What is the issue with CoolSculpting- PAH-paradoxical adipose hyperplasia?

Dr. Dean Kane Q & A shutterstock_38910175

Q. What is the issue with CoolSculpting- PAH-paradoxical adipose hyperplasia? Counsel cryolipolysis patients about paradoxical adipose hyperplasia is a title I read about online. How common is it? I am a 19 year old who thought this was amazing and really wanted to do it, but all I’m reading is bad reviews.

A. I have replied to you before so I know you are curious and properly reviewing the pros, cons and side-effects of CoolSculpting (CS) and other options for body fat reduction and contouring.

​Conceptually, PAH or paradoxical adipose hyperplasia is similar to hypertrophic scarring. Hypertrophic scars develop when the activity producing collagen (scar) is greater than the enzymes breaking scar down to produce a thin white line. With PAH, the stimulus activates a reactionary process in the fatty tissues to thicken and expand cells rather than breakdown and excrete them.

​This happens rarely, approximately 1 in a million but if it happens to you, I can understand your concern. Should it happen and be properly documented, the Zeltiq company will work with you to have it improved. Further CS will not help, you will need to undergo traditional or “powered” (eg., VASER, ultrasound, other) liposuction.

​Of 500 patients, I have had 1 patient develop PAH which was cared for with traditional tumescent liposuction.

​I hope this helps. All the best!

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