Since the FDA’s clearance of CoolSculpting, a non-invasive form of cryolipolysis, 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 you can prevent it, and what you can do if you have been affected by it.
What is Paradoxical Adipose Hyperplasia (PAH)?
Paradoxical adipose hyperplasia is a rare, 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 PAH has a rate of incidence of 0.0051% of the 1.5 million CoolSculpting procedures performed worldwide, which indicates it is rare. This number only reflects reported cases as PAH is not a well known side effect.
PAH causes a gradual enlargement of the treated area. It occurs when the stimulus (the freezing of the fat cell) 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 can typically not be confirmed until you are at least 6 months out from your treatment.
Figure 1: Left: Photo of Man’s Treatment Area Affected by PAH (courtesy of the JAMA Network)
Benefits of 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 perfect for areas of stubborn fat on the abdomen, flanks, bra line, and thighs. The hyperthermic nature of SculpSure uses heat to destroy fat cells, leaving you with up to 25% less fat 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 people will need two treatments of SculpSure to achieve the best 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 your body to process and filter out the damaged fat cells which take several weeks. Typically it takes about 12 weeks for you to see full results.
Unlike cryolipolysis, SculpSure leaves patients with only slight tenderness rather than the intense pain patients can experience as a result of cryolipolysis. Patients have not experienced PAH as a result of SculpSure. If you are looking into a non-invasive fat reduction treatment, and there are many to choose from, consider all of the pros and cons of each procedure and read reviews to see what others are saying about it.
What Can I Do if I Have Been Affected by PAH?
If you already have PAH, know that it can be corrected. 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. Once the fat is melted, suction is applied to manually remove the fat from the area. While we understand the thought of having to have another procedure to fix what a previous procedure left you with isn’t what you had planned for, you can be confident to know that once you have Smartlipo, the problem will be resolved.
It is recommend that if you suspect you have PAH that you return to your treating facility for evaluation. If it is confirmed, they may be able to make contact with the manufacturer on your behalf for resolution.