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Is There a Negative Side to CoolSculpting?

Aug 7, 2020 | Body

When individuals want to treat small pockets of fat in certain areas, they often turn to noninvasive CoolSculpting® to get the appearance they want. Instead of using incisions to remove unwanted fat, this procedure uses cooling technology that does not damage or cause scarring in the skin. Before getting CoolSculpting in Beverly Hills, CA, however, patients should be aware of all the potential risks and negative consequences of the procedure, including paradoxical adipose hyperplasia (PAH).

So what is paradoxical adipose hyperplasia, and what does it mean for people seeking fat reduction in the abdomen or hips? When you see board-certified plastic surgeon Dr. Jaime Schwartz, we can review what causes paradoxical adipose hyperplasia, the most common symptoms, and effective treatment options. Learn more about PAH by scheduling a consultation with one of our team members today.


To understand what causes paradoxical adipose hyperplasia, it is important to know how CoolSculpting works first. This fat-freezing procedure is cleared by the FDA to eliminate fat using a process called cryolipolysis. During the procedure, no local anesthetics or pain relievers are needed. The CoolSculpting device is first positioned on the body where the patient wants fat reduction. The device then targets and kills off the extra fat cells. Once the cells die, our bodies process them over a period of a few months, resulting in a slimmer appearance.


For the most part, CoolSculpting has a strong record of safety among patients. The majority of individuals experience mild side effects, such as redness and numbness, which resolve after a few days. However, patients should be aware of a rare complication that may occur as a result of this fat removal treatment. So what is paradoxical adipose hyperplasia?

Cryolipolysis is designed to cool tissue to the point where fat cells disintegrate and leave the body as waste. In a small number of cases, the fat in the treated areas expands and hardens in response to the cold temperature. So instead of shrinking down, CoolSculpting causes the area to enlarge and become firmer than the surrounding tissue. This is what is known as PAH.


After teaching patients about what causes paradoxical adipose hyperplasia, Dr. Schwartz informs individuals about the symptoms. Even though PAH affects one out of 20,000 people, there is no guarantee that individuals will or will not get this condition after CoolSculpting treatment. Paradoxical adipose hyperplasia symptoms include some discomfort in the treated area, including tenderness when touched. CoolSculpting should not cause any pain, so call a physician right away if this is the case.

The most obvious symptom is the appearance of a growth in the treated area, usually within 1 – 2 months of your cryolipolysis session. The lump generally looks like a stick of butter, just like the shape of the CoolSculpting applicator. However, the shapes and sizes may vary among patients. It may even appear as if you have gained weight over a short period of time. If you have been maintaining a healthy lifestyle with diet and exercise, and experience signs of weight gain, contact your doctor for a visit right away.


Once individuals are diagnosed with paradoxical adipose hyperplasia, Dr. Schwartz will present them with several treatment options. Since diet and exercise will not address PAH, it needs to be removed through a liposuction procedure. Patients should wait for 6 – 9 months in Beverly Hills, CA for the fat to soften before the area can be addressed, however.

Treatment for paradoxical adipose hyperplasia uses a special technique to smooth out the skin and break down the fat cells. If this is not effective, we may suggest more invasive surgery to remove the harder fat cells. Keep in mind that this situation is rare, and PAH usually responds well to minimally invasive liposuction.


CoolSculpting is a generally safe way to slim down areas with stubborn pockets of fat and improve hard-to-reach places that are not affected by diet or exercise. If you are unsure about the negative effects of CoolSculpting, we encourage you to contact our office for more options in Beverly Hills, CA. Dr. Board-certified plastic surgeon Dr. Jaime Schwartz is well-versed in all aspects of CoolScuplting and the process of cryolipolysis. We are also happy to teach you about treatment for paradoxical adipose hyperplasia if you experience hard, fatty areas as a result of CoolSculpting.



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