Paradoxical adipose hyperplasia after noninvasive radiofrequency treatment: A novel report and review

The past decade has experienced a surge in the frequency of nonsurgical procedures, including injectables, skin rejuvenation, and nonsurgical fat reduction. Nonsurgical fat reduction methods include cryolipolysis (Coolsculpting), ultrasound (Vaser Shape), laser (Liposonix), and radiofrequency (Vanquish). These methods generally produce good results, with cryolipolysis gaining much popularity over the past few years. Multiple reports of paradoxical adipose hyperplasia have been reported with Coolsculpting, with an incidence of 0.025% to 1%. This entity has never been reported with other methods of nonsurgical fat reduction, including noninvasive radiofrequency (Vanquish). We present a case of paradoxical adipose hyperplasia in a 57-year-old male following treatment with noninvasive radiofrequency (Vanquish) to the abdomen. He was treated with power-assisted liposuction to the abdomen and flanks. This is the first case in the literature of paradoxical adipose hyperplasia in a patient treated with this form of noninvasive fat reduction.