Fat hyperplasia after CoolSculpting: How much would corrective procedure (lipo) cost and what is the recovery time? (photos)

I believe I have paradoxical adipose hyperplasia after cryolipolysis aka CoolSculpting and as you can see in my photos, the treated areas (arms, abdomen, sides, outer thighs) became more enlarged. I am looking for a plastic surgeon who has experience with this kind of situation. I know that the solution is liposuction, but I am worried about loose skin afterwards. Any thoughts?

Doctor Answers 5

Worse After Cool Sculpting

Dear Bride25, You need to be evaluated from your center. In your area I would seek help from Dr. Grant Stevens who was my mentor and very well experienced in cool sculpting. I have personally treated 3 PAH clients in my practice (1 from our treatment center and then 2 referred to me from others in town who can't do surgery). I have had excellent outcomes treating this situation with liposuction. With that being said Zeltiq helped my client with the cost of my fee but if they hadn't I would have done him at no charge. If you went to a good center they will have your before and after photos, your pre and post treatment weight to assume you're comparing equal pictures and they'll ask for a physician assessment. So....1. GO back to your center for assessment 2. Hopefully you're at a board certified practice with a surgeon 3. If not, seek help with Dr. Steven's practice and see if they can help you. This is documented to occur in about 1 in 4000 treatments and something we discuss on every consult and have patient sign on their consent. I hope you were informed!

Best of Luck. 

Columbus Plastic Surgeon
4.9 out of 5 stars 65 reviews


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

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Paradoxical adipose hyperplasia after Coolsculpting

This happens a few times per 10,000 treatments. Liposuction will help this. A tummy tuck is needed to have best skin tightening and would be the best solution for you. Laser liposuction will tighten skin about 18% in some cases but needs to be done with regular lipo in your case. Cost is highly variable and I suggest seeing a few surgeons to get the best way to proceed.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

What? I'm WORSE after Coolsculpting?!?!

As Coolsculpting treatments reach into the millions, more stories of PAH seem to be circulating. The process of crylipolysis is effective and reliable at inducing programed cell death. If the reports of adipose hyperplasia continue this may represent an opportunity for further investigation. 

However, in cases where there is excess skin involved there may be a selection bias to treatment in patients where surgical excision of the skin along with fat removal may have been a preferable initial treatment. Thus, in such cases the PAH may be more an unmasking of the underlying problem and that simply liposuction alone may not achieve desired results. Skin excision with fat removal may be the optimal option. However, in selected patients delivering heat energy to the skin from a cannula may shrink the skin enough in conjunction with fat liposuctioning to achieve desired results

R. Brannon Claytor, MD, FACS
Bryn Mawr Plastic Surgeon
5.0 out of 5 stars 41 reviews

Fat Hyperplasia After CoolSculpting

Sorry to hear about your CoolSculpting experience. It is extremely rare to have fat hyperplasia in all areas that were treated. It usually occurs in the abdomen. Did you gain any weight since your treatments? I would make sure you follow up with your treating provider and have them contact the CoolSculpting company about this. If they determine that this is truly fat hyperplasia then often the company will cover the cost of your liposuction. Best wishes.

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