Great question — and you're definitely not alone in asking this! The short answer is no, 59 is not too old for liposuction, especially if you are in good overall health and have realistic expectations. However, there are some important things to consider, particularly in your case with possible Paradoxical Adipose Hyperplasia (PAH) and your concerns about skin laxity. 1. Addressing Paradoxical Adipose Hyperplasia (PAH) PAH is a known, though rare, complication of CoolSculpting, where the treated fat actually grows instead of shrinking. It can result in firm, lumpy areas of fat that do not respond to diet, exercise, or further non-invasive treatments. The most effective treatment for PAH is usually liposuction or sometimes surgical excision, depending on the severity. Since you're not 100% sure you have PAH, it would be smart to consult with a board-certified plastic surgeon who is familiar with post-CoolSculpting complications. They can do an in-person assessment and confirm whether you are dealing with PAH or just stubborn fat and skin laxity. 2. Liposuction at 59 — What to Expect • Fat removal itself is not age-limited. However, skin elasticity tends to decline with age, so the skin’s ability to “snap back” after lipo will likely be reduced. • You’re correct that removing fat from areas like the inner thighs, banana roll, and abdomen could leave behind some sagging skin. • That’s why many surgeons combine liposuction with skin tightening procedures, especially for patients in their 50s and 60s. 3. Options for Skin Tightening with Lipo There are several ways to improve skin tone after liposuction, including: • Renuvion (J-Plasma) — This is a very popular minimally invasive skin tightening treatment often done alongside lipo. It uses radiofrequency (RF) energy combined with helium plasma to contract and tighten skin. • BodyTite — Another RF-assisted liposuction (RFAL) technology that can shrink and firm skin while removing fat. • Morpheus8 Body — This is a non-surgical option that uses microneedling with radiofrequency to tighten skin. It’s often done in the months following liposuction to further enhance results. • Surgical options (if skin laxity is significant) — In cases of severe sagging, a thigh lift, tummy tuck, or other skin excision procedures may be necessary to get the smoothest result. 4. What’s Realistic at 59? You can absolutely improve your shape and contour with lipo + skin tightening, but it’s important to set realistic goals. A skilled surgeon will: • Tailor the procedure to your skin type and age. • Combine techniques (lipo + skin tightening) to get the best results. • Be honest about the potential need for more invasive skin removal procedures if tightening alone isn’t enough. 5. Next Steps • Consult with a plastic surgeon experienced in treating PAH and working with older patients. • Ask about combining liposuction with skin tightening tech like Renuvion or BodyTite. • If your skin is already quite loose, consider whether a lift might be a better option (thigh lift, mini tummy tuck, etc.).