PAH after CoolSculpting? (Photo)

Question

I got a newer version of coolsculpting performed on my lower stomach and inner thighs last November. It is meant to be gentler with NO RISK of PAH (that's what my doctor said), using a hand-held device with no suction. After 24hours, my inner thighs have swollen, were red and inflamed. I got a terrible fever. This lasted for two weeks, but I've been constantly getting sick since then. The area is bigger than it was and discolored. Can this be PAH? How long after treatment would it develop?

Juan Guillermo Breton, MD · Answer

I think that you had a superficial second degree burn, usually the only thing is to avaid sun exposure because of the risk of postinflamatory hiperpeygmentation. FDA cancelled the flat applicators, because not only the suction matters, but how you vacuum the tissue, thats why the are only round applicators available

Hung William Song, MD · Answer

First of all I would disagree with your doctor. Although the new Coolsculpting Elite is supposed to have lower risk of PAH, it is definitely not zero. Having said that, swelling and hardening of the fat treated with cryolipolysis is a normal reaction to the treatment. This could last several weeks. Numbness and tenderness of the treated area can last over a month. Most people will see reduction in the fat after 8 weeks, so if you are only a few weeks out, I would just be patient and hopefully you are not one of the less than 1% of people who develop PAH.  If PAH (Paradoxical Adipose Hyperplasia) develops, most people initially notice some reduction of the fat and then start to see the fat get bigger in the treated area, usually 2 to 6 months after the treatment. Make sure your weight is at or lower than when you received the treatment and then get a consultation from a doctor who has a lot of experience treating PAH to see if it is true PAH. If it is determined to be true PAH, you may be able to get Allergan to pay for your treatment to resolve it. Treating PAH can be tricky. I have had limited success with non-invasive options like Sculpsure or Kybella. Power assisted liposuction can be helpful, but the fat is very fibrous and the best way to treat it is with Vaser ultrasound assisted liposuction. Multiple treatments may be necessary.

John W. Tyrone, MD · Answer

PH is extremely rare but is always a risk after having a CoolSculpting treatment. Some redness and swelling can be expected after having this treatment done. Your symptoms do not seem to align with PH. I recommend following up with your doctor to address your concerns. I have included a link to help provide you with more information on the CoolSculpting treatment.

Drew Varano, MD · Answer

That is not PAH , pah usually takes 6-9 months to develop, it’s an enlargement I the shape of the applicator  and firm  …..there is always a risk for PAH with cryolipolysis no matter what machine is used .. your repeated illness which sounds like cellulitis-like is not related to coolsculpting . Your skin would have to break to have an infection which CS doesn’t break the skin and if it did somehow it would not be bilateral on  both sides

PAH after CoolSculpting? (Photo)

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