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

I had one cool sculpting session seven months ago and I believe I am suffering from paradoxical adipose hyperplasia. What treatment options are available?

Doctor Answers 7

Coolsculpting

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


Beverly Hills Plastic Surgeon
4.9 out of 5 stars 51 reviews

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

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,

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 425 reviews

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

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, FICS
Triple Board Certified Plastic Surgeon

Richard Chaffoo, MD, FACS
San Diego Plastic Surgeon
4.7 out of 5 stars 16 reviews

VASER Hi Definition Liposuction / Body Contouring with Fat Grafting

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.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Paradoxical adipose hyperplasia from Coolsculpting options

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.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

Paradoxical Adipose Hyperplasia After CoolSculpting

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.

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

Paradoxical adipose hyperplasia

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.

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.