Lisette Hilton

Dermatologists and aesthetic physicians are using the social media platform TikTok to educate and market their practices. And it’s working.

“…TikTok holds great potential as a platform for disseminating educational information,” wrote authors of a 2021 article published in the 

Journal of the American Academy of Dermatology

And TikTok’s influence is only growing. For example, views for #acne on TikTok more than doubled from 3 billion to 6.7 billion from September 2020 to February 2021, according to the article.

Brooklyn, New York, dermatologist Angelo Landriscina, MD, started using TikTok regularly when the pandemic began. The platform in turn helped him build his dermatology practice, which he started in December 2020. Using the handle @Dermangelo and with more than 258,000 TikTok followers, Landriscina tackles topics such as skincare. He also busts social media-inspired “hacks” such as why people should not apply vodka to their faces.

“At the time, I was already active on social media, mostly on Instagram,” Landriscina says. “While my primary goal is to produce educational content for the public, many patients have found me via TikTok. Having a presence on social media has been very helpful in building my patient base.”

New York City-based celebrity cosmetic dermatologist Paul Jarrod Frank, MD, uses the handle @drpauljarrodfrank on TikTok. He capitalizes on social media platforms to drive traffic to his PFRANKMD aesthetic health care brand.

“At the end of the day, everything we do on social media is educational and leads back to the [return on investment] of bringing in new patients and building brand awareness,” Frank says. “TikTok is a platform where content needs to be quick and digestible, and it allows us to take our creativity to the next level, while still providing educational content.”

Frank discovered TikTok’s power when he contracted COVID-19.

“It was a very scary time, and I wanted to openly share my experience to educate others who may have been going through the same thing,” Frank says. “As one of the first people to document my COVID-19 journey, my videos began to go viral and started important conversations. My educational COVID-19 videos got over 4000 comments and reached over 3 million people all over the world. Our treatment videos also go viral as they show eye-catching procedures and results that followers may have never seen before.”

Despite being banned in some countries, TikTok is the seventh most-used social network with 689 million active users worldwide as of January 2021. The majority of TikTok users in the US are younger than 30, according to Hootsuite.com.

“Social media platforms such as TikTok are changing the way we connect and interact,” Szeto et al wrote in an article published in April 2021 in the 

TikTok offers a constant, addictive stream of short, catchy videos curated for users, with the potential for cross-generational appeal. It is user-friendly and shows viewers videos based on their interests, according to an email to

™ from 2 of the article’s authors, Colby Presley, DO, a practitioner in the Department of Dermatology at Lehigh Valley Health Network in Allentown, Pennsylvania; and Mindy Szeto, MS, Department of Dermatology at the University of Colorado in Aurora.

“Typically, TikTok users post and seek out content they enjoy, things they’re passionate about,” they wrote. “They can also ‘duet’ to build on existing videos and communicate with people around the world in real time, so it becomes easy to make and develop those human connections. Our published study also highlighted how TikTok videos are unique because they can be posted to Instagram as Reels. With this capability, TikTok can make its videos available on both their application and Instagram, presently the largest social media application by follower numbers. [Although] TikTok is currently used heavily in the younger generation, Instagram has a wider age range of users and those Instagram users can see TikTok videos.”

Providers can leverage the fact that consumers and patients are using TikTok to discover and discuss medical information to directly connect with the public, as well as promote their brand and practice, Presley and Szeto wrote.

“Interactive ‘duets’ are very popular on highly viewed skin care videos, and we encourage providers to use this feature to be a presence and provide guidance on what medical advice videos say and do,” the authors wrote. “However, it’s also very important, and we recommend, that providers conduct themselves ethically, being aware of privacy and confidentiality, explicitly disclosing conflicts of interest, and maintaining professional boundaries, among other social media best practices. Furthermore, the amount of inaccurate or misleading health care information being shared on these platforms is high. We hope that greater provider presence on social media can help dispel some of the health care myths.”

