I got PAH from CoolSculpting. Can i-Lipo fix it? (photos)

Question

37 years old 136 pound 5’1

Hung William Song, MD · Answer

Hello, I have quite a bit of experience with Paradoxical Adipose Hyperplasia (PAH) since I developed it myself. We have performed thousands of CoolSculpting treatments and only had three cases of true PAH and one of them was me. I was able to successfully treat the PAH in my patients with Vaser® Liposuction and I have treated numerous cases of PAH referred from other practices with the Vaser, but I cannot do liposuction on myself, so I tried all the different non-invasive modalities that we have access to. I was able to reduce the PAH with our Sculpsure® laser but it required multiple sessions. We don't have the i-Lipo because this is a very low level laser treatment that does not permanently destroy the fat cells. I would not waste money on trying to treat PAH with this device. You should talk to the clinic where you received the Coolsculpting and if they are able to prove that you have a true case of PAH, you may be able to get Allergan to pay for Vaser Liposuction to correct the PAH. Good luck.

Jason Emer, MD · Answer

PAH needs vaser liposuction with renvuion. there is scar tissue that needs to be sculpted and shrunk.

my whole practice is doing lipoabdominoplasty, or at least liposuction with internal heating (which is not the gold standard for skin tightening with body contouring).

the smaller you are before liposuction the more contouring you can get from the procedure. most of my liposuction patients get pre and post surgical optimization with hormonal therapy (see link to help boost their weight loss before surgery and help them heal after).

You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Mary Beth Mudd, MD · Answer

Sorry to hear that your CoolSculpting experience did not go as well as planned. Paradoxical fat hypertrophy occurs when the fat cells get stimulated by the cold and actually grow rather than be destroyed. It is a relatively rare complication and we still don't know exactly why this occurs in some patients. I would not recommend I-Lipo to fix this problem since it is a temporary fix. I-Lipo basically uses a laser to punch little holes in the fat cell walls, allowing the fat to drain out which shrinks the cells temporarily, BUT DOES NOT REMOVE THE CELLS. They will start to enlarge again when you take in more calories that are not burned up so you will go back to looking like you do now. CoolSculpting, liposuction, LaserLipo, BodyTite, Evolve, Sculpsure, etc are body contouring treatments that work by permanently destroying the existing fat cells which can not grow back again.  I would recommend scheduling a consultation with a physician who is knowledgeable about PAH as well as experienced in treating this complication so that you can be properly assessed. Then the physician will be able to discuss the permanent fat removal methods that would be best to treat your problem. Best wishes, Mary Beth Mudd

I got PAH from CoolSculpting. Can i-Lipo fix it? (photos)

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I got PAH from CoolSculpting. Can i-Lipo fix it? (photos)

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Everything you need to know about i-Lipo

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