When CoolSculpting goes wrong
Demand is high for nonsurgical fat reduction, as evidenced by Zeltiq’s claims on its corporate website that nearly 1.5 million CoolSculpting treatments have been performed worldwide. And while CoolSculpting, which is approved for the abdomen, flank and thighs, has been shown in studies to be relatively safe and effective, there are side effects and potential complications.
Kavitha K. Reddy, M.D., a dermatologist and director of the Cosmetic & Laser Center at Boston University Medical Center, Boston, Mass., says her practice regularly uses CoolSculpting on male and female patients.
“… we have new patients requesting the treatment each week,” Dr. Reddy says.
Redness, swelling, bruising and temporary tingling or numbness are common, normal side effects, according to Dr. Reddy. She says potential complications with cryolipolysis include skin damage, leading to ulceration or scarring; prolonged or severe pain; abrupt fat layer changes, including "step-off" changes; and paradoxical adipose hyperplasia.
Myla Bennett, M.D., a plastic surgeon and owner of the Ederra Bella Plastic Surgery and Medical Spa, in Johns Creek, Ga., says she has performed hundreds of CoolSculpting cases. Among those, two of her CoolSculpting patients had post-treatment paradoxical adipose hyperplasia.
“That’s where the patient will actually get a reverse reaction. Instead of fat reduction, they actually end up with more fat cells in that area. It happens more commonly in men than women, and there’s really nothing you can do to prevent it or even know if somebody is at risk for it,” Dr. Bennett says.
Dr. Bennett says she is not aware of the complication arising from other types of fat removal or reduction approaches.
Researchers reported on the side effect in March 2014 in JAMA Dermatology, documenting a case of a man in his 40s who underwent a single cycle of cryolipolysis to his abdomen and developed a large subcutaneous mass in the months following treatment.
“Paradoxical adipose hyperplasia is a rare, previously unreported adverse effect of cryolipolysis with an incidence of 0.0051%. No single unifying risk factor has been identified. The phenomenon seems to be more common in male patients undergoing cryolipolysis. At this time, there is no evidence of spontaneous resolution,” according to the study’s abstract.
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