TikTok, as with most social media sites, does not verify users’ credentials. So anyone can say they are a medical professional and provide medical advice, according to Presley and Szeto.

Frank says TikTok gives him the opportunity to set the record straight on important safety measures such as the use of at-home hyaluronic lip fillers.

Some dermatology and aesthetic topics or themes really seem to strike a chord with TikTok users.

“Recent topics that have done well on my page include using benzoyl peroxide for acne, tips for saving money on prescription drugs, and the lack of data behind using rice water for hair growth,” Landriscina says.

To make TikTok work for their practices, clinicians need to spend time on the app. “[TikTok] is not the same as other social media platforms, so you should familiarize yourself with the types of content that people respond to, see what kinds of content end up as trends, and absorb the overall vibe before producing anything yourself,” Landriscina says.

Users may ask clinicians who post on the app for individual medical advice, Landriscina cautions.

“Keep in mind that answering these requests is not considered ethical,” Landriscina says. “A good way to keep people happy is to see what topics people ask about frequently and produce educational videos about [those topics].”

Landriscina says he was successful on TikTok because he went into it without expectations and to produce content that he likes.

“People can tell if you’re enjoying yourself or not,” Landriscina explains.

It is OK to get a little bit personal, according to Frank, who uses his hobbies, including cooking and roller-skating, in his TikTok videos.

“It’s ok to experiment with different forms of content as long as it’s authentic and true to yourself and your brand,” Frank says. “It’s nice to get a glimpse into someone’s personal life.”

1. Kassamali B, Villa-Ruiz C, Mazori DR, Min M, Cobos GA, LaChance AH. Characterizing top educational TikTok videos by dermatologists in response to “TikTok and dermatology: An opportunity for public health engagement.” 

 2021; 85(1):e27-e28. doi:10.1016/j.jaad.2021.02.051

2. Sehl K. 23 important TikTok stats marketers need to know in 2021. Hootsuite. May 5, 2021. Accessed May 18, 2021. 

3. Szeto MD, Presley CL, Pulsipher KJ, et al. Dermatologist influencers on social media: Instagram Reels and TikTok interactive short videos. 

. 2021;85(3):e185-e188. doi:10.1016/j.jaad.2021.04.052

Articles

The app helps dermatologists and aesthetic physicians promote their practices, gain new clients, and share information. 

Inside DermTok: Winning TikTok Strategies

Intrinsic and extrinsic causes of hair aging differ among race and ethnicity.

For example, hair graying with age is universal, but its average age of onset varies with race. The average age of graying in Caucasians is in the mid-30s, for Asian people it is in the late-30s and for Black people, the mid-40s.

There also are different presentations among ethnicities of common hair concerns. A Caucasian patient seeking recommendations on what to do about damaged hair is more likely to experience damage at the distal hair shaft. A Black patient with the same complaint would be more likely to present with damage closer to the hair root.

Understanding these differences and why they occur can lead to more informed, culturally sensitive recommendations for treating and managing hair aging concerns, according to a review of studies published earlier this year in 

the Journal of Clinical and Aesthetic Dermatology

Study author Neelam Vashi, MD, founder and director of the Boston University Center for Ethnic Skin, director of the Boston University Cosmetic and Laser Center, and associate professor of dermatology at the Boston University and Boston Medical Center, in Massachusetts, says conducting the review helped to qualify and quantify what she sees in the clinic when Black, Asian, Hispanic or Caucasian patients present with hair aging concerns.

“There is very little published on hair aging in different ethnicities,” she says. “I really wanted to better understand the differences that we visibly see.”

Intrinsic hair aging includes the natural physiological changes that happen with time, according to the authors. “Intrinsic aging is what we are born with,” Vashi says. “It is dependent on the genes that we inherit from our parents, and it is also what we’re made of—our ethnicity and background.”

Hair graying is associated with aging and the decline in melanocytes thought to happen naturally with age. “I have had some patients come in because they felt like they were graying too early,” she says.

