysis uses cooling to damage and destroy subcutaneous fat cells, without damaging the skin to reduce the amount of fat in the treated area. This phenomenon of CoolSculpting PAH has a reported rate of incidence of 0.0051% of the 1.5 million CoolSculpting procedures performed worldwide. It is likely much higher due to under recognition of the condition by patients and clinicians. Our physicians at WIFH have seen many patients in consultation that had no idea they had this condition.

The CoolSculpting PAH side effect causes a gradual enlargement of the fat tissue in the area treated by CoolSculpting. It occurs when the stimulus (the freezing of fat cells) activates a reactionary process in the fatty tissue that thickens and expands the fat cells rather than breaking them down and allowing the body to process and remove them.

PAH is only known to occur following a cryolipolysis, or CoolSculpting body contouring treatment. PAH typically cannot be confirmed until about 6 months post-procedure, with patients complaining that they are getting bigger in the exact shape of the applicator, as depicted below.

What To Do If You Get PAH After CoolSculpting

Smartlipo Fixes Coolsculpting PAH Side Effect
Before & After: Smartlipo Fixes CoolSculpting PAH

Those who have developed PAH after CoolSculpting need to have it corrected surgically. Changes in lifestyle (diet and exercise) won’t address this complication. We often find that many of these patients have more Coolsculpting as they are told that is what will address the problem, or they blame themselves for doing something wrong that caused the PAH to happen. We have also found that this complication is rarely mentioned to prospective patients by providers of the Coolsculpting procedure.

Smartlipo is a great option to correct the effects of PAH. Smartlipo is a laser-assisted liposuction procedure, known as laser lipolysis. It is performed under local anesthesia using a laser to melt the fat while simultaneously tightening the skin. Because the laser energy destroys the fat, we believe there is a lower chance of recurrence of the PAH, which is a common complication after liposuction removal of PAH.

If you suspect you have PAH, WIFH recommends you return to your CoolSculpting provider to be evaluated. If it is confirmed, they may be able to make contact with the manufacturer on your behalf to pay for the procedures needed for resolution. If you are unable to contact them or feel you have PAH and have not been diagnosed correctly, schedule a complimentary consultation with our Doctors today.

SculpSure vs CoolSculpting
SculpSure vs CoolSculpting:
Non-Invasive Fat Reduction Compared
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WarmSculpting™ as a Coolsculpting Alternative

Get WarmSculpting™ with SculpSure

SculpSure is the first FDA approved non-invasive, warm laser treatment for fat reduction, utilizing a 1060 nm wavelength diode laser. It is safe for all skin types and ideal for areas of stubborn fat on the abdomen, love handles, bra line, and thighs. The hyperthermic nature of SculpSure uses heat to destroy fat cells, leaving you with up to 24% less fat at 12-15 weeks after treatment. The contact cooling system keeps the surface of the skin cool while the heat treats the fat and surrounding tissue.

Like most non-invasive treatments, most patients require two treatments of SculpSure to achieve desired results. Each treatment takes 25 minutes, and patients experience absolutely zero downtime afterward. Non-invasive treatments like SculpSure or CoolSculpting do not provide immediate results because it relies on the body to process the damaged fat cells, which can take several weeks. It typically takes about 12 weeks to see full results.

WarmSculpting™ Recovery vs. Cryolipolysis

Unlike cryolipolysis, SculpSure leaves patients with only slight tenderness rather than the intense pain, bruising and swelling for days that patients can experience as a result of cryolipolysis. Patients have not experienced PAH as a result of SculpSure. Patients seeking a non-invasive fat reduction treatment should consider all of the pros and cons of each procedure and read patient reviews. They should also expect that there is no current noninvasive technology that can deliver the results of an experienced liposuction surgeon.

Fix The Coolsculpting PAH Side Effect With Smartlipo

Have you had CoolSculpting and think you have been affected by the unfortunate PAH side effect? WIFH can help!

Reach out and request a complimentary consultation with our doctors to see if you are a candidate to remove your CoolSculpting PAH with Smartlipo.

Paul E. Cox, MD, MS

Dr. Paul Cox MD, MS is the Owner and Medical Director of WIFH, serving the Atlanta-area community as a physician for over 20 years. A 1999 graduate of the University of Tennessee College of Medicine, Dr. Cox completed his residency in Family Medicine in 2002 and is board certified in both Family Medicine and Anti-Aging Medicine. He has been licensed in Georgia since 2001. As one of the first physicians trained in Smartlipo in 2007, Dr. Cox has performed thousands of Smartlipo laser liposuction procedures without complication. He has been performing cosmetic injectables since 2003 and has a wealth of knowledge and experience in the world of aesthetics.