From Miami Plastic Surgery; the Department of Surgery, Florida International University Herbert Wertheim College of Medicine; and Cayetano Heredia University, School of Medicine.
Plast Reconstr Surg. 2018 Jul;142(1):17e-22e. doi: 10.1097/PRS.0000000000004523.
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.
摘要：反常性脂肪增生是冷冻溶脂术罕见的不良反应，目前尚无自发缓解的报道，其治疗方法也鲜有描述。本文旨在介绍作者在冷冻溶脂术后治疗反常性脂肪增生的经验。作者对 2013 年 5 月至 2016 年 5 月期间在作者诊所就诊的所有反常性脂肪增生患者进行了回顾性图表分析。记录了患者的治疗参数、人口统计学特征、发现时间和随后的治疗方案。共发现 11 例反常性脂肪增生（8 例男性，3 例女性），所有患者均为西班牙裔背景。7 例患者接受了手术治疗（单纯吸脂 6 例，吸脂联合腹部整形术 1 例）。平均随访 9.6 个月（2 至 32 个月）。3 例接受吸脂术的患者需要进行二次手术。所有接受手术治疗的患者对最终效果非常满意。反常性脂肪增生是冷冻溶脂术罕见的并发症，其发生率可能高于制造商报告的数据。最佳治疗方法是在冷冻溶脂术初始治疗后 6 至 9 个月，待受累区域软化后再进行治疗。动力辅助吸脂术是首选的治疗方法，但在某些情况下，可能需要进行腹部整形术。对于复发或持续隆起的情况，可能需要进行二次治疗。在为纠正非侵入性治疗的并发症而提供侵入性治疗时，必须对患者的担忧保持敏感性。