Not only is average age of graying onset different among ethnicities, but so is what is considered to be premature graying. “Graying is premature if it occurs at different times in different populations. It is at about age 20 in Caucasians, 25 in Asians, and 30 in African Americans,” Vashi says. “A lot of the differences can be attributed to pigment.”

This is important information to have when managing patient expectations and addressing their concerns, she says.

“If someone is an age where changes such hair loss is premature, then we can be more aggressive possibly in the medications we use and advise them to follow up with us,” she says.

There also are structural differences in hair that can impact how hair ages among ethnicities. The average diameter, or thickness, of Asian hair is from 80 to 120 µm, compared to 65 µm in Caucasian hair and 55 µm in Black hair. The average diameter of Hispanic/Latino hair tends to fall between that of Asian and Caucasian.

Caucasians have the highest hair density among the ethnicities studied. Black people have the lowest. Asian people have hair density that falls somewhere in between. The review authors did not have enough data on Hispanic hair density.

Black people have the lowest growth rate of hair but the highest eumelanin content. Breakage is increased or faster in this hair type. This group also has smaller hair cuticles than other ethnicities.

And while the hair shaft shape in Caucasians is cylindrical, it is ellipsoid or flattened in Black people, circular in Asian and cylindrical and circular in Hispanic populations.

The more manageable and controllable hair aging factors are extrinsic, including environmental exposures and physical stress from grooming practices. “Oxidative damage of the hair that can be caused by ultraviolet light and chemicals can change the quality and quantity of our hair,” Vashi says. “Chemicals, like hair dye or products for hair straightening, can cause damage to the hair fiber. Smoking can increase the rate of hair aging.”

In fact, studies have shown that the risk of hair graying is nearly twice as high in smokers vs nonsmokers, according to the review.

“There is a component of extrinsic aging related to different cultural practices. It’s not just how you were born and your genetics, but also your culture and what you do,” she says.

For example, the findings that Asian and Caucasian people present with more distal hair damage at the hair shaft and Black people with damage closer to the hair root is due not only to the structure of hair but also extrinsic factors, like cultural hair care practices, according to Vashi.

“Patients have come to me who say their hair just stopped growing,” Vashi says. “They think there is something wrong with them. There is nothing wrong with them. The hair is growing but when a break happens it is in a different hair. There is one hair that is growing and another that is breaking. If the breakage is happening faster there is a visible perception that there is no hair growth.”

There are things patients cannot avoid as they age, including graying and hair density decreases. But there are general and culturally specific changes and practices that can prevent premature hair aging. Among those strategies that health care providers can recommend are appropriate grooming habits; careful hair styling; better choices for shampoos, conditioners and leave-in products; better hair coloring choices; and medical therapies to treat underlying conditions, according to the study authors.

“If we can practice better hair styling regimens or if we can advise our patients to, then the aspect of breakage may at least improve,” Vashi says. “Then the perception of hair is that it is longer and growing more.”

Some examples of recommendations include telling Caucasian patients with hair damage to avoid hot straighteners. Black people with hair damage should also try to avoid harsh chemicals in hair care products, such as chemical relaxers, and practice healthier hair styling practices.

“Unique hairstyles, such as cornrows, tight hair ties, braiding, and weaves, common in individuals with African hair, create traction on the scalp, yielding traction alopecia,” the authors wrote. “Furthermore, as African hair exhibits tight coiling, everyday washing, combing and grooming practices increases knot formation and leads to a high prevalence of fractures along the hair’s length.”

Interestingly, cosmetic products to bleach, color, perm, or straighten hair can impact hair types differently. For example, Asian hair tends to be more resistant to straightening treatments than Caucasian and Black hair. Asian hair seems to have larger amounts of integral lipids, fatty acids, cholesterol, and wax esters than other hair, which makes Asian hair less susceptible to UV damage, as well, according to the review.

Hair dyes, in general, can cause allergies and damage hair, according to Vashi.

