I had the Coolsculpting done, and I ended up with PAH and they brought me back on for another round, was a redo a mistake?

Doctor Answers 8

PAH following Coolsculpting

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It depends on whether the correct diagnosis was made. If you do not get the results you expected after the second session, you should try selective liposuction, using ultrasonic liposuction. Good luck.

Birmingham Plastic Surgeon

I had the Coolsculpting done, and I ended up with PAH and they brought me back on for another round, was a redo a mistake?

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Thank you for a question. Sorry to hear that. The only way to treat PAH after CoolSculpting is Liposuction, which may even be covered for by Zeltiq themselves. Speak to your chosen provider. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 519 reviews

Hyperplasia After Coolsculpting -- Only VASER HI DEF

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Hyperplasia will not improve from more coolsculpting.  Liposuction, specifically hi def sculpting is needed due to the fibrosis that occurs.  Please see an expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Paradoxical Adipose Hyperplasia After CoolSculpting

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Was this confirmed to be PAH by your treating physician and Zeltiq? In true cases of PAH no further CoolSculpting should be done. Treatment involves liposuction. In true cases, Zeltiq often covers the cost of the liposuction. 

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 reviews

PAH and Coolsculpting

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PAH should not be treated with Coolsculpting.  I would recommend liposuction or some other modality.  Please consult an expert.  Best, Dr. Green


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Dear nikkitay:

I am so sorry hear that you are one of the very few to have have developed this rare side effect from CoolSculpting.  Our understanding of the reasons for this event is incomplete, but I believe it is related to an alteration in normal adipocyte (fat cell) turnover.

All of us are born with a certain number of adipocytes. When we gain weight, each cell enlarges; when we lose weight, each adipocyte gets smaller.  However, in those individuals who have gained a significant amount of weight (eg, are obese), the number of fat cells needs to increase to accommodate the fat that needs to be stored, so the adipocytes are in a proliferative state. It appears that these individuals may be at risk for PAH.

I have been told that Zeltiq has paid for liposuction for the few patients to develop this side effect. Perhaps it would be worthwhile to ask your doctor if this is still the case. In any case, this should be reported to Zeltiq so that we can gain a better understanding of why this very rare event happens, and prevent it from occurring in our patients. I would be grateful if you could provide the particulars  of your case to me by contacting me through RealSelf or my website. 

Sheryl D. Clark, MD
New York Dermatologist
4.7 out of 5 stars 10 reviews

PAH Post Cool Sculpting

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Thank you for your question.
If a patient develops PAH after a non-surgical fat reduction treatment, it may be an indication that you are a better surgical liposuction candidate.
As physicians are victims of their training, you could see several MDs and get various opinions.
Your experience after your first session would suggest an alternate solution.
Best wishes.

Greg Chernoff, MD
Indianapolis Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Paradoxical Adipose Hyperplasia

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When a patient experiences Paradoxical Adipose Hyperplasia, it's not something you can CoolSculpt. It is correctable only by liposuction. Without any pictures or an assessment there's no way of telling.

Robert G. Aycock, MD, FACS
Bay Area Plastic Surgeon
4.7 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.