![]() I believe this is case with liposuction vs CoolSculpting. Yet sometimes surgery remains the superior option. Non-surgical cosmetic treatment options continue to improve, and many are safe, suitable alternatives for patients wishing to make changes without significant downtime. ![]() Liposuction remains your best option for fat removal & sculpting Moreover, this means the patient ends up having to undergo and pay for two procedures to address unwanted fat that liposuction could have taken care of the first time-with more precise, predictable sculpting than what’s possible with any non-surgical option. This can be hard on a patient both emotionally and physically, especially considering they sought out fat reduction in the first place to address a bothersome issue that now appears worse. However, patients who develop the condition have to live with a conspicuous bulge for about six to nine months until the fat softens enough to remove safely. Now the good news: PAH can be treated with liposuctionįortunately, PAH is not life-threatening, and it is fully treatable with liposuction. It is one reason why I continue to eschew non-surgical fat reduction technology in favor of tried-and-true liposuction. Over the years, I have treated a number of patients in the Seattle and Bellevue area who developed PAH after cryolipolysis, and I have been aware of the condition for quite some time. And, with a proliferation of other devices and at-home fat freezing belts on the market, PAH is something we need to pay closer attention to. While this is still an incidence rate of less than 1%, it concerns me as a physician any time we see a rise in complication rates with a procedure-particularly one with such strong claims of safety and ease. We don’t exactly know why PAH happens to certain patients, and recent studies suggest that PAH occurs far more often (1 out of 138 treatments) than the manufacturer has previously reported (1 out of 4,000 treatments). (Note: CoolSculpting brand applicators differ in design.) Is PAH after cryolipolysis happening more than we think? Instead of gradually shrinking, the bulge after CoolSculpting actually gets bigger and usually becomes firmer than surrounding tissues, sometimes having a “stick of butter” appearance that resembles the shape of the CoolSculpting applicator.Įxample of patient receiving cryolipolysis treatment tissue is suctioned into the applicator. This is called paradoxical (abnormal) adipose (fat) hyperplasia (unusual increase in a structure), or PAH for short. In a small number of cases, however, the fat in the treated area expands and hardens into an unnaturally shaped lump in response to the extreme cold. The technology behind CoolSculpting, cryolipolysis, is designed to chill tissue to the point where fat cells crystalize, disintegrate, and leave the body as waste, helping a treated area marginally slim down. ![]() What is paradoxical adipose hyperplasia and why does it sometimes happen after CoolSculpting? I am talking about a complication called “paradoxical adipose hyperplasia (PAH)” or, in layman’s terms, the “stick of butter” effect. However, one more serious CoolSculpting side effect appears to be more common than we originally thought. The majority of patients experience mild side effects such as redness, tingling, and numbness, which go away after a few days. When CoolSculpting hit the market in 2010, it sounded almost too good to be true: freeze away stubborn fat bulges without surgery or downtime and all you have to do is sit there for an hour? Yet here we are eight years later, and CoolSculpting seems to be soaring in popularity among patients and cosmetic practices alike.įor the most part, CoolSculpting has a good safety record.
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