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. 

PAH usually is a delayed outcome that is very distinct in presentation. What you describe doesn't seem like it is that however without a picture or physician assessment I can not guide you for sure. I would recommend seeing your provider for an assessment to check on it. In the cases we have seen in our business it is thick, fibrous feeling, