Fixing Paradoxical Adipose Hyperplasia (PAH) in New York

Paradoxical adipose hyperplasia (PAH) is a rare but documented adverse effect of cryolipolysis with CoolScupting, a non-surgical method to remove fat. Cryolipolysis is more commonly known as CoolSculpting, a cosmetic procedure that destroys fat cells by cooling them to a specific temperature. PAH occurs when the cooling effect of cryolipolysis causes the fat cells to expand instead of breaking down, resulting in an increase in the size of the underlying fat. PAH typically appears within one to three months following the procedure and may take up to six to nine months to fully develop.

PAH can occur in anyone who undergoes cryolipolysis, but it is more commonly reported in men and individuals with darker skin types. The condition can cause significant emotional distress and is a challenging problem to treat. Currently, the only way to solve PAH is through liposuction. Dr. Cameron Rokhsar is a world expert in liposuction and has performed liposuction procedures for years in all body areas including the belly, love handles, arms, inner thighs, outer thighs, back, and neck fat. While PAH is a potential risk associated with cryolipolysis, it is a rare complication. The overall rate of PAH is low, with less than 1 percent of patients experiencing the condition. Nonetheless, it is crucial for patients considering cryolipolysis to be aware of the potential risks associated with the procedure, including PAH.

While it is not entirely clear why PAH happens, it is thought to be a reaction to the freezing of the fat cells, which can cause them to expand rather than shrink. There is no known way to completely prevent PAH, but there are some things that patients and doctors can do to reduce the risk.

Firstly, it is essential to choose a qualified and experienced practitioner who will take the time to evaluate your health and discuss the potential risks and benefits of the treatment. CoolSculpting should only be performed on patients who are in good health and have realistic expectations about the results.

Another way to reduce the risk of PAH is to consider alternative body contouring treatments, such as liposuction, which is considered the gold standard for body sculpting and contour changes. Additionally, using cryolipolysis devices with smaller handpieces can also reduce the risk of PAH.

PAH can occur after cryolipolysis treatment, but it is a rare complication, occurring in only a small percentage of cases.

The symptoms of PAH can start to appear anywhere from a few days to several months after the cryolipolysis treatment. However, the most common timeframe for PAH to appear is around 3-6 months after the initial treatment. PAH can be identified by a treated area that looks and feels thicker, a mass or swelling that may be felt under the skin and is often slightly painful to touch, and hard lumps or bumps in the treated area. The entire treated area may also appear bigger, not smaller.

It is unknown why PAH takes so long to appear in the body. At this time, there is no evidence of spontaneous resolution for PAH, meaning it does not go away on its own. While the frequency of PAH is up for debate and likely underreported, it is more common in male patients undergoing cryolipolysis.

Instead of reducing the amount of fat in the treated area, PAH causes fatty tissue to grow and become firm, creating an irregular and raised lump that is well-outlined and often in the shape of the CoolSculpting or cryolipolysis applicator. The lump feels thicker and firmer than surrounding fat and may be slightly painful to the touch. PAH may appear a few days to weeks after the cryolipolysis treatment and can range in severity from moderate to severe. Patients with PAH may develop visible fat lumps that are often described as “sticks of butter” in the areas of their body that were treated with cryolipolysis. Redness, tenderness, stinging, muscle cramping, itching, and diarrhea are common side effects of fat freezing, but PAH is a less common and more serious side effect. It is important to consult a board-certified dermatologist or cosmetic surgeon if you are experiencing any of these symptoms after a cryolipolysis treatment.

The incidence rate of PAH after CoolSculpting varies, with reported rates ranging from 0.0036% to 2%. The manufacturer of the CoolSculpting device reports a rate of 0.025%, based on post-market consumer data. While PAH is rare, it is always essential to weigh the risks of any cosmetic procedure you undergo. If you are considering CoolSculpting or have concerns about PAH after undergoing the procedure, we recommend consulting with Dr. Cameron Rokhsar, a double-board-certified dermatologist and cosmetic surgeon who specializes in the treatment to discuss your options.

First, it is important to choose an experienced and qualified provider for your CoolSculpting treatment. Look for someone who is board-certified and has a proven track record of successful treatments. Additionally, be sure to have a thorough consultation with your provider to discuss your goals and any concerns you may have.

It is also important to follow all pre- and post-treatment instructions provided by your provider. This may include avoiding certain medications or supplements that can increase the risk of complications, as well as avoiding excessive sun exposure and strenuous activity in the days and weeks following your treatment.

The only solution to get rid of the fat associated with PAH is through liposuction. Dr. Rokhsar performs all his liposuction procedures under local anesthesia. This makes the liposuction procedure more safe. It also allows for rapid recovery. Dr. Rokhsar has treated PAH with liposuction effectively. Any area on the body can be treated with liposuction including arms, legg, abdomen, thighs, knees and the neck.