This past week I saw a patient with Paradoxical Adipose Hyperplasia (PAH). What is PAH? It’s an extremely rare complication of CoolSculpting where the treated area gets larger rather than smaller. It was the first time I had seen a case like this, but something I had read about before. We have been performing CoolSculpting since March 2010, long before anyone else in San Antonio, and I have never had a case of PAH. So far, the causes for PAH have not been found, so it doesn’t seem that this is a preventable complication. Although unavoidable, it is treatable by a qualified Plastic Surgeon
The patient is a healthy lady who went to a Dermatologist in San Antonio to have her upper back/bra fat treated. After her first treatment, the area felt hard. When she went for a follow up, they decided to treat her again, since she didn’t have any reduction. After the second treatment, the treated areas became even larger. Now the skin has stretched and she looks worse than when she started. We talked about options and discussed either cutting out the areas, or trying laser liposuction in an attempt to get some skin contraction.
Unfortunately, she did not go to a Plastic Surgeon first for her CoolSculpting. Sure, I’m biased, but I think that the best person to evaluate and recommend treatments is a Board Certified Plastic Surgeon. We have extensive training on body contouring and can recommend the best treatment whether it is surgical or non-surgical. Not to say I would have recommended anything different at the beginning, but now that there is a complication, she NEEDS to see a Plastic Surgeon. At least if she had seen a Plastic Surgeon first, she would not have the delay in treatment that she has now. There are many places out there to get your CoolSculpting, you want to make sure that the provider you see is a Board Certified Plastic Surgeon. To learn more about the training of plastic surgeons, refer to this info from the American Society of Plastic Surgeons.
This patient said she did not see a Plastic Surgeon first because she did not want surgery and figured if she went to a Plastic Surgeon they would have just wanted to operate. I get that perception, but the best Plastic Surgeons know when to operate and when not to operate. It is important to see a Plastic Surgeon who offers the full spectrum of treatment. Some place like Advanced Concepts in Plastic Surgery where we offer CoolSculpting, Cellulaze, and Traditional Liposuction. All of our patients are seen by me before any procedure and we have a thorough discussion about your goals and if they are realistic. If I don’t think CoolSculpting is for you, I’ll let you know. Similarly, if you are not a good surgical candidate or if you just need to lose weight, I will let you know.
There is an old saying often quoted in Plastic Surgery that goes something like this: “If the only tool in your box is a hammer, then all the world is a nail”. So, if you go to a provider who is not a Plastic Surgeon and the only tool they have to reduce fat is CoolSculpting, then all the world is one big FAT nail. If you are considering CoolSculpting, see someone that has many tools in their toolbox.
One other thing to consider when choosing a CoolSculpting provider is: “Can the Physician handle all of the complications?”. If the provider you visit cannot perform excision or liposuction of the area should PAH occur, you should keep looking for someone who can.
I hope I have convinced you of the importance of choosing wisely when looking into CoolSculpting. You need someone with Experience who has been doing CoolSculpting for several years. They should have the Expertise to be able to handle any complications. Make sure they have a Reputation for Excellence as evidenced by reviews and recommendations. Finally, they should provide Personalized Care and choose the treatment that is right for you and in line with your goals. If you need help finding someone who fits all these criteria, just give Linda or Hilda a call and they’ll set you up with the Plastic Surgeon who is right for you!
The patient is a healthy lady who went to a Dermatologist in San Antonio to have her upper back/bra fat treated. After her first treatment, the area felt hard. When she went for a follow up, they decided to treat her again, since she didn’t have any reduction. After the second treatment, the treated areas became even larger. Now the skin has stretched and she looks worse than when she started. We talked about options and discussed either cutting out the areas, or trying laser liposuction in an attempt to get some skin contraction.
Unfortunately, she did not go to a Plastic Surgeon first for her CoolSculpting. Sure, I’m biased, but I think that the best person to evaluate and recommend treatments is a Board Certified Plastic Surgeon. We have extensive training on body contouring and can recommend the best treatment whether it is surgical or non-surgical. Not to say I would have recommended anything different at the beginning, but now that there is a complication, she NEEDS to see a Plastic Surgeon. At least if she had seen a Plastic Surgeon first, she would not have the delay in treatment that she has now. There are many places out there to get your CoolSculpting, you want to make sure that the provider you see is a Board Certified Plastic Surgeon. To learn more about the training of plastic surgeons, refer to this info from the American Society of Plastic Surgeons.
This patient said she did not see a Plastic Surgeon first because she did not want surgery and figured if she went to a Plastic Surgeon they would have just wanted to operate. I get that perception, but the best Plastic Surgeons know when to operate and when not to operate. It is important to see a Plastic Surgeon who offers the full spectrum of treatment. Some place like Advanced Concepts in Plastic Surgery where we offer CoolSculpting, Cellulaze, and Traditional Liposuction. All of our patients are seen by me before any procedure and we have a thorough discussion about your goals and if they are realistic. If I don’t think CoolSculpting is for you, I’ll let you know. Similarly, if you are not a good surgical candidate or if you just need to lose weight, I will let you know.
There is an old saying often quoted in Plastic Surgery that goes something like this: “If the only tool in your box is a hammer, then all the world is a nail”. So, if you go to a provider who is not a Plastic Surgeon and the only tool they have to reduce fat is CoolSculpting, then all the world is one big FAT nail. If you are considering CoolSculpting, see someone that has many tools in their toolbox.
One other thing to consider when choosing a CoolSculpting provider is: “Can the Physician handle all of the complications?”. If the provider you visit cannot perform excision or liposuction of the area should PAH occur, you should keep looking for someone who can.
I hope I have convinced you of the importance of choosing wisely when looking into CoolSculpting. You need someone with Experience who has been doing CoolSculpting for several years. They should have the Expertise to be able to handle any complications. Make sure they have a Reputation for Excellence as evidenced by reviews and recommendations. Finally, they should provide Personalized Care and choose the treatment that is right for you and in line with your goals. If you need help finding someone who fits all these criteria, just give Linda or Hilda a call and they’ll set you up with the Plastic Surgeon who is right for you!