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Treatment of Paradoxical Adipose Hyperplasia following Cryolipolysis: A Single-Center Experience

Kelly, Michael E., M.D.; Rodríguez-Feliz, Jose, M.D.; Torres, Carolina, M.D.; Kelly, Emma, B.A.

Plastic and Reconstructive Surgery: July 2018 - Volume 142 - Issue 1 - p 17e–22e
doi: 10.1097/PRS.0000000000004523
Cosmetic: Ideas and Innovations
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Summary: Paradoxical adipose hyperplasia is a rare adverse event associated with cryolipolysis. No evidence of spontaneous resolution has been described and little has been written about its treatment. The purpose of this report is to share the authors’ experience treating patients with paradoxical adipose hyperplasia after cryolipolysis. A retrospective chart review was performed for all paradoxical adipose hyperplasia patients seen in the authors’ practice between May of 2013 and May of 2016. The treatment parameters, demographics, onset of findings, and subsequent treatment were chronicled. Eleven cases of paradoxical adipose hyperplasia were identified (eight men and three women). All patients were of Hispanic background. Seven patients were treated surgically (six cases of liposuction alone and one case of liposuction and abdominoplasty). Average follow-up was 9.6 months (range, 2 to 32 months). Three of the patients treated with liposuction required a secondary procedure. All surgically treated patients were very satisfied with their final appearance. Paradoxical adipose hyperplasia is a rare complication of cryolipolysis that may occur more frequently than in the manufacturer’s reported data. Treatment is best delayed until the affected area has softened, which normally occurs in 6 to 9 months after the initial cryolipolysis procedure. Power-assisted liposuction is the preferred method of treatment, but in some cases, abdominoplasty may be necessary. Secondary treatments might be needed for recurrence or persistent bulge. One must be sensitive to heightened patient concerns when offering an invasive procedure to correct the complications from a noninvasive one.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Miami, Fla.; and Lima, Peru

From Miami Plastic Surgery; the Department of Surgery, Florida International University Herbert Wertheim College of Medicine; and Cayetano Heredia University, School of Medicine.

Received for publication March 14, 2017; accepted January 9, 2018.

Disclosure: None of the authors has a financial interest in any of the products or devices mentioned in this article.

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A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to PRSJournal.com and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch. On the iPad, tap on the Hot Topics icon.

Michael E. Kelly, M.D., 8940 North Kendall Drive, Suite 903-E, Miami, Fla. 33176, mkelly@miamiplasticsurgery.com

©2018American Society of Plastic Surgeons