CoolSculpting hit the market in 2010 and revolutionized the manner in which body contouring procedures were undertaken. CoolSculpting helps freeze away stubborn fat deposits in a non-surgical way with no downtime. The time taken to complete the procedure is an hour or less.
After almost a decade of its launch, CoolSculpting continues to remain a sought-after procedure among patients as well as cosmetic practices.
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 is PAH?
CoolSculpting, for the most part, has a good safety record. Most patients experience mild side effects such as tingling, redness, and numbness, which resolve after a few days.
But serious side effect of CoolSculpting seems to be slightly more common than originally thought. This side effect is a complication known as paradoxical adipose hyperplasia (PAH),” or in common terms, the “stick of butter” effect.
Patients should have a fair idea of what is PAH and why does it sometimes occur after CoolSculpting.
Cryolipolysis is the technology behind CoolSculpting. It is meant to chill tissue to the level where fat cells crystallize, break down, and are expelled from the body as waste, enabling the treated site to slim down.
In general, this is exactly what occurs. However, in a small percentage of cases, the fat in the treated site expands and hardens into an abnormally shaped lump in response to the freezing temperature.
This is known as paradoxical (abnormal) adipose (fat) hyperplasia (abnormal increase in a structure), or PAH. Rather than slowly shrinking, the fat actually gets bigger after CoolSculpting.
It also typically becomes firmer than the adjacent tissues and at times, creates a “stick of butter” appearance, resembling the shape of the CoolSculpting applicator.
Is PAH after cryolipolysis occurring more often than originally thought?
The exact reason why PAH occurs in certain patients is not known, and according to recent studies, PAH occurs far more commonly (1 out of 138 treatments) than the manufacturer had earlier reported (1 out of 4,000 treatments).
The incidence rate is still under one percent, but it concerns a responsible medical practitioner any time they see an increase in complication rates with a procedure, especially one with compelling claims of safety and ease.
PAH warrants closer attention with the proliferation of other cryolipolysis devices as well as at-home freezing belts available in the market today. A skilled surgeon can effectively treat a patient who developed PAH following cryolipolysis.
Treating PAH with Liposuction
The good news is that PAH can be addressed with liposuction.
Thankfully, PAH is not a life-threatening condition, and it is entirely treatable with liposuction. Regardless, patients who develop PAH have to live with a visible bulge from around six to nine months until the fat softens enough to eliminate in a safe manner.
This can be emotionally and physically draining on patients considering that they wanted a fat reduction in the first place to remove a troublesome condition that now looks worse than before.
In addition, this means that the patient will have to undergo another procedure and bear further expenses to remove unwanted fat that liposuction could have eliminated at the outset itself, with more targeted and predictable contouring than possible with any non-surgical procedure.
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 Northern Virginia, Washington DC, Vienna, McLean, Fairfax, Loudoun County, Ashburn, Tysons Corner, Reston, Arlington, Fredricksburg, Chevy Chase, Potomac, Maryland Richmond, VA and surrounding communities.