What Is PAH? | Understanding Paradoxical Adipose Hyperplasia Due To CoolSculpting
May 2, 2022
PAH usually presents as an enlarged bulge in the treatment area, and is firm or dense when compared to surrounding tissue.
So, you’ve decided to get rid of that stubborn fat for once and for all.
You’ve done the research, studied the Before & Afters on RealSelf (they’re impressive, right?), found a provider, and reserved your CoolSculpting consultation. You have a general sense of what CoolSculpting treatment entails.
But do you really know what you’re in for? Are you really prepared to spend upwards of $1,500-3,000 on a single treatment session without knowing exactly what’s included?
Here’s the simple truth. Successful CoolSculpting treatment requires an expert understanding of the underlying anatomy, a careful eye for aesthetic detail, and knowing how to harness the fat-freezing power of CoolSculpting to achieve fantastic results. In many ways, this boils down to proper selection, positioning, and usage of the various Coolsculpting applicators.
With all the different names and versions of CoolSculpting applicators, things can get quite confusing fast. Luckily, we’ve sorted it all out for you below. Get familiar with what’s available so you can receive the best possible results.
Keep in mind, some providers may not have all of the latest CoolSculpting applicators. You’ll want to check that they do before you begin treatment!
CoolSculpting was introduced to the world in 2010, and has since become the number one leader (by far!) in noninvasive fat reduction. (Learn more here.)
The first generation of CoolSculpting applicators was a set of four applicators, known as the CoolCore, CoolCurve+, CoolMax and CoolFit.
In 2017 a 2nd generation of applicators was released, known as the “CoolAdvantage” family. These updated applicators are more efficient, more effective and more comfortable for patients. The CoolAdvantage applicators have an improved freeze detection system which uses real time monitoring to regulate consistent freeze temperatures on the surface of the skin, thus ensuring better results for patients while keeping them safe.
Other additions to the CoolSculpting family include the CoolSmooth applicator which was added in 2014, and it’s successor the CoolSmooth PRO. The CoolMini was added in 2015.
Start with the best, of course. There are three main Advantage applicators, and the CoolAdvantage applicator is the workhorse of the bunch. It’s versatile enough for large debulking, and small enough for spot treatments, too.
The CoolAdvantage works well on the abdomen, flanks, love handles, bra fat, banana rolls (under butt), and bra line. It can be used to create an “hourglass” shape around the hips for women, and to achieve a coveted “V-taper” for men.
There are three different contouring heads used with the CoolAdvantage: the Fit, Core, and Curve+. Your provider will select the best attachment head for use with the CoolAdvantage.
A typical treatment cycle with the CoolAdvantage applicator takes about 35 minutes. If you spend any amount of time in a CoolSculpting treatment chair, there’s a good chance you’ll be familiar with the CoolAdvantage.
Next in line in the main suite of Advantage applicators is the CoolAdvantage Plus.
This is the heavy lifter of the group, designed to go to work on big, bulky problem areas. It’s commonly used on the upper and lower abdomen and for love handles.
The newest version of the CoolAdvantage Plus is 25% faster than its predecessor. A single cycle takes about 45 minutes. There are two different attachment heads for the CoolAdvantage Plus: the Core and the Curve+.
Not every patient needs treatment with the CoolAdvantage Plus, but if you think you might- be sure to check with your CoolSculpting provider that this applicator is available before getting started.
Last on the list of the three CoolAdvantage applicators is the CoolAdvantage Petite, the smallest of the group. This applicator is used for, you guessed it- smaller, more detailed work. The Cooladvantage Petite freezes and eliminates stubborn fat on the inner thighs, the arms, the abdomen, and the flanks.
Like other members of the CoolAdvantage family, the Cooladvantage Petite has a set of different contouring heads: the Flat, Curve, and Curve+.
The CoolAdvantage Petite takes 35 minutes per cycle. The newest model is once again an improvement upon previous generations, including updated suction and monitoring.
If you’re looking to get rid of excess fat in smaller areas such as the upper arm, bra fat or flank areas, you’re sure to see the CoolAdvantage Petite.
The CoolMini received FDA clearance in 2015, and is an amazing addition to the CoolSculpting family.
As the name implies, the CoolMini is specially designed to treat small problem areas. This applicator has about half the surface area as that of the CoolAdvantage Petite. But don’t be fooled by its diminutive size- it still packs a punch!
The CoolMini is useful for treating the under chin area (submental and submandibular areas), the front armpit area, and the small fat pads above the knees. It has a small vacuum cup perfectly designed to access these small areas, achieving fat reduction in areas that could previously only be targeted with surgical liposuction (read here for more info).
Normal treatment time with the CoolMini is about 35 minutes. Not every CoolSculpting practice has the CoolMini applicator, so again, check ahead to make sure it’s available.
Last on the list here is the CoolSmooth PRO. This applicator has a very broad cooling surface, making it a great choice for areas with non-pinchable fat such as the lateral thighs and upper abdomen.
The unique design of the CoolSmooth PRO makes it an ideal complement to the CoolAdvantage applicators. It can be used as a “finishing treatment” to achieve uniform coverage over large surface areas.
For example, the CoolSmooth PRO is often used on the abdomen during 2nd or 3rd treatment sessions and enables positioning that would otherwise not be obtainable with CoolAdvantage applicators alone. Because of it’s non-suction design, the CoolSmooth PRO works well in areas over and around the belly button, (whereas the CoolAdvantage suction applicators should be avoided there).
Normal run time for the CoolSmooth PRO is a bit longer at 75 minutes, due to the non-suction design. But don’t worry, results from the CoolSmooth PRO are worth the extra wait!
As you can see, it’s easy to get confused with all the different CoolSculpting applicators out there!
You don’t have to be an expert on CoolSculpting applicators (leave that to your CoolSculpting provider!) But it’s good to have a general understanding of what will be included in your treatment plan.
Find a certified CoolSculpting provider that you’re comfortable with, and check to see that they have the newest CoolSculpting applicators available. You deserve the best!
Ready to start your CoolSculpting journey?
Dr. Crawford is a board certified medical physician with a special interest in guiding patients to their full health potential, integrating mind, body & spirit.
He has extensive clinical experience in the ambulatory, acute care and critical care settings.
PAH usually presents as an enlarged bulge in the treatment area, and is firm or dense when compared to surrounding tissue.
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