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Paradoxical Adipose Hyperplasia (PAH)

What is PAH?

Paradoxical adipose hyperplasia (PAH) is a condition that can occur after non-invasive cryolipolysis, where surgical sculpting is done with cold or heat-type methods. PAH was first reported in the medical literature in 2014 and has been estimated to occur with every 4,000 cryolipolysis treatments. It’s important to note that many patients often receive multiple cryolipolysis treatments for their desired results, and thus PAH may be occurring even more commonly.

Patients are often frustrated by gaining fat and contour irregularities after non-surgical treatments that were supposed to make them slimmer.

What Is Cyrolipolysis?

Cryolipolysis is a cosmetic procedure that freezes or heats fat cells to eliminate them. Extreme temperatures induce apoptosis, leading to the natural removal of fat cells by the body. This non-invasive procedure gained popularity for fat removal without major surgery. Cryolipolysis commonly targets the inner thighs, abdomen, love handles, and buttocks. Some patients may experience paradoxical adipose hyperplasia (PAH) after this non-invasive procedure, and a PAH revision can be performed to correct the deformity.

Cool sculpting treatment that may lead to paradoxical adipose hyperplasia

Cryolipolysis Fat Freezing

What Are the Symptoms of Paradoxical Adipose Hyperplasia (PAH)?

PAH is a complication associated with cryolipolysis and results in the fat cells growing rather than diminishing. This usually develops 3-6 months after non-invasive cryolipolysis treatment; however, the exact cause is unknown. PAH is characterized by an irregular, firm, and raised area from the cyrolipolysis treatment.

When Does PAH Require Surgery?

The only known treatment to reverse paradoxical adipose hyperplasia is liposuction to remove excess fat. Most patients with PAH report that it does not resolve itself.

How Is the Surgery for PAH Performed?

Dr. Azouz performs a variety of advanced liposuction techniques to help disintegrate the fat associated with PAH, including SAFE liposuction and power-assisted liposuction. In severe cases of the abdomen, he can perform a tummy tuck to help tighten the skin and completely excise the fat associated with PAH.

What Is the Anesthesia for PAH Treatment?

Dr. Azouz will most often use sedation with local anesthesia. Patients are sedated in a comfortable, deep sleep. Dr. Azouz will inject a numbing medication into the affected area of PAH, which can last many hours after the procedure.

What Is the Cost of PAH Surgery?

The cost of any surgery varies extensively. Dr. Azouz will start with a medical history and physical examination to help determine the cost.

What Is the Recovery after PAH Surgery?

Recovery from PAH surgery is similar to other liposuction procedures. Patients may experience bruising and swelling for several days to weeks after the procedure. Dr. Azouz will advise which compression garments will help with the swelling. He sees patients a few days after surgery in his office for routine follow-up visits where he can monitor healing and provide more instructions regarding post-surgical care.

Schedule a Consultation with Dr. Azouz

If you are concerned that you may have paradoxical adipose hyperplasia after cryolipolysis, contact us online or call us at (972) 702-8888. Your consultation with board-certified plastic surgeon Dr. Azouz includes a thorough medical history and physical examination to determine the best treatment plan for you. Virtual consultations are available for patients who live far from Dallas.