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Paradoxical Hyperplasia Caused by a CoolSculpting Side Effect

Paradoxical Hyperplasia Caused by a CoolSculpting Side EffectDoes a quick, non-surgical procedure to eliminate stubborn fat deposits sound too good to be true – particularly, if this procedure is also virtually painless, touted as safe, and has no downtime?

Meet cryolipolysis, also called fat freezing or CoolSculpting. The FDA has cleared this procedure, which uses a wand-like device to disintegrate fat cells with cold temperatures through 40 to 60-minute treatment sessions.

The results become visible just a few weeks later, with the size of the treated area shrinking by around 25 percent in nearly six months after the treatment.


More Common Based on New Research

However, a very small number of patients experience an exact opposite effect. The cryolipolysis treated areas actually become bigger and tighter. In addition, new research indicates that the complication, known as paradoxical adipose hyperplasia (PAH), might actually be more common than previously believed.

Modern Body Contouring & Laser Center (MBody), led by board certified plastic surgeons Dr. Burton M. Sundin and Dr. Reps B. Sundin, provides CoolSculpting to patients in Northern Virginia, Washington DC, Vienna, McLean, Loudoun, Ashburn, Tysons Corner, Reston, Arlington, Chevy Chase, Richmond, Fredericksburg, and surrounding locations.


What’s the Risk?

According to a paper published in the most recent issue of the medical journal Plastic and Reconstructive Surgery, researchers found that PAH develops in 1 out of every 138 cryolipolysis treatments.

Researchers further explain that rate is significantly higher than the manufacturer’s stated rate of 1 out of every 4,000 treatments.

Both the manufacturer and the study measured the PAH rates on the basis on a treatment cycle, which is defined as the use of cryolipolysis on a specific spot on the body. But those numbers do not disclose this risk of complication on a per-patient level, as individuals usually get multiple spots on their body treated simultaneously.

In case a patient who had six spots treated develops PAH in one spot, then that is one-sixth, depending on the manner that the manufacturer and researchers measure the rate of incidence, the researchers expounded.

However, in terms of what individuals are really concerned about, the reality is that the patient has a substantial swelling-it doesn’t matter to them that it is only one spot out of six. They should use the number of patients, instead of the number of cycles that have PAH as the denominator.

According to some experts, despite the fact that the new data suggests the per-treatment incidence of PAH is 0.72 percent, the actual risk on a per patient basis is likely higher.


Who may develop PAH?

The exact cause of PAH development is unknown to researchers. However, some experts believe that cold temperatures create swelling. But for most patients, this will cause the fat cells to be eliminated. In PAH, the fat cells in a small group grow in response to the cold rather than go away.

But there is some good news-PAH is entirely treatable with liposuction after a few months. But doctors must explain the treatment options in a highly sensitive manner, as patients are “initially aggravated” by the delay and the requirement to undergo a plastic surgery procedure that they had not wanted in the first place.

The most suitable candidates for cryolipolysis treatments are typically individuals with an average weight or slightly heavier with good skin elasticity in the particular area that they want to change the contours of.

Upon considering this medical procedure, it is always a good idea for patients to discuss potential complications with their doctor.

Plastic surgeons at MBody receive patients from Northern Virginia, Washington DC, Vienna, McLean, Loudoun, Ashburn, Tysons Corner, Reston, Arlington, Chevy Chase, Richmond, Fredericksburg, and nearby areas for CoolSculpting.
For more information on the surgical and non-surgical procedures and treatments by Board Certified Cosmetic Plastic Surgeons Dr. Reps Sundin and Dr. Burton Sundin please visit

Serving Richmond, Henrico VA, Fredricksburg, Williamsburg, Northern Virginia, Washington DC, Vienna, McLean, Fairfax, Loudoun County, Ashburn, Tysons Corner, Reston, Arlington and surrounding communities.

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