“There are certain components of hair dyes that can act as allergens,” she says. “I don’t tell patients to stop dying their hair, but I advise on safe procedures and to avoid anything that is causing pain, itching or burning on the scalp. We are only born with so many hair follicles. Once a hair follicle scars down or goes away, that’s it.”

Vashi says she offers patients patch testing to determine which hair dye ingredients might be causing the reaction and gives them an alternative recommendation.

Hair dyes are not the only culprits. Some relaxers or hot hair styling treatments can cause burns that permanently damage the hair follicles.

“Hair is such an important aspect of how people and patients perceive themselves,” Vashi says. “Cross culturally, there are certain aspects of the appearance of hair that are considered to be beautiful. We also have a population that is aging but wants to maintain a youthful, vibrant appearance. A lot of what we can do is to counsel, make hair care recommendations, offer treatments, and set expectations in a culturally sensitive way.”

Maymone MBC, Laughter M, Pollock S, et al. Hair Aging in Different Races and Ethnicities. 

A patients’ race and cultural background may be a factor in how the hair ages, according to a study in the Journal of Clinical and Aesthetic Dermatology.

Hair Aging in Different Races and Ethnicities

In his 25 years of treating women with hair loss, Alan J. Bauman, MD, ABHRS, FISHRS, says cosmetic physicians should take postpartum hair loss seriously, not only because of its potential cosmetic toll but also because of the emotional burden that comes with hair loss.

“If women say they are losing their hair, 99% of the time they are right,” says Bauman, who has a hair restoration practice in Boca Raton, Florida. “We take the situation seriously, and we more often than not uncover an underlying tendency toward hereditary hair loss which we can evaluate and treat if she desires.”

Common misconceptions about postpartum hair loss, according to Bauman, are that staying on prenatal vitamins will take care of it, there’s nothing patients can do about it, and shampooing less will help.

Hormones often cause postpartum hair loss, according to Jessica A. Shepherd, MD, MBA, FACOG, a board-certified obstetrician-gynecologist, women’s health expert, minimally invasive surgeon, and founder and CEO of Sanctum Med + Wellness, in Dallas, Texas.

“There is a significant shift in the postpartum phase that can lead to changes in how the hair processes, such as when you go through the actual cycle of hair growth. But that is temporary,” Shepherd says. “Patients usually say that they see more of their hair falling out, particularly in the shower, and when they are washing their hair.”

Women often describe postpartum hair loss as a synchronized shedding phase that starts 6 to 12 weeks after childbirth. They complain of decreased hair volume, decreased coverage, and sometimes recession in the hairline and temples, according to Bauman.

What happens to hair postpartum is much different from during pregnancy.

“During pregnancy, due to the effects of hormones, follicles are held in anagen [growth phase], longer, delaying telogen [resting phase]. Therefore, less daily shedding occurs,” Bauman says.

Hormones return to normal after childbirth, and those follicles that were previously in a prolonged anagen phase begin to turn off and hairs begin to shed—a lot—starting about 6 weeks after childbirth and continuing for at least another 2 months, he says.

“This telogen effluvium after childbirth is sometimes referred to as telogen gravidarum,” he says. “Within a few months after pregnancy, a higher percentage of follicles than normal are in the

telogen phase. Regrowth can be slow and some of our postpartum hair loss patients complain of poor hair quality, dull hair, [and] brittle hair.”

However, hormones do not explain all postpartum hair loss.

“There’s also a multifactorial process occurring that includes emotional stress, physical stress, immune response, a healing response, and likely some nutritional gaps that could make this situation much worse for some, especially those who have preexisting conditions like strong hereditary hair loss in the family or genetic traits such as thin, fine, less dense hair [fewer follicles], or a previous history of telogen effluvium, either chronic or acute,” Bauman says.

It is important to reassure patients that postpartum hair loss generally is normal and temporary, according to Shepherd.

“I tell patients hair usually returns to its usual hair growth cycle between 6 and 12 months after birth,” she says.

