Lipo for paradoxical adipose hyperplasia from CoolSculpting? (photos)

Question

What do I do? Developed PAH after CoolSculpting and I look deformed. Feeling so discouraged. Met with a plastic surgeon and told me I may need two rounds of lipo due to the tissue being so thick..

Finny George, MD · Answer

Hi, thank you for your question. 
This is an unfortunate complication of CoolSculpting. It can be treated with liposuction with the goal of complete resolution in one session. 
Be sure to see a board certified plastic surgeon who will listen to your concerns and explain the realistic goals and complications of any procedure. 
Best of luck!

David Hansen, MD · Answer

We have fixed so many patients who have this problem but you need to see a doc who does the PAL tum. liposuction to really get the fibrous scar tissue out.  It is totally fixable.

Jason Emer, MD · Answer

I suggest seeing in expert this can be improved with liposuction or liposuction + internal heating and skin removal.  Best, Dr. Emer.

Mariusz Sapijaszko, MD, FRCPC · Answer

Increased fat after CoolSculpting happens and patients are very distressed. BodyTite Can help.BodyTite removes fat cells and tightens the skin. At the same time, it is important that all prospective patients need to have detailed examination.I have been performing BodyTite Liposuction for over 7 years and it is a great technique for fat removal as well as skin tightening.Please make sure that you see an experienced doctor for a thorough consultation and assessment prior to undergoing any treatments.Best regards and I hope this helps, Dr. Sapijaszko (Fellow, American Academy of Cosmetic Surgery)

Robert M. Tornambe, MD · Answer

edennicole95So sorry you are having this issue and we are seeing more and more of it in patients after CoolSculpt treatments. Another reason why I am not a fan of this procedure!Be certain to consult with a board-certified plastic surgeon because you should be able to be treated in one session. Best of luck.

Jennifer Greer, MD · Answer

I have treated PAH after CoolSculpting with liposuction. It is a very effective treatment, but I would strongly recommend seeing a surgeon who is very experienced with liposuction. As a surgeon, my goal would be to correct the PAH in a single treatment. This is because there will be scar tissue after the first treatment, making a second round of liposuction much more difficult. Have you been back to the office that performed your CoolSculpting? Zeltiq usually covers liposuction if you are within a few pounds of your pretreatment weight and have good before and after photos. Best of luck to you!

Robert J. Paresi Jr., MD, MPH · Answer

Thanks for the question.  Unfortunately, I have treated patients with a similar problem after coolsculpting.  Coolsculpting does have a tendency to induce scarring in the treatment areas making subsequent liposuction more challenging.  That being said, I have been able to achieve good results with liposuction in patients who developed PAH after Coolsculpting.

Leonard Tachmes, MD · Answer

Hi and welcome to our forum!
PAH is an unusual condition where hardened areas develop in the areas of previous cryolipolysis treatment. The condition can be successfully treated with liposuction. As the fat is denser than normal, augmented liposuction is recommended to facilitate adequate recontouring. One usually waits 3 months or so following cryolipolysis to allow for subsidence of edema before undergoing surgical correction.
I agree with your surgeon's gameplan.
Best wishes...

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