American Society of Plastic Surgeons
For Medical Professionals
one year ago

Where do I find a surgeon to diagnose my paradoxical adipose hyperplasia

I was part of a trial for Cool Sculpting. Long story short I have bulging of hard lumpy fat on my abdomen and fat stranding of “unknown etiology” on a CT scan. Trial clinic sent me to pcp for dx. Pcp knows nothing about PAH. Referred me to find a plastic surgeon on my own. 8 months later and I’m still searching for someone to help me. I need my insurance billed. Desperate. Where do I need to look?

Procedure: Body Contouring
Location: Oceanside, CA

Replies 4

Gary Culbertson
ASPS Surgeon
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Paradoxical Adipose Hyperplasia (PDH) is a well known complication of fat freezing devices like CoolSculpting. Your insurance carrier most likely will not cover any treatment for your condition as it arouse from a Aesthetic or Cosmetic procedure. Consider addressing the issue with the vendor- CoolSculpting. If they provide no resolution then, consider legal assistance. Best,

Gary R Culbertson, MD, FACS

Aaron Stone
ASPS Surgeon

Treatment is best delayed until the affected area has softened, which normally occurs in 6 to 9 months after the initial cryolipolysis procedure. If you attempt to treat PAH too early in its course it will get worse. Liposuction is the preferred method of treatment,

Alfred Antonetti
ASPS Surgeon

Medical insurance will not cover any of this. You need to look for an ABPS certified physician for a consultation and go from there.

Brian Dorner
ASPS Surgeon

Cool sculpting (Abbie Vie and Allergan) have traditionally been very good about covering this. Not sure what you mean by a “Trial clinic” (Coolsculpting has been around for many years) but if you send a claim to Allergan there is a reasonable chance they might reimburse you for liposuction if PAH is preset. However, you will need a lot of information from your trial clinic (machine ID, your weight and pre-procedure photos, etc). If this clinic is either out of business or unwilling to help you may be out of luck. Hope this helps.


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