Postpartum hair loss can take an emotional toll, especially given the changes and stresses after a baby is born. Patients unaware of the possibility of postpartum hair loss might find it shocking or worrisome, Shepherd says.

“Unfortunately, many doctors shrug off female hair loss in general and don’t understand the emotional connection between a woman’s hair and her well-being,” he says. “This is especially true about postpartum hair loss.”

Bauman starts the patient evaluation by taking a thorough history and doing a physical exam.

 and the new AI [artificial intelligence]-driven HairMetrix

 (Canfield Scientific) for a detailed hair growth analysis so we can establish a baseline and monitor over time. We recommend evaluations every 90 days,” Bauman says.

While there are a few treatment options for postpartum hair loss, Bauman says, it is important not to prescribe medications during pregnancy or nursing.

“Nonchemical, breastfeeding-friendly therapy must support the mom’s body and mind, as well as not affect breast milk or the baby,” he says. “Nutrition, self-care, feeling calm, [and] getting rest are all part of the equation. Taking a multitherapy and holistic approach may be preferred.”

As part of his emphasis on self-care, Bauman’s practice offers scalp makeover treatments, performed by a certified trichologist.

“These became exceptionally popular during the pandemic as a safe and relaxing, mentally transporting experience that also helps maintain healthy hair and scalp by addressing scalp inflammation and cortisol levels. A Keravive

 [HydraFacial] exfoliation combined with a scalp massage is therapeutic but also extremely relaxing,” he says.

Nutritionally, since many women continue their prenatal vitamins in the months immediately following childbirth, Bauman says, he is careful not to overdo nutritional recommendations. He recommends supplements, including Nutrafol Postpartum

(Nutraceutical Wellness Inc), which is breastfeeding-friendly, works with prenatal vitamins and addresses the stress/cortisol component of shedding. He also recommends theanine and shatavari, which are herbs and stress adaptogens to help with stress hormones and relaxation, specifically for female physiology, according to Bauman.

At-home laser therapy devices can help, Bauman says. They are nonchemical, noninvasive, and convenient. Plus, today’s options deliver more energy to larger areas of the scalp in less time, he says.

“Avoid weak, clunky-plastic consumer devices and stick to physician-prescribed devices that have over 300 diodes,” he says. “You get what you pay for on this.”

Platelet-rich plasma (PRP) is among the most aggressive of the minimally invasive treatments, and local anesthesia is not an issue for nursing, according to Bauman, who cites a published report in Stem Cell Investigation.

Shepherd, who is unlikely to recommend treatment for postpartum hair loss for up to 1 year after childbirth, says she might recommend PRP if hair loss continues past that point.

“PRP injections are a good avenue because the treatment does not impact moms who are breastfeeding,” she says.

Most importantly, doctors must leave patients feeling reassured that postpartum hair loss will most likely straighten itself out on its own, and give women the time to revert to a normal hormonal status, Shepherd says.

Bauman and Shepherd report no relevant disclosures.

1. Haircheck. Haircheck. Accessed August 9, 2021. http://www.haircheck.com/for-the-trade/ 

2. HairMetrix. Canfield Scientific. Accessed August 9, 2021. https://www.canfieldsci.com/imaging-systems/hairmetrix/

3. The scalp health solution: Hydrafacial Keravive. Hydrafacial. Accessed August 9, 2021. https://hydrafacial.com/keravive/

4. Nutrafol Postpartum. Nutraceutical Wellness Inc. Accessed August 9, 2021. https://nutrafol.com/nutrafol-postpartum-for-women/

5. Garg S, Manchanda S. Platelet-rich plasma-an ‘elixir’ for treatment of alopecia: personal experience on 117 patients with review of literature. Stem Cell Investig. 2017;4:64. Published July 18, 2017. doi:10.21037/sci.2017.06.07

Postpartum hair loss can cause acute emotional burden, according to Alan J. Bauman, MD, ABHRS, FISHRS, and physicians must be aware of the considerations needed for this patient group.

