PAH, after CoolSculpting and my technician want me to do more CoolSculpting what can I do? (photo)

Question

4 months ago I had coolsculpting after that I gained almost 4 lb, yesterday I went to see the techinnitian who did my coolsculpting she took pictures And my abdomen was much better before the treatment now it's bigger, she said because I gained 4 lb, but doesn't coolsculpting freeze the fat, She offers me another Coolsculpting, but I need to be 126 same weight when I did the first treatment, how can I see if I have PAH, it seems like the technitian is hidden it from me, It look like Im pregnant

Jason Emer, MD · Answer

It can take 3-6 months for final results with Coolsculpting. Gaining weight can impact results, but doesn't necessarily mean you have PAH. Keep in mind, some people need more than one treatment of Coolsculpting and 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. PAH is extremely rare, but would need a hi definition procedure like VASER to give improvement. See an expert. Best, Dr. Emer

Michael A. Zadeh, MD, FACS · Answer

PAH is extremely rare after CoolSculpting, but it can happen. You need to see an expert physician and not a technician for an in-person examination and comparison of your before and after pics to see if what you are experiencing is truly PAH. Best wishes.

Steven F. Weiner, MD · Answer

Gaining weight after Coolsculpting with definitely affect your results. The risk of PAH is about 1:10000 and this probably doesn't represent that problem. I have seen pictures and it usually is more significant than what you are showing. If you aren't happy with your result, discuss with your provider's doctor and/or seek another opinion. You can't expect much improvement with gaining weight however. Also, it is common to have more than one treatment to get optimal results.

Garry K. Kim, MD · Answer

Paradoxical Adipose Hyperplasia (PAH) after CoolSculpting is extremely rare.  The rate of occurrence is about 0.005%.  What is seen with PAH is a fairly localized area of increased fat accumulation.  This would be where the CoolSculpting treatment was performed.  It should be well demarcated; meaning the boundaries should be obvious.  Your pictures don't really show what we would expect from PAH.  That being said, I would recommend you see a physician and not a technician to have this further evaluated.  It's possible that your weight gain could have negated the impact of CoolSculpting.
Hope this helps,
Dr. Garry K. Kim

Drew Varano, MD · Answer

You should see a physician who is certified for Coolsculpting and not a technician . And do not do more Coolsculpting !! It does appear that you have a very likely case of pah. The area is firm and well demarcated . The only treatment is liposuction. Coolsculpting has a compensation program that it will cover the cost of the corrective surgery if your case is diagnosed as pah , but only the physician can make that diagnosis from the practice that did the original procedure

James Clayton, MD (retired) · Answer

Thank you for your photos which show your problem.  PAH (paradoxical adipose hyperplasia) is very rare and your photos look more like a change due to the weight gain.  It is important that you visit with your physician to examine you and see what is going on.  A single treatment with CoolSculpting is usually not impressive enough in the specific area treated to give the result most would want to see.  In my experience, treating the same area a minimum of two times is required.

Justin Harper, MD - Account Suspended · Answer

The best way to ensure that your results are accurate is by measuring your measurements and weight. Do it at the same time every day for the most reliable results.

PAH, after CoolSculpting and my technician want me to do more CoolSculpting what can I do? (photo)

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