How to determine if I have Paradoxical Adipose Hyperplasia, can diet and exercise reduce the enlarged area? (photo)

Paradoxical adipose hyperplasia is extremely rare, but I see this everyday in my practice.  Weight might play a role in this or fat was redistributed back to that area. In my practice I offer various treatment but I have seen the biggest change with the VASER hi def procedure as this type of fat is very fibrous and needs an energy based device to remove it.   Best, Dr. Emer.

I wish we know who was at risk for this but we don't.  I do let my patients know that if hyperplasia occurs (which it never has), I will perform liposuction on them for free... that is how rare it is. 
Best of luck,

Sheila Nazarian

Thank you for your question. It is difficult to tell from your photo. I would recommend speaking directly with your treating physician. If you do have paradoxical adipose hyperplasia, liposuction would be the only way to treat it. This would be covered by Zeltiq. Regards,

True Paradoxical Adipose Hyperplasia is extremely rare and happens in less than 1% of CoolSculpting treatments. In these cases the fat is usually more firm than before your treatment. Have you gained weight since your treatment? Did you follow up at the recommended intervals after your treatment  so that your progress could be tracked? If you haven't already, you should follow up with your treatment provider. These cases are submitted to Zeltiq's clinical department for further investigation. Best wishes.

This is an extremely rare side effect from coolsculpting. I have never seen it in my practice.  The only way to treat this is with liposuction.  You should be re-evaluated by your treating physician who can determine if this is truly paradoxical adipose hyperplasia. Coolsculpting has a protocol to document this and will usually cover any treatment that is needed to correct this.

Hi and sorry to hear that you are having problems after coolsculpting. I would recommend that you return to the practice where the coolsculpting treatment was performed. This practice can examine you, take photos, and submit this information to Zeltiq. If the company determines you have PAH they will offer liposuction treatment to you for correction of this problem. Make sure you see a surgeon who is certified by the American Board of Plastic Surgery if you decide to undergo liposuction. Good luck.Richard Chaffoo, MD, FACS, FICSTriple Board Certified Plastic Surgeon

This is a rare occurrence. It does look worse in the after photo. If you have gained weight, then it is due to that. Treatment options include liposuction or you might want to try Vanquish ME or Sculptsure. I don't have any studies on these after this problem but if you aren't up for lipo, they are an option. Obviously, diet and exercise will help most cases of excessive fatty deposits.

Paradoxical adipose hyperplasia is very uncommon but is known to happen in a small percentage of people who likely have different body metabolism. Coolsculpt is investigating this.  It is important for you to go back to the clinic where you had coolsculpt and have them evaluate you, take photos and submit them to the company along with your treatment record.Typically the way to correct this is with liposuction.