Coolsculpting is an FDA approved,
established and non-invasive treatment for excess fat. Based on the
principles of cryolipolysis, when fat is exposed to controlled cold
temperatures of -5°C, a cell death and inflammatory response occurs
(panniculitis) that results in the reduction of the layer of fat treated
without harming the top layers of skin. Although the treatment has been
proven effective and is often sold as an alternative to liposuction,
most experts in fat removal agree that it is NOT a replacement for
liposuction. Coolsculpting, although effective, is used only for limited
fat reduction and spot treatment. It is not as effective as properly
performed liposuction and it is also not without side effects. Most
commonly, patients can often experience swelling, bruising, numbness or
chronic pain in areas treated. Although many patients do respond with
mild to moderate fat reduction, it is not always successful in
contouring treatment areas given the ergonomics of the device and the
lack of human interaction with the tissue. Also, patients often require
several treatments to obtain a desirable result.
The most alarming side effect of
cryolipolysis appears to be unique to the Coolsculpting procedure and
has not been seen with other competing technologies such as Sculpsure,
Liposonix, and Ultrashape which do not use cold to destroy fat cells.
Paradoxical Adipose Hyperplasia (PAL) is a condition in which the fat
cells actually overgrow instead of getting destroyed. The affected areas
usually become firm and swollen anywhere from 2-6 months after treatment
of the area. Although uncommon, this complication was originally
considered extremely rare. After several years on the market, we are
realizing that the severity of the condition lies on a large spectrum of
mild to severe cases and occurs more commonly than thought. Because many
clinics treat patients without thorough evaluation by physicians, cases
are very under reported and patients with the condition are sometimes
merely retreated thinking the patient just gained weight. Unfortunately,
there is no good data to suggest the exact frequency at which it occurs
or whether or not there are any preventable means to avoid the
complication. For now, the only treatment recommendation is
liposuction.
As a leading expert in
fat reduction, Dr.
Frank has treated over 50 cases of this condition to date with
VASER-assisted (ultrasound) Tumescent
Liposuction. Unfortunately, PAL is often difficult to treat with
traditional liposuction given the extreme firmness or fibrousity of the
affected area. In many cases there is chronic inflammation
(panniculitis) in the fat that must be treated medically prior to
surgical intervention. A thorough medical history and work up is
essential to planning out the treatment of this condition. Surgical
intervention, although effective, is not simple and it must be performed
with microcannular technique under local anesthesia with ultrasound
assistance by a physician who has vast experience in both the technique
and this complication. Often a second or staged procedure is necessary
to rid of the problem completely. If you have had the Coolsculpting
procedure and feel you may be experiencing this side effect, it is
essential to inform your provider. If you believe you need medical and
surgical intervention during your treatment we are available to consult
with you to educate on the options available.
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