The bottom line: “This complication could happen to anyone after a CoolSculpting procedure, and the risk factors are unknown,” says Bruce Katz, MD, a board-certified dermatologist in New York, who had samples of PAH fat analyzed by a pathologist to see if there was anything unusual about it. “We found out that it was normal fat cells,” he says. “There was just a large proliferation of them in one area.” To date, the medical establishment does not understand how PAH works, why it occurs, and who may be at higher risk for it.
But know this: PAH is pretty rare
According to published scientific research, paradoxical adipose hyperplasia has been estimated to occur in one out of every 4,000 treatments, for an incidence of 0.025 percent globally. “I’ve done hundreds of CoolSculpting procedures in the past eight or nine years, and I’ve never had an incidence of PAH,” says Henry. But Katz (who chooses not to do CoolSculpting at his office) thinks PAH is underreported and “may be more common than once thought.” He’s successfully treated seven cases of PAH since 2018.
How is PAH treated?
It can usually be successfully corrected with surgical liposuction or minimally invasive laser-assisted lipo. “I have successfully treated seven cases of PAH with Smartlipo, which uses laser energy to heat up and liquefy that dense fat, which is then suctioned out,” says Katz. “The patient experiences swelling for about three days afterward and has to wear a compression garment during that time to keep pressure on the area, but I’ve had excellent results, with no abnormalities or scarring of the skin.”
How to know if CoolSculpting is right for you
The first thing to understand is that this technology is not meant for general weight loss. CoolSculpting works best to spot-treat stubborn problem areas that are hard to exercise away, like a little belly fat or love handles. An ideal candidate is close to her ideal body weight (give or take a couple of pounds), but can pinch an inch or two of fat in a certain spot. (Hello, muffin top.)
Make sure that the doctor administering your treatment has a lot of experience using the device. “I recommend asking the physician how many of these procedures he or she has done, and also ask to see before-and-after photos,” says Katz.
