AirSculpt for treating paradoxical adipose hyperplasia (PAH) (photos)

Question

Hello, I had CoolSculpting in 2020. It resulted in me having PAH. After searching for and speaking with physicians in New England, I came to the conclusion that I needed to travel to NYC to find a doctor who was well versed in PAH and treatment (which included Vaser Lipo). I had Vaser Lipo 6/22 & revision 12/22. My tummy looks bigger now than 2 weeks after revision, is uneven. Will airsculpt work for 3rd treatment? Does it “kill” fat cells? I found drs. In MA that perform this.

Hung William Song, MD · Answer

Hello, I'm sorry that you are going through this. PAH is rare but when it occurs, it can be quite a challenge to treat. We have been performing CoolSculpting almost since the beginning and have had a few cases of PAH over the years and we have treated many patients who developed PAH after being treated elsewhere. We have used everything from SculpSure (non-invasive) to liposuction with SmartLipo, Tickle Lipo, Vaser and Microaire. We have not used AirSculpt but this is just another version of power assisted liposuction. Vaser is different because it uses high frequency ultrasound and we have found that Vaser is really the best tool available at this time. Having said that, even with the Vaser, the fibrous fat is very difficult to get through and may require multiple treatments to get you back to where you were before the PAH. In the end you really do have to go to someone who has treated PAH because the technique required to remove PAH fat is very different from regular liposuction. If you are going to someone who wants to treat you with Air Sculpt, please make sure they have a lot of experience treating PAH with the Air sculpt otherwise you may be disappointed with this treatment as well.

Kamran Khoobehi, MD · Answer

I am sorry that you are having issues with your treatments. Based on your pictures you were not a good candidate for coolsculpting or any other liposuction treatments. You will get the best results from tummy tuck

Mats Hagstrom, MD (license on probation) · Answer

Based on your limited pictures, you were never a good candidate for coolsculpting or Liposuction.
Patients who have had previous procedures, should always include proper before and after pictures. If you don’t have before, and after pictures, then ask your surgeon to forward the ones they took.
In regards to the front of the abdomen, there are four variables that determine what the abdomen looks like. If someone doesn’t like the way, their belly looks it is always because of one or more of those four variables. The four variables that determine what the abdomen looks like are abdominal skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies and excess visceral or intra-abdominal fat. In your case you have all four of them. Subcutaneous fat has been reduced through Liposuction so what you know I will see is an abdomen with significant skin Laxity, significant muscle, seperation, and Excess fat due to obesity.
To get a better looking abdomen, you need to lose weight and have a full tummy tuck. Liposuction or any type of subcutaneous fat reduction is not going to give you a good results.
Subcutaneous fat is not the primary problem in your case. Skin laxity and muscle seperation are contributing much more than subcutaneous fat as is visceral fat most likely.
It’s difficult to differentiate visceral fat from muscle separation, because they have a fairly similar appearance.
I suggest having multiple in person, consultations with local board-certified plastic surgeons. There’s no need to travel, because Liposuction is not the right treatment in your case. 
Airsculpt is a form of liposuction performed by Elite Body Sculpture. It uses a form of power assisted laser liposuction. Air sculpt is performed with patients awake and the company has a good reputation.
Airsculpt is a good option for individuals who are good candidate for Liposuction but in your case, I don’t believe Liposuction is the correct procedure. That is why the VASER Liposuction didn’t improve your situation.
Best,
Mats Hagstrom, MD

AirSculpt for treating paradoxical adipose hyperplasia (PAH) (photos)

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AirSculpt for treating paradoxical adipose hyperplasia (PAH) (photos)

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