How common is CoolSculpting PAH effect? Am I at risk with my stats?

Question

I am a 22 year old female, 5’2 and 105 pounds with a stubborn stomach pooch. I am interested in CoolSculpting but very worried about the PAH effect. Do any doctors find this to be common, or think it would be a concern for me based off of my age/height/weight? Also, is it ok to go to someone who is CoolSculpting trained/certified at a dermatologist office? Versus the actual dermatologist...

Michael A. Zadeh, MD, FACS · Answer

There have been studies which show the incidence of Paradoxical Adipose Hyperplasia (PAH) after CoolSculpting as being less than 0.1%. This is probably underreported. We have been doing the treatment since 2013 and have performed thousands of treatments. We have only seen 1 case of PAH and that was with the older applicators. We have not seen any instances with the newer applicators. I evaluate all patients interested in CoolSculpting myself and I would recommend you see an experienced physician provider to minimize the risk of unwanted effects. Another option for you besides CoolSculpting would be the new EMSculpt treatment. In someone your size this will decrease fat and tone your abdominal muscles making you look more defined. There is no risk of PAH with EMSculpt. Most importantly, make sure you are under the care of an experienced physician. Hope this helps answer your question!

Jason Emer, MD · Answer

This is an extremely rare side effect with Coolsculpting. While it's difficult to predict who will develop PAH, it is not typical for the vast majority of patients that get Coolsculpting. For best results with Coolsculpting, I recommend a combination approach. I recommend adding radiofrequency treatments like Vanquish, Venus Legacy, Exilis Ultra for skin tightening and with Z wave/Cellutone for skin smoothing. VASER with ThermiRF is a great alternative. See an expert. Best, Dr. Emer

Edward Tangchitnob, MD, FACOG, FACS · Answer

Dear cosmeticcurls,
Great question! The statistic for PAH is 0.0036%. PAH is less common with newer applicators.
- Dr. Edward Tangchitnob

Laura A. Katz, MD · Answer

PAH is a condition in which the fat cells become thicker and expand instead of being eliminated.  The incidence of this is extremely rare.  Most recent quotes on this condition are about .0051% of all the millions of CoolSculpting treatments performed worldwide.  There really isn't a way to know if you in particular would be at risk or not.

John A. Fry, MD · Answer

This is an extremely rare adverse event and I personally have never seen it. Almost all Coolsculpting providers will perform an in person assessment for free. I would seek consultation by a professional experienced in fat reduction and body skin tightening procedures. Your best outcome may be from. a combination of therapies. Using Alastin transform body cream often enhances Coolsculpting results.

Anshul Gambhir, MD · Answer

The risk of PAH after CoolSculpting is very minimal. CoolSculpting is a procedure that using cryolipolysis, a term meaning it freezes and destroys fat allowing your own body to naturally excrete it. It can be used in areas including abdomen, flanks, thighs, underneath your chin, back, bra line, or upper arms. Results are generally seen within 1-3 months. Multiple treatments are often needed depending on the area and based off of your statistics it sounds like you would be a good candidate, though typically an in person consultation would be recommended so the provider is able to feel the area in real time. In terms of who performs the procedure, I would just make sure they are certified through CoolSculpting and have plenty of experience.

Kent V. Hasen, MD · Answer

While Paradoxical Adipose Hyperplasia (where the fat expands instead of getting smaller) is a documented side effect of CoolSculpting, it is extremely rare.  There have been only a small number of documented cases out of the millions of people who have had the treatment.  Unfortunately, it is impossible to know who will develop this complication.  Based on your statistics, you are likely a good candidate for treatment.  You will be in good hands with a provider experienced in performing the treatment.  I would suggest discussing your concerns with your provider.

Joseph Franzese, MD (license on probation) · Answer

Thank you for your question.  It is not really possible to say whether or not someone is a candidate for Coolsculpting by height and weight.  An in office evaluation is necessary to determine if your body type and fat deposits are appropriate for the Coolsculpting applicator.  Regarding to PAH, I do believe that the incidence is extremely under reported.  It is impossible to predict which patients are are a higher risk of developing PAH.  There are recent thoughts that it is not the cold, but the suction that contributes to the development of PAH.  I have seen several cases of the past few years.  The overall incidence is very low and, if your "stubborn stomach pooch" is appropriate for the applicator, and you are a otherwise healthy young woman, you are likely a very good candidate.  As to the person who works with you, as long as they are experienced at the assessment, placement, AND the massage after the applicator is removed, then you should be in good hands.

How common is CoolSculpting PAH effect? Am I at risk with my stats?

Answers (9)

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