I had CoolSculpting 14 days ago on my flanks and now have hard swollen flanks. Is this normal?

Question

Both sides are hard and swollen, the bruising has gone down but the areas are still tender, inflamed, red, hard and warm. Pain was so bad day 1-6 I went to urgent care and they put me on prednisone and Vicodin for a few days. I got it done at ideal image and went back for a check up, they said it could be PAH but it’s very uncommon to have it happen this fast. Has anyone had a similar situation this early post treatment? Did it resolve?

Jason Emer, MD · Answer

Yes, swelling and/or firmness can be typical. Lymphatic massage may give improvement. Keep in mind, it will take 3-6 months for final results with Coolsculpting. For best results with Coolsculpting, I recommend a combination approach. I recommend adding radiofrequency treatments like Vanquish, Venus Legacy, Exilis Ultra for skin tightening and with Z wave/Cellutone for skin smoothing. VASER with ThermiRF is a great alternative. See an expert. Best, Dr. Emer

Christopher Dannaker, DO, MPH, FAAD · Answer

This is likely an exaggerated inflammatory response which has been described in the medical literature.  The inflammation and hardness (induration) typically slowly subsides in a few weeks, without treatment.  If it is severe, your physician may consider some treatment.  When this inflammation occurs,  the amount of fat reduction is often greater than the expected 25%, hypothesized due to increased destruction of fat from an enhanced inflammatory body reaction.  The cause is not currently known.  It is unlikely this will result in PAH but if it does it will usually occur within 3 months and never later than at 6 months after the treatment.  I'd expect an enhanced result and recommend you wait the full 4-6 months before accessing the end result.
Best Regards,
Christopher Dannaker, FAAD
Board Certified American Board of Dermatology and Preventive Medicine
Fellow, American Academy of Dermatology

I had CoolSculpting 14 days ago on my flanks and now have hard swollen flanks. Is this normal?

Answers (2)

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