CoolSculpting gone wrong. Is there a treatment for PAH other than a tummy tuck?

Question

I am very sad and depressed. I got CoolSculpting 5 months ago and was very excited. Now my abdomen has swollen so much bigger than it ways before my treatment and I wish I would’ve just left well enough alone. I’m hearing the only treatment for PAH is a tummy tuck but there’s no way I can afford that. I’m so sad. Is there a suggestion besides a tummy tuck? Help

Michael A. Zadeh, MD, FACS · Answer

Sorry to hear about your CoolSculpting experience. PAH is most commonly treated with Liposuction or a Tummy Tuck. If there is documentation to prove you actually have PAH then Allergan (the company that manufactures the device) will cover the cost of your corrective surgery. PAH is much less common with the newer CoolAdvantage applicators. Best wishes.

Warren Schutte, MD · Answer

Hello, I am so sorry that you are experiencing this very very rare side effect of CoolSculpting.
However CoolSculping as a company takes this situation very seriously. I would advise that you immediately follow up at the clinic you received your treatments and seek help amongst the clinic and CoolSculpting. They should have a rep that can get you on the right track for assistance through this process.

Jason Emer, MD · Answer

PAH is rare after CoolSculpting. iI recommend a formal recommendation from a cosmetic surgeon. You may have some swelling for 3-6 months after the procedure. Most patients require a second treatment 2-3 months after the first to see better outcomes. For best results with Coolsculpting, a combination approach is needed. I recommend adding radiofrequency treatments like Vanquish, Venus Legacy, Exilis Ultra for skin tightening and with Z wave/Cellutone for skin smoothing. However, a Vaser liposuction/liposculpture with ThermiRF/J plasma/Renuvion/InMode Body Tite procedure may be needed to give more contouring, fat removal, skin tightening and definition. See an expert. Best, Dr. Emer

Thomas Fiala, MD, FACS, FRCSC · Answer

Generally, power-assisted liposuction is the treatment for PAH, rather than a tummy tuck.Should also be much easier to manage, financially.  Check with the CoolSculpting company about this - they have some financial assistance available.

Michael Kerin, MD · Answer

Hi.  Thank you for the question.  PAH is a known complication with CoolSculpting, although not very common.  Liposuction is the treatment, not a tummy tuck.  If you have true PAH, the company will pay for your liposuction, so see the doctor who performed your CS and get this documented so you can start the process.Best of luck,Michael Kerin, MDKerin MedSpa NY

Grant Stevens, MD · Answer

It's really important to follow up with the provider that treated your abdomen initially.  Once they document your weight then and now and photographs of your treatment area, if it is determined that you do have PAH then your case can be submitted to Coolsculpting.  Your provider and Coolsculpting will help you with a solution if this is PAH and the solution does not involve a tummy tuck.  Your first and most important step is to follow up with your provider.  Best of luck.

Edward Tangchitnob, MD, FACOG, FACS · Answer

Dear princess6870,
If PAH, your options are liposuction or tummy tuck. First, I recommend seeing your personal provider for official diagnosis and documentation. Best of luck on your recovery!
- Dr. Edward Tangchitnob

Laura A. Katz, MD · Answer

So sorry that this happened to you.  First, make sure that the diagnosis of PAH( Paradoxical Adipose Hyperplasia) is confirmed.  This diagnoses cannot really be made with certainty until you are at least six months out from treatment.  Pictures with documentation are very helpful here. The reported rate of PAH after Coolsculpting is about .0051% so it is very rare. There really isn't a way to determine for sure which patients would be at risk for this.  The only contraindications to Coolsculpting treatment are cold agglutinin disease and cryoglobinemia, which most patients would already know if they had.  PAH occurs when the freezing process activates an adverse reaction in the fat cells and causes them to thicken and expand rather than breakdown as intended.  Truthfully the only treatment options are surgical with a tummy tuck, especially if you have lax skin, or non invasive options such as Smart Liposuction.  Please contact your original provider with your concerns and get proper documentation.  Sometimes you can get assistance from the actual company with additional procedure costs.

Tanya Judge, MD · Answer

Hi,
Im sorry to hear that you have had this experience!  Unfortunately the only real way to get rid of fat in these instances is liposuction or a tummy tuck if you also have excess skin.  As mentioned by other surgeons, once documented, the company can usually assist in the cost of such procedures to help you get the look you desired.
Best,
Dr. Tanya Judge

Daniel P. Markmann, MD · Answer

Unfortunately, I am seeing more and more cases of PAH at my practice as a result of CoolSculpting.  I had the machine for about 1.5 years when it first came out.  But, due to the chronic pain that many patients had after the treatments as well as the unpredictable results, we got rid of it.   We now do SculpSure.   I have never seen PAH after Sculpsure and consistently get great results.

CoolSculpting gone wrong. Is there a treatment for PAH other than a tummy tuck?

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