Paradoxical Adipose Hyperplasia

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Treatment of Complications of CoolSculpting in Beverly Hills

While CoolSculpting remains popular, the treatment can come with the risk of developing several complications. For many patients, these complications, such as paradoxical adipose hyperplasia, can lead to outcomes that turn their lives upside down. But the right plastic surgeon can help you overcome this all-too-common side effect. Dr. Gabbay is proud to offer patients paradoxical adipose hyperplasia treatment for both women and men.

At Gabbay Plastic Surgery, we do not utilize CoolSculpting because of its risk of causing PAH, instead using safer non-surgical methods for achieving body contouring results. But, we do provide treatment for complications from CoolSculpting, specifically treating a common side effect called paradoxical adipose hyperplasia, allowing patients to take back their bodies from this debilitating side effect.

Before & After Paradoxical Adipose Hyperplasia

Female abdominal fat removal results showcasing a patient's flatter tummy area, with no side effects from the liposuction procedure. The fat removed is permanently gone, with straightforward maintenance of results.
Results of a safe abdominal liposuction surgery that provided this female patient with notable slimming. Note the flat stomach from the profile view with no overhang above the waistline.

What Is Paradoxical Adipose Hyperplasia?

Paradoxical adipose hyperplasia (PAH) is a condition that is now commonly called the “stick of butter” effect. PAH happens when the fat cells that were treated with CoolSculpting expand significantly and harden, resulting in a large bulge where the treatment was applied. So, rather than seeing fat disappear as the treatment promises, they are left with a worsened condition that will not go away on its own. It is estimated that this side effect occurs in about 0.2-3% of patients who undergo this procedure, and it can affect both women and men. While this may seem low, it means that numerous patients across the United States have been affected.

At Gabbay Plastic Surgery, we specialize in treating paradoxical adipose hyperplasia and other complications from CoolSculpting to help prevent your experience from becoming worse. We understand how upsetting it can be to experience something like this, and we are dedicated to helping every patient with PAH to reclaim their body.

Stock image of a woman without face , holding her stomach with both hands to show excess fat .

Does PAH Go Away on Its Own?

Instead of losing fat, patients see an accumulation of fatty tissue greater than what they started with. However, regular fat can typically respond well to diet and exercise. However, the tissues that develop as part of paradoxical adipose hyperplasia will not go away without treatment. No amount of diet or exercise will be able to eliminate these accumulations, due to their unique nature and consistency.

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The Dangers of Paradoxical Adipose Hyperplasia

While PAH is not known to be a health risk, that does not lessen the impact it can have on a patient’s life. The hardened pockets of fat can make it difficult to feel confident about one’s body, affecting one’s quality of life and mental health overall in big ways. It can become an almost insurmountable challenge to feel comfortable in your own body, which is nearly as severe as any physical health risk. That is why we strive to help patients affected by this condition and give them back a sense of control and pride in their bodies. You deserve to look your best and love your body, and we are here to help ensure that can happen.

What Is CoolSculpting?

CoolSculpting is a method of non-invasive body sculpting that uses a cooling device to freeze and destroy fat cells. While most people do not experience side effects, a growing number of patients are coming to us from other cosmetic surgeons with complications from their treatment. One of the biggest complaints that patients have about CoolSculpting complications is called paradoxical adipose hyperplasia. Instead of this treatment getting rid of fat, it can leave the patient worse off than when they came in. While the side effects are rare, they can be absolutely devastating and disappointing.

Why Does CoolSculpting Cause PAH?

The exact cause of PAH is still unknown, but it has been linked to certain techniques and devices used in CoolSculpting. For instance, PAH is more likely to occur when the device is set at a higher temperature for too long or if there are large areas being treated with the same suction cup. If a patient had the procedure performed by an inexperienced or unauthorized practitioner, these factors could increase the risk of developing complications from CoolSculpting like PAH. However, there is no guaranteed way to predict whether or not a patient will experience PAH as a side effect of CoolSculpting. Other procedures that use the same method as CoolSculpting (i.e., cryolipolysis) may also be at risk for developing PAH.

Who Is at Risk for Paradoxical Adipose Hyperplasia?

Though PAH is not fully understood yet, a few prevalence indicators have been noted in recent research. These are not causes of the condition, but they simply denote factors that are associated with higher rates of developing PAH. These include your physician using a larger CoolSculpting applicator, having a treatment focusing on the abdomen, and being biologically male. As this condition continues to appear, we will update this page when more medically-valid information becomes available.