Expert Advice: Don’t Shrug Off Postpartum Hair Loss

Most reported adverse events (AEs) associated with cryolipolysis (CoolSculpting; Allergan) treatment are minimal and transient. But there are a handful of potentially serious complications from the popular noninvasive body contouring option.

The most common and relatively mild AEs of erythema, numbness/paresthesia, bruising, and edema are to be expected from a technology that freezes subcutaneous adipose tissue, according to Bobak Hedayati, MD, dermatology resident at University of California (UC) Irvine and first author of a systematic literature review of cryolipolysis-associated AEs published last year in 

In the review, the less-serious common AEs developed within a week of treatment and resolved spontaneously, according to the authors.

“The meat of our study was to look for those uncommon or rare complications that are possible,” Hedayati says.

In their review of 53 articles and a total 3,312 cryolipolysis patients, Hedayati and colleagues found the more serious AEs (SAEs) associated with cryolipolysis were: dysesthesia—including increased sensitivity, tingling or burning in 59 patients—delayed, severe, or persistent pain in 49; paradoxical adipose hyperplasia in 30; skin blanching in 15; vasovagal reactions in 14; skin hyperpigmentation in 8; and contour irregularities in 3 patients. Nerve injuries also occurred in some patients.

A Closer Look: Paradoxical Adipose Hyperplasia

Less than 1% of cryolipolysis patients develop paradoxical fat hyperplasia, an unexpected increase in the number of fat cells, according to the American Society of Plastic Surgeons website.

Paradoxical fat hyperplasia is three times more common in men than in women and is seen more in those of Hispanic or Latino descent, according to the American Society of Plastic Surgeons.

“This is a serious complication in the sense that it does not go away on its own,” Hedayati says. “It is a benign tumor of the fat cells. All the cases in our review had to be treated with liposuction.”

There is evidence that some patients with paradoxical adipose hyperplasia resolve without treatment, according to a 2018 paper published in 

 Investigators studied 398 patients who each had a session of cryolipolysis, 4 of which presented with voluminous painless swelling in the treated area between 2- and 4-months posttreatment. While 1 patient was treated with liposuction, the other 3 did not receive any additional treatment and their symptoms stabilized after several months, according to the authors

 of nearly 8,700 cycles of cryolipolysis in 2,114 patients, investigators reported paradoxical adipose hyperplasia incidence rates of 0.05% to 0.39%. However, incidence rates fell by more than 75% with new CoolSculpting units, according to the 2021 paper.

 Italian investigators reported that transitioning from the CoolSculpting CoolCore system to the CoolAdvantage applicator system had no impact on safety but led to greater versatility and increased numbers of cycles per treatment.

“There were only 2 significant complications: 1 paradoxical adipose hyperplasia (with CoolCore) and one loss of sensation (with CoolAdvantage),” the authors wrote.

Some suggest paradoxical adipose hyperplasia can result from improper use of the device—not freezing an area long enough or not latching on well enough to the treatment site to achieve adipose tissue apoptosis, according to Hedayati.

Nerve injuries post-cryolipolysis are also more likely to occur with improper or inappropriate use of the CoolSculpting device, says study author Margit Juhász, MD, MSc, a dermatology resident at UC Irvine.

“It’s very rare to have nerve pain or numbness that lasts for more than a week after cryolipolysis,” Juhász says.

study included a case where a patient treated with CoolSculpting on the upper arm developed a radial nerve injury leading to weakness in the wrist and finger extension. The patient’s motor function was restored 6 months later with no additional treatment.

One possible reason for the complication, according to Hedayati, was the patient was thin and might not have had enough adipose tissue on the arm to indicate cryolipolysis.

“The radial nerve runs pretty superficially to the skin, so a skinnier person may have a higher risk of damaging those superficial nerves,” she says.

