Is it possible to develop paradoxical adipose hyperplasia in one area only after all other areas treated had no issue?

Hyperplasia is rare but can occur in any areas of coolsculpting. Moderate swelling, which can be asymmetrical, is normal after Coolsculpting and should resolve in several days to weeks. Coolsculpting results can take up to 3-4 months. For best results with Coolsculpting, I recommend a combination approach.  I recommend adding radiofrequency treatments like Vanquish, Venus Legacy, Exilis Ultra for skin tightening and with Z wave/Cellutone for skin smoothing. VASER with ThermiRF is the best alternative if you want a more contouring outcome.  If you have someone that has PAH you should send them to a physician like myself that treat this complication with liposuction.Best, Dr. Emer

It would appear that there are two issues here. First, PAH(Paradoxical Adipose Hyperplasia) is extremely rare, and only presents in .01% of patients(1 in 10,000) treated with CoolSculpting, and would most likely not be seen until around 90 days post treatment.  But, to answer your question from a strictly medical perspective, and in no relation to your situation, it is possible to get PAH in only one area, even if other areas have proven to be fine post treatment.  The most common area would be in the abdomen, and PAH is rarely ever seen in other parts of the body. At
At the time of posting this inquiry, you are one day post treatment  and this much too soon to even begin to think about PAH as a possible outcome.  Post treatment, It is very typical that an area will be swollen on one arm and not the other, or one area may feel harder than the other.   This is very common and is not in any way a determination that PAH is going to be the outcome. Give yourself some time to see what is really going to happen after these latest treatments. It would be a good idea to have a follow up visit with your Coolsculpting provider after 1 month or around 6 weeks. Good luck with your results, and thank you for your question!