When one is affected with PAH post CoolSculpting, is it obvious?

Thank you for your question and I’m sorry you haven’t seen positive results from your CoolSculpting treatments thus far. Paradoxical adipose hyperplasia is an extremely rare side effect of this procedure that is characterized by a large pocket of hardened fat. Smaller bumps are not a common symptom. 
I recommend scheduling a follow-up with a board-certified dermatologist who can assess you in person and determine whether CoolSculpting is the right choice for you. This procedure does require expertise and precision when it comes to placement of the applicators and proper settings to achieve the best possible results. A board-certified dermatologist with expertise in this treatment can determine whether the process needs to be adjusted or if another treatment would offer better results for you. 

Hello and thank you for your question. PAH is rare, but can occur after Coolsculpting. Any physician providing this treatment should be aware of this complication. With your weight staying generally the same, this could be a few things, either a cyst or small area of PAH. Your physician would need to examine you. PAH usually does not present as lumps but rather a larger, diffuse area. I hope that this helps and wish you the best of luck.

I understand your concern, particularly in light of the fact that you haven’t seen great results from your CoolSculpting treatments so far. Rest assured that paradoxical adipose hyperplasia or PAH is a very rare complication from CoolSculpting and the symptoms you are describing do not match the condition. PAH presents as a hard area of localized fat. It is not characterized by the small lump you have. 
I would say that it’s unusual for a doctor performing CoolSculpting to be unaware of PAH. Although it is rare, it is directly associated with this device and providers should be aware of the risk, no matter how slight. Based on that and your less-than-stellar results, I might suggest scheduling a consult with another board-certified dermatologist with expertise in non-surgical body contouring to see if you can’t achieve a better outcome.