Is there a non-surgical solution to paradoxical adipose hyperplasia resulting from Coolsculpting?

Question

Jason Emer, MD · Answer

The best results I have gotten in my hands are VASER contouring procedures.  However, we have used sculpsure and vaniqush with cellutone and had decent outcomes.  Dr. Emer.

Kally Papantoniou, MD, FAAD · Answer

Another option to target and treat an area of PAH with a non-invasive option is to inject Kybella, which would be off label from the original FDA approval for the treatment of submental fat. Kybella contains deoxycholic acid which breaks down fat cells, and can potentially used for PAH.

Sheila S. Nazarian, MD · Answer

I would go with liposuction as well.  It can be done awake if it is a localized area with minimal scarring and risk.

Andrew Campbell, MD · Answer

PAH is very rare, but the only non-surgical way to treat it that I know of would be with another fat melting device that uses heat instead of cold. There are many out there including Vanquish, but my personal experience with these devices are that they are rather limited in their ability to make a significant visible change. Otherwise, your only choice would be liposuction.Andrew Campbell, M.D.Quintessa Aesthetic Centers

Michael A. Zadeh, MD, FACS · Answer

The occurrence of Paradoxical Adipose Hyperplasia (PAH) after CoolSculpting is very very rare. The only treatment for it at this point is liposuction. If it is a true case of PAH and has been confirmed by Zeltiq (the company that makes the CoolSculpting device) then I have heard that they will cover the cost of liposuction for you. Hope this helps.

Martin Jugenburg, MD · Answer

Thank you for your question. Not that I am aware of. Liposuction would be the best route. However, you can check with Zeltiq and your chosen provider to see if there are any other options. Regards,

Ryan Greene, MD, PhD · Answer

I am not aware of any effective non-surgical treatment to address paradoxical adipose hyperplasia after cryolipolysis. Liposuction is typically the best treatment if this very rare response is encountered. I would recommend that you follow up with the office where you were treated to discuss options. Hope this helps.

Adam J. Mamelak, MD · Answer

Paradoxical adipose hyperplasia is an extremely rare adverse effect that has been reported with coolsculpting. At this point, liposuction is the primary recommended modality for correcting this outcome. There are some other body contouring devices available, including Vanquish and Sculpsure. You should speak with your physician to see if you are a candidate for these other non invasive treatments

Dean P. Kane, MD, FACS · Answer

Dear jaovanna:Thanks for this question. PAH or paradoxical adipose hyperplasia following CoolSculpting (CS) is poorly understood. This puzzling opposite response to cooling fat tissues is stated to occur in one of 300,000 patients. Much like the undesirable and reverse response in a ropey, hypertrophic scar rather than the formation of a thin normal scar, PAH is thought to be the genetic stimulation of fat cell hyperplasia rather than the desired and expected apoptotic death of these cells. Other than liposuction removal of these fat cells, there is no known no-surgical option from PAH.I hope this was just a question and not a untoward result for you. If it was, contact your CS Specialist and Zeltiq for assistance. All the best!

Jeffrey M. Hartog, DMD, MD · Answer

From what I am aware of, the only solution for paradoxical adipose hyperplasia resulting from CoolSculpting is liposuction.  Using more CoolSculpting or other non-invasive methods may actually make it worse.  Check with a board certified plastic surgeon to see if this is something you may need done.  Also, have your provider check with Zeltiq to help fix this problem.

Is there a non-surgical solution to paradoxical adipose hyperplasia resulting from Coolsculpting?

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