What is Paradoxical Adipose Hyperplasia?

What is Paradoxical Adipose Hyperplasia?

Paradoxical adipose hyperplasia (PAH) is an adverse effect of cryolipolysis. This is the technical term for the process by which CoolSculpting® destroys the fat cells in the treatment area. It damages them by reducing their temperature. In most cases, the procedure is extremely effective. However, certain patients have the exact opposite response. Instead of going away, the fat cells in the treatment area get bigger. While it can take anywhere from a few days to 6 months for PAH to develop, here are a few of the warning signs:

• Treatment area looks and feels thicker
• Mass of swelling develops that is often painful to the touch
• Hard lumps or bumps
• Entire area looks bigger, not smaller

PAH was originally thought to be a rare occurrence of about 1 in every 4,000 treatment cycles (incidence rate of 0.025%). However, recent data shows that it may be more common than originally thought.

Risk Factors for PAH

While there is still more unknown than known about the definitive causes of PAH, here are a few of the factors that could put you at a higher risk:

• Gender – men are three times more likely than women to develop PAH
• Prior CoolSculpting® procedure
• Use of a large handpiece during the procedure
• If you are of Hispanic or Latin descent
• Cryolipolysis to the abdominal region
• Genetic predisposition

One of the simplest ways to reduce your risk of developing PAH is to choose a different body contouring procedure such as SculpSure® or liposuction.

SculpSure® Has Not Been Associated with Paradoxical Adipose Hyperplasia

SculpSure® is one of my specialties. Instead of using cold to destroy the fat cells, SculpSure® is a laser that uses heat. The benefits are two fold. First, SculpSure® does not cause paradoxical adipose hyperplasia as the later only occurs following a cryolipolysis treatment. Second, one of the potential downsides of any fat reduction procedure is that you may be left with more loose skin. Elastin is what allows the skin to “bounce back” and reform over your new, leaner contour. However, factors such as:

• Age
• Weight gain/loss
• Pregnancy
• Menopause

These can all weaken, and stretch your skin. One of the things that I like about SculpSure® is that, for some patients, the heat from the laser may have a mild tightening effect. This is ideal for patients with a mild degree of loose skin. If you have more severe drooping, I will probably recommend a surgical procedure such as a tummy tuck or Mommy Makeover.

Liposuction is the Gold Standard for a Reason

Some patients who come in to discuss non-surgical body contouring do not want a surgical procedure. I respect this decision, and simply make sure that they have realistic expectations about what can and cannot be achieved. However, many patients have a misperception about liposuction. They think that it’s a bigger deal than it actually is. While yes, liposuction is a surgical procedure that will require an investment in terms of recovery, it is also something that I routinely perform under local anesthesia and one where the incisions are so small that they often don’t even require stitches.

Liposuction is the gold standard in body contouring for a reason. It gives me the most precision and control. I can basically sculpt your body into a more ideal proportion. Furthermore, the fat that we remove can also be placed into other areas where you may have lost volume such as the breasts. It is the ultimate in recycling. So, if you are concerned about PAH, and are unhappy with the look of your body, come in to see me so we can discuss other options.

To find out more about SculpSure®, liposuction, or any other surgical or non-surgical procedure with Dr. Sean Doherty at his Boston or Brookline office, contact us today or call (617) 450-0070 to schedule a consultation.