Additional complications written in the review included separate patients reporting left mandibular nerve injury, throat swelling, and hoarseness after submentum cryolipolysis.

Post-inflammatory hyperpigmentation from cryolipolysis occurred from 2 days to 3 months after treatment and resolved in 7 of the 8 patients within a year. There was 1 report of unresolved skin hyperpigmentation that lasted more than a year and was treated with nonablative laser therapy, according to the review.

There was an additional complication reported in the literature, Hedayati says, that did not make it into the review. It was a case of cryolipolysis-induced morphea in a 67-year-old woman from a single CoolSculpting session. Six weeks later, she had multiple firm, thickened sclerotic plaques on her lower abdomen and inner thigh, according to the 

“The patient's lesions subsequently spread to her bilateral labia majora, causing severe ongoing pain and allodynia,” the authors wrote. “She was treated with a tapered course of prednisone (40 mg/d; dose decreased by half every 2 weeks), 20 mg once weekly of methotrexate, and 1 mg daily of folic acid. Her topical regimen was amended as follows: tacrolimus 0.1% ointment (Protopic; LEO Pharma INC) twice daily during the week and halobetasol propionate 0.05% ointment (Ultravate) twice daily on the weekends. Over 3 months, she had significant clinical improvement; her lesions resolved with hyperpigmentation, and she had a subsequent decrease in pain.”

Cryolipolysis is safe when performed by a health care professional who is experienced and well-trained in its use, according to Hedayati.

Recent statistics suggest CoolSculpting is increasing in popularity. Noninvasive fat reduction—including Coolsculpting, Liposonix, Emsculpt, Vanquish, and Zerona—was the eleventh most popular minimally invasive cosmetic procedure in 2020, with nearly 358,000 performed, according to the 2020 Plastic Surgery Statistics Report by the American Society of Plastic Surgeons.

In many cases, even the more serious AEs tend to resolve on their own, Hedayati says.

“If you compare cryolipolysis to liposuction, which is a more invasive version of adipose tissue removal, the side effect profile of cryolipolysis is much better,” Juhász said. “Death has been reported with liposuction but not with cryolipolysis. With advancing technology in cryolipolysis, I think that we are probably going to see less of the erythema, transient pain, and temporary nerve deficits associated with treatment. But I don’t think side effects will ever totally go away, no matter how advanced the machinery gets.”

Hedayati B, Juhász M, Chu S, Mesinkovska NA. Adverse events associated with cryolipolysis: A systematic review of the literature. 

. 2020;46 Suppl 1:S8-S13. doi:10.1097/DSS.0000000000002524

Nonsurgical fat reduction. American Society of Plastic Surgeons. Accessed August 9, 2021. 

https://www.plasticsurgery.org/cosmetic-procedures/nonsurgical-fat-reduction/cryolipolysis

Stroumza N, Gauthier N, Senet P, et al. Paradoxical adipose hypertrophy (Pah) after cryolipolysis. 

https://pubmed.ncbi.nlm.nih.gov/29145587/

Nikolis A, Enright KM. A multicenter evaluation of paradoxical adipose hyperplasia following cryolipolysis for fat reduction and body contouring: a review of 8658 cycles in 2114 patients. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279305/

Gualdi A, Gatti J, Bertossi D, et al. Evolution of the treatment approach to cryolipolysis using the CoolAdvantage applicator family: results from a retrospective database review. 

https://link.springer.com/article/10.1007/s00238-021-01789-2

Ladha M, Poelman S. Cryolipolysis-induced morphea. 

https://www.jaadcasereports.org/article/S2352-5126(19)30023-2/fulltext

Plastic Surgery Statistics Report. American Society of Plastic Surgeons. Accessed August 9, 2021. 

https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf

When used incorrectly or inaccurately, cryolipolysis can, in rare cases, result in SAEs including dysesthesia, pain, paradoxical adipose hyperplasia, skin blanching, vasovagal reactions, skin hyperpigmentation, contour irregularities, and nerve injuries.