What is PAH? (Paradoxical Adipose Hyperplasia)
The medical definition broken down into non-medical terms:
Adipose is fat tissue
Hyper means high, beyond or excessive and plasia means growth or cellular multiplication
so Hyperplasia means an increase or excess in the number of cells or amount of tissue
A Paradox is something contradictory
So…Paradoxical Adipose Hyperplasia is a complication of CoolSculpting™ in which the opposite of what is intended happens; rather than decreasing fat cells, the patient experiences an increase of fat cells and tissue.
PAH is specifically a complication of Cryolipolysis, or attempting to destroy fat cells using freezing (“Cryo”) temperatures. It does not happen with body sculpting by laser, which uses heat to remove fat cells. (WarmSculpting™ or SculpSure™)
With PAH, the increased fat cells in the treated area become firm over the few months following the treatment, leaving a hard, defined mass. PAH appears to be permanent unless removed by surgery or a special type of liposuction.
What happened to Linda Evangelista?
Linda Evangelista recently revealed where she has been and why. She reported having CoolSculpting™ treatments in 2015 and developing Paradoxical Adipose Hyperplasia that caused an increase in body and chin fat rather than a decrease. The supermodel has filed a lawsuit against the company, claiming it left her “permanently deformed” and ruined her career. “PAH has not only destroyed my livelihood, it has sent me into a cycle of deep depression, profound sadness, and the lowest depths of self-loathing,” she shared, adding, “In the process, I have become a recluse.”
How Common is Paradoxical Adipose Hyperplasia?
PAH seems to be more common than originally suspected. The American Society of Aesthetic Plastic Surgeons recently reported (Nikolis,MD Nov 2020) in a multi-center study from January 2015 to December 2019 that the incidence may be as high as 0.039% This means that as many as 1 patient in 256 treatments may experience paradoxical adipose hyperplasia from CoolSculp™ treatments.
What are the Problems with CoolSculpting?
Other than PAH, there are other negative complications with CoolSculting™. Because the device kills fat tissue by freezing it, the nerves under the skin can also be frozen, causing long-term numbness or pain.
CoolSculpting™ freezes only the tissue that is sucked into the treatment applicator which means tissue surrounding the area is unaffected. This often leaves what people refer to as “the ridge”, “sharkbite” or “stick of butter” in which the borders of the treated area are sharply defined. It can appear as a sharp drop-off so that the margins remain permanently visible.
Is CoolScupting Safe?
Although there are problems with CoolSculpting™, the side effects are uncommon and not life-threatening. Nerve damage and pain can be long-lasting and PAH is permanent unless further treatment with surgery is done, but the effects of PAH are cosmetic (and, as in Linda Evangalista’s case, possibly emotionally traumatic). Each patient must evaluate the risks.
Does PAH happen with WarmSculpting™ (SculpSure™)?
Paradoxical Adipose Hyperplasia does NOT occur with WarmSculpting™ (SculpSure™). PAH is a paradoxical reaction of adipose (fat) tissue specifically in response to extreme cold (Cryolipolysis). WarmSculpting™ utilizes heat to disrupt the fat cells and does not cause PAH.
Is WarmSculpting™ Safer than CoolSculpting™?
Both devices are effective, non-invasive body-sculpting devices. Both are great options for targeting stubborn areas of fat that persist despite clean eating, regular workouts and even weight loss. Both can destroy up to 24% of fat in the treated areas, per treatment. However, CoolSculpting™ carries the risk of some very unpleasant and even debilitating side effects that SculpSure™ does not cause. WarmSculpting™ does not cause nerve damage, long-term pain, long-lasting painful lumps, “shark-bite” or paradoxical adipose hyperplasia (PAH).
Because WarmSculpting ™ (SculpSure™) is almost as easily accessible as CoolSculpt™ now, and is usually a more affordable option, why would you risk PAH and other complications?
Nikolis,MD, A Multicenter Evaluation of Paradoxical Adipose Hyperplasia Following Cryolipolysis For Fat Reduction and Body Contouring: A Review of 8,658 Cycles in 2,114 Patients, Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery41(10), November 2020
At Skin Deep Laser MD, serving Fort Worth, Weatherford, Benbrook, Burleson, Mansfield, Granbury, and Arlington, Texas, Dr. Laura Riehm offers a range of aesthetic and age reversal options.
To learn more about body sculpting and more, schedule a consultation with Dr. Riehm or her Team. They will examine your skin and explain each treatment to help you decide which ones are right for you. You can schedule an appointment by calling 817-263-7546 or book online.