Paradoxical Adipose Hyperplasia Treatment for Men

Male patients who undergo CoolSculpting⁠, a non-surgical procedure that addresses fat deposits using cryolipolysis, may experience a condition called Paradoxical Adipose Hyperplasia (PAH).

When patients undergo CoolSculpting, they are seeking to decrease the number of fatty deposits (adipose tissue); however, when PAH occurs, these patients experience an unexpected increase in fatty deposits rather than a decrease in them. This PAH condition has been reported to be rare, but when it does occur, can be troublesome to patients as they experience the opposite effect of what they expected from CoolSculpting. Although this is a challenging condition to manage, Dr. Steinbrech specializes in Paradoxical Adipose Hyperplasia (PAH) treatment in men.

What is Paradoxical Adipose Hyperplasia (PAH)?

Paradoxical Adipose Hyperplasia has only been reported to occur after undergoing CoolSculpting, and not with other fat-loss procedures. This is a breakdown of the medical term:

Paradoxical:  the tissues that are treated with CoolSculpting react to it by growing rather than decreasing – an unexpected, hence, paradoxical effect.

Adipose: refers to fatty tissues that contain adipose cells, which are more predominant under the skin especially in areas like the abdomen, flanks (“love-handles”), back and thighs.

Hyperplasia: a term that refers to the growth of cells in the tissues, which is typically stimulated by something.

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Why Does PAH Occur and What Does it Look Like?

The reason why CoolSculpting can lead to PAH in some patients is still not clear to many experts. There have been research studies done that have been able to describe what patients and doctors should look for, and also identify which patients may be at greater risk of experiencing PAH. It has been shown to occur within 6 months post-procedure and the unwanted changes are seen in the area in which the CoolSculpting device was applied. These tissues affected by PAH typically appear to be more swollen and sometimes can also be very firm to the touch.

How Common is PAH?

PAH is considered to be rare with a reported incidence of 0.005%. Most recent studies have found that it occurs 1 in every 500 to 5000 CoolSculpting treatments.

Who is at Risk of Developing PAH After CoolSculpting?

Research has also identified patient characteristics that have been associated with a greater likelihood of developing PAH. These known risk factors include: use of a large applicator, male sex, Hispanic background, and abdominal location of treatment. Age has not been shown to be a factor in the development of PAH.

How Is PAH Treated?

The treatment for PAH is with liposuction once the affected area has softened, which normally occurs a few months after the initial CoolSculpting procedure. Depending on the case, managing PAH with liposuction may require more than one treatment and/or other more advanced surgical procedures such as a tummy tuck.

Recovery Time

After undergoing treatment of PAH with liposuction and/or other surgeries, there is an approximated time of recovery of 4-6 weeks and results typically are appreciated around 6 weeks after surgery. During recovery, it is recommended to avoid strenuous physical activity and a mandatory abdominal binder is worn until healing has completed.

How to Determine if You Have Paradoxical Adipose Hyperplasia

The main indicator that PAH has developed is when the patient notices greater fullness in the area where CoolSculpting was done that is even greater than the amount present before undergoing CoolSculpting, and that it does not improve 4 to 6 weeks after the procedure. One very specific indicator that the patient has PAH is when this affected area is limited to the area of skin in which the CoolSculpting applicator was placed. During a scheduled consultation, Dr. Steinbrech can review with you whether you have developed PAH and make a treatment plan for you.

Book Your Consultation

Book your consult with us today in New York, Chicago, or Los Angeles. For more information about treating Paradoxical Adipose Hyperplasia, please contact our office. Prospective patients may set up a consultation or speak with one of our patient advisors. Based on the findings from your visit with Dr. Steinbrech, you will be able to review the treatment options for PAH.

REFERENCES:

1. Kelly ME, Rodríguez-Feliz J, Torres C, Kelly E. Treatment of paradoxical adipose hyperplasia following cryolipolysis: a single-center experience. Plast Reconstr Surg. 2018 Jul;142(1):17e-22e.
2. Keaney TC, Naga LI. Men at risk for paradoxical adipose hyperplasia after cryolipolysis. J Cosmet Dermatol. 2016 Dec;15(4):575-577.
3. Singh SM, Geddes ER, Boutrous SG, Galiano RD, Friedman PM. Paradoxical adipose hyperplasia secondary to cryolipolysis: an underreported entity? Lasers Surg Med. 2015 Aug;47(6):476-

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