Shockwave therapy for the prevention of paradoxical adipose hyperplasia after cryolipolysis: Myth or reality?

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Alain Michon

The Ottawa Skin Clinic, Canada

: J Plast Surg Cosmetol

Abstract

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Data abstracted from a multicenter evaluation between January 2015 and December 2018 showed an incidence of between 0.05% and 0.39% of paradoxical adipose hyperplasia (PAH) per cryolipolysis treatment cycle. This is equivalent to a rate as high as 1 PAH case per 256 treatment cycles, which is more than the incidence of 1/4000 or 0.025% per treatment cycle suggested by the manufacturer of the largest cryolipolysis brand in the world, CoolSculpting. The underlying mechanisms of PAH development have yet to be fully elucidated. It is our belief that a new standardized protocol of combined cryolipolysis and shockwave therapy (SWT) will improve outcome and significantly decrease PAH incidence. Between April 2017 and mid-January 2021, our center performed 2291 treatment cycles of cryolipolysis followed by SWT. Out of these treatment cycles, we had no cases of documented PAH. SWT has recently been shown to have a high patient satisfaction rate when performed after cryolipolysis while being safe and effective. Not only has SWT been shown to increase the incidence of adipocyte death after cryolipolysis to enhance results, but it also improves blood flow and microcirculation. It also has an antifibrosclerotic effect and decreases oxidative stress in tissue. Oxidative stress is present after cryolipolysis and can be one of the numerous causes of panniculitis. Hence, SWT can only have a positive effect in postcryolipolysis tissue.

Biography

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Dr Alain Michon has completed his medical doctorate and two postdoctoral degrees, one in Family Medicine and another in Emergency Medicine, from the University of Ottawa in Canada. He has been practising non-invasive aestheticine medicine for 15 years. He is the founder and director of The Ottawa Skin Clinic, a well known clinic in Ottawa who won many awards. He has recently published three papers in reputable journals, has been a speaker for BTL Aesthetic and SkinCeuticals, and is an advisory board member and speaker for Allergan Aesthetics.