Signs You Have Paradoxical Adipose Hyperplasia

In many cases, the symptoms of PAH are highly visible and easy to recognize. Other patients may have milder responses but will still have significant symptoms. We encourage anyone who has had CoolSculpting to stay alert for any signs of this condition developing and to seek treatment as soon as you notice them. Effects tend to become most apparent between about 2-6 months following a CoolSculpting treatment session.

The effects tend to come about gradually, appearing over time in the weeks following a CoolSculpting treatment. Be alert for signs of swelling or increases in fat in the affected area. If the swelling does not go away on its own and instead seems to harden, then you may have PAH. We advise calling the cosmetic surgery office of Dr. Gabbay, a specialist in helping patients with his effective and unique approach to paradoxical adipose hyperplasia treatment.

Our Treatment for PAH

Treating paradoxical adipose hyperplasia requires an in-depth understanding of the body’s natural structures and how they respond to treatments like CoolSculpting. Dr. Gabbay uses a combination of approaches based on your individual situation to find the best path for removing or breaking down the hardened fat from PAH.

Liposuction performed by a board-certified surgeon will always be the most consistent way to eliminate unwanted fat, and by adapting techniques to deal with hardened fat, Dr. Gabbay aims to help patients overcome PAH and restore their bodies. The procedure can typically take about two hours, though this can vary depending on the amount of PAH tissue needing treatment.

Some patients may also require a tummy tuck to address loose skin after the initial liposuction. Fortunately, liposuction and a tummy tuck are readily combined and can be completed together in a single visit to our surgical center.

Choosing the Right Surgeon to Treat Paradoxical Adipose Hyperplasia

We understand the difficulty in trusting a medical professional again after encountering the effects of PAH. At Gabbay Plastic Surgery, we are always glad to fully discuss your situation and answer any questions you might have so you can understand what sets us apart.

Our board-certified surgeon Dr. Gabbay has been a leading cosmetic physician in Beverly Hills for years, providing positive, life-changing procedures for his patients. At his practice, you will never be rushed through any procedure, and we fully disclose all information beforehand.

We also encourage you to ask questions during your consultation. The more open communication between patient and surgeon is, the better the outcomes.

Stock image of a woman without face, wearing a bikini lying on sand .

What Body Parts Can Develop Paradoxical Adipose Hyperplasia?

PAH most commonly occurs in patients who have had CoolSculpting treatment on the abdominal area. However, it appears as though it can occur in any body part treated with cryolipolysis treatments. Whatever body part it affects, it can feel devastating to have your treatment results in PAH instead of the outcomes you expected.

How to Avoid Paradoxical Adipose Hyperplasia?

The only guaranteed way to avoid this complication is to not have any treatments that are known to cause it. With the current data, there is not enough information for physicians to know how to prevent it from happening in patients treated with cryolipolysis. Factors like having a skilled physician provide the treatment may lower the risk, but there is no conclusive evidence to support this. At present, the only way to avoid paradoxical adipose hyperplasia is to look elsewhere for body contouring away from cryo treatments.

An Alternative to CoolSculpting

At Gabbay Plastic Surgery, we offer a safer, faster, and effective alternative to CoolSculpting called SculpSure. Instead of using cold, it uses a thermal applicator for results that are just as effective as CoolSculpting, but they also appear sooner and with less risk of complications. Its unique applicator also allows for greater flexibility in treatment, allowing patients to treat a wider range of body areas.

With SculpSure, there is no risk of developing paradoxical adipose hyperplasia. Instead, you see the results you want without the downside of your body reacting drastically to the treatment.

Schedule Your Consultation

If you believe you are affected by PAH after CoolSculpting, then we recommend setting up a consultation with Dr. Gabbay, a premier plastic surgeon in Beverly Hills. During your consultation, he will assess the situation and create a custom treatment plan tailored to help you see results that boost confidence rather than break it down. Call us today to get started on eliminating expanded and hardened body fat from PAH.
At Gabbay Plastic Surgery, our team is prepared to help you feel radiant and confident. Call us today at (310) 205-9500 to schedule your appointment or to learn more about how we can help!
Gabbay Plastic Surgery
465 N. Roxbury DriveSuite 1001
Beverly Hills, CA 90210