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CoolSculpting and Paradoxical Adipose Hyperplasia

Since 2011, when CoolSculpting revolutionized the field of non-invasive fat reduction by harnessing the power of cryolipolysis to freeze and break down unwanted fat cells, many patients across the nation have experienced a condition known as paradoxical adipose hyperplasia, or PAH, after having a single or multiple treatments. Although this is not a new possible side-effect, recent media attention has increased awareness about this unfortunate condition that can follow a CoolSculpting procedure. 

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What is Paradoxical Adipose Hyperplasia (PAH)?

Paradoxical adipose hyperplasia is a rare, but known, adverse effect of cryolipolysis that has generated many negative news headlines recently, particularly since supermodel Linda Evangelista’s recent lawsuit. Cryolipolysis uses cooling to damage and destroys subcutaneous fat cells without damaging the skin to reduce the amount of fat in the treated area. Although PAH has a reported rate of incidence of only 0.0051% of the 1.5 million CoolSculpting procedures performed worldwide, many physicians do, indeed, see cases in their offices.

PAH causes a gradual enlargement of the treated area, often in the shape of the actual CoolSculpting paddle. It occurs when the freezing of fat cells activates a reactionary process in the fatty tissue that, actually, thickens and expands the fat cells instead of breaking them down, as intended. PAH is only known to occur following a cryolipolysis or CoolSculpting body contouring treatment. PAH is, typically, not diagnosed until about 6 months post-procedure, when patients report that their treated area has increased instead of decreased, in the exact shape of the applicator, as shown below. 

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To learn more, schedule your consultation with Dr. Schwartz by filling out the form on this page or by calling his practice at 913-451-8346. Premier Vein & Body by Schwartz serves patients throughout the Kansas City metro.

SculpSure WarmSculpting

Although Premier Vein & Body by Schwartz was among the very first Kansas City healthcare providers to offer CoolSculpting for non-surgical fat reduction, Dr. Craig Schwartz jumped at the opportunity to add SculpSure to his menu of body contouring and fat reduction treatments once it became available in 2015 because of the shortcomings of CoolSculpting, stemming from patient concerns with both the high discomfort level many experienced during treatment, as well as the inconsistent results, including the potential for PAH. 

SculpSure is the first FDA-approved non-invasive, warm laser treatment for fat reduction, utilizing a 1060 nm wavelength diode laser. It is safe for all skin types and ideal for areas of stubborn fat on the abdomen, flanks, bra line, and thighs. In fact, because SculpSure has 4 separate handpieces, compared to CoolSculpting’s single handpiece, placement can be customized to treat almost any body area. Furthermore, unlike CoolSculpting, which uses cryo lipolysis to freeze the fat cells, SculpSure uses laser heat to target and destroy fat cells, leaving patients with up to 25% less fat after each 25-minute treatment.  The laser warms these cells to a temperature just above your natural body temperature, yet cool enough that it won’t risk burning your skin. The increase in temperature causes many of the fat cell walls in the targeted area to rupture, triggering a process called lipolysis.

Like most non-surgical treatments, most patients require a minimum of two treatments of SculpSure to achieve desired fat reduction results. Similar to CoolSculpting, patients will not notice their results for approximately 10-12 weeks while they wait for the body to process and filter out the damaged fat cells.  Unlike CoolSculpting treatments, the SculpSure treatment leaves patients with only slight tenderness rather than the intense pain patients often experience as a result of cryolipolysis. SculpSure patients have no risk of PAH post-treatment!  Patients seeking a non-invasive fat reduction treatment should consider all of the pros and cons of each of these popular procedures before proceeding.


*Individual Results May Vary


Read from real patients about their experiences with Dr. Schwartz and his team at Premier Vein & Body by Schwartz.

How Can PAH Be Treated?

Patients who have developed PAH post-CoolSculpting can have the area “corrected” by Dr. Schwartz with one of our in-office, minimally-invasive liposuction procedures that are performed under local tumescent anesthesia. Unlike CoolSculpting and SculpSure, some visible results are immediate, with continued improvements for months after the procedure.  In fact, Dr. Schwartz often recommends that patients consider skipping the non-invasive options altogether in favor of one of his liposuction procedures, which provides better, more predictable results with just one treatment and minimal downtime. 

If you suspect you have PAH, it is recommended that you meet with your original CoolSculpting provider, who can contact the manufacturer on your behalf for possible financial resolution.  It’s also recommended that you meet with a liposuction surgeon, such as Dr. Schwartz, for an evaluation to see if a different procedure may be able to reverse the PAH.

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