The patented cryolipolysis technique developed by Zeltiq to eliminate unwanted fat bulges is very safe. However, a very rare side effect is paradoxical adipocyte hyperplasia (PAH), in which more not less fat actually develops in the treated area. I’ve seen this only once in 6 years in which the patient developed a golf ball-sized area of fat after CoolSculpting. We know this tends to occur more commonly in men in the lower abdomen, although it can occur anywhere. It shows up a few months after CoolSculpting. At the present time, we really don’t know the factors that trigger this side effect, so I cannot tell you how to avoid it. Fortunately, it is very rare and it is treatable. Should it develop, we can treat it through traditional liposuction, injection or other non-invasive fat removing devices.