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Can I Minimize the Chance of PAH After CoolSculpting?

Nov 3, 2021 | Body

Sometimes getting smoother body contours can be difficult, especially with diet and exercise alone. CoolSculpting® is an excellent noninvasive procedure that can help you achieve the body of your dreams. This advanced treatment uses cryolipolysis to freeze and get rid of unwanted fat in areas like the abdomen and thighs.

When it comes to CoolSculpting, some patients are concerned about a rare condition called paradoxical adipose hyperplasia, or PAH. Even though it happens in less than 1% of cases, it is important for patients to be informed. Call Beverly Hills plastic surgeon Dr. Jaime Schwartz to find out what is paradoxical adipose hyperplasia and what to do when it occurs.


CoolSculpting has a good record in terms of safety and efficiency. In fact, many patients see a 2 – 25% fat reduction in just three months. Our patients not only love the results but also the short recovery time compared to traditional cosmetic surgery. Common side effects of CoolSculpting include temporary redness and tingling. So, what is paradoxical adipose hyperplasia? PAH happens when the fat freezing process causes the tissue to thicken and expand instead of breaking down. This CoolSculpting complication is usually confirmed about six months after the original procedure.


Patients can rest knowing that most side effects of cryolipolysis are mild and not noticeable in the days following treatment. Most individuals can return to their normal schedules shortly after their session. Paradoxical adipose hyperplasia, however, does not go away by itself and needs to be examined by an experienced board-certified plastic surgeon. PAH causes the treated area to get bigger and firmer than the surrounding areas, having a “stick of butter” appearance similar to the shape of the CoolSculpting applicator.

Other signs of this CoolSculpting complication include:

  • Uneven fat distribution

  • Hard knots of tissue around the treatment area

  • Exaggerated fat in specific treated areas

  • Visible deformities of the tissue


Even though paradoxical adipose hyperplasia is not life-threatening, it can be embarrassing or frustrating in social situations. Dr. Schwartz can have this excess tissue removed so you get the original results you were looking for. Undergoing additional CoolSculpting sessions is not the answer. Liposuction can remove any unwanted CoolSculpting complications and help you achieve a natural, sculpted area.

So, how do you prevent paradoxical adipose hyperplasia after CoolSculpting? Keep in mind that Dr. Schwartz only recommends cryolipolysis for patients who are in generally good health and are aware of the risks involved. During your initial assessment, we will review your health history and address any questions you may have. This will minimize your chances of getting PAH as much as possible.


CoolSculpting is not your average body contouring procedure. Most cosmetic treatments that remove fat require lasers or extensive surgery, which can leave the surrounding tissue damaged. Cryolipolysis is one of the safest ways to feel good about your body again. If you are concerned about paradoxical adipose hyperplasia, contact Beverly Hills plastic surgeon Dr. Jaime Schwartz. During your initial meeting, we can talk about your expected side effects and results. We can also diagnose and treat your PAH symptoms in our office. 



Beverly Hills Office

240 South La Cienega Boulevard
Suite 200
Beverly Hills, CA 90211

Phone: 310-882-5454