I had coolsculpting a year ago and was left with 3 rock hard, golf ball size nodules? (Photos)

The office who treated me did 10 to 15 treatments of Zeltiq, and 6 Vanguish but it did not help with the hard balls. They have offered to retreat with Coolsculpting but I am extremely nervous, and don't want to make things worse. The Dr is not sure what the lumps are, but doesn't think it's the very rare hyperplasia. Is lipo my safest option at this point?

Doctor Answers 9

Nodules after CoolSculpting

It is difficult to evaluate the nodules without an in person examination. It is possible to form inflammatory nodules after CoolSculpting treatment. Typically, they resolve in a few months. I would not have any more Coolsculpting until they resolve. 


Summit Emergency Medicine Physician
5.0 out of 5 stars 24 reviews

Nodules after CoolSculpting

  Dear Tricia billings:

  Nodules after CoolSculpting are rare but in the last have always resolved without further treatment, and generally quickly. I suggest that you avoid any further treatments until these resolve.  You might consider asking your doctor to have someone from Zeltiq evaluate you as well.

   All the best,   Dr. Clark 

Sheryl D. Clark, MD
New York Dermatologist
5.0 out of 5 stars 7 reviews

Nodules post Coolsculpting treatment

In reviewing your photos it is hard to determine what the nodules or lumps may be. I suggest you have  in person consultation with a board certified Dermatologist of Plastic Surgeon to see what the best options would be. I would not suggest having Coolsculpting in these areas again, as Coolsculpting targets pinchable fat.

Steven H. Dayan, MD
Chicago Facial Plastic Surgeon
4.2 out of 5 stars 22 reviews

Persistent hard lumps after CoolSculpting

It is possible that you are describing paradoxical adipose hyperplasia (PAH), a rare complication of cryolipolysis (0.0051% incidence in one study). If that is the case, further CoolSculpting is not recommended. I would recommend evaluation by an expert who can confidently diagnose your condition. PAH does not resolve on its own and liposuction (e.g. ultrasound-assisted VASERlipo) has been shown to be an effective treatment.

Nodules from Coolsculpting

It is difficult to evaluate the nodules without an in patient examination.  I would not do Coolsculpting again for this area as it sounds like paradoxical hyperplasia.  Please consult an expert.  Best, Dr. Green

Hard Nodules After CoolSculpting

It is possible to form inflammatory nodules after CoolSculpting treatment, however, these usually fully resolve within a matter of months. It is rare to have them a year after treatment. You would need an in-person examination to fully evaluate these nodules. I would not recommend additional CoolSculpting treatments. Liposuction may be an option. Best wishes.

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 9 reviews

"Hard nodules" not likely to go away with CoolSculpting

It isn't entirely clear from your photos where or what these hard nodules are.  That being said, it is unlikely that any kind of hard nodule beneath the skin would go away with CoolSculpting, since this treatment specifically targets fat.

Jill C. Fichtel, MD
Columbus Dermatologic Surgeon
5.0 out of 5 stars 16 reviews

Nodules after Coolsculpting

I would try using the Zimmer Z wave for these. This device can break these up. It causes shock waves to go thru the area and increased circulation. There is no downside to it. I don't think that Coolsculpting is the way to go. Another device is the Exilis. This uses RF and can help with these as well. A combo with the Z Wave would give best results.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Need to compare photos before and after

I guess your photos before and after are necessary. Are the photos posted above are after?  It would be very important to compare your photos before and after.

I was told hyperplasis very rare in which case your lumps could be liposuctioned safely; it would be covered by Zeltiq since this is very unpredictable .

Hope this answer helpful.

Good luck!


Mi Ran Park, MD
San Jose Family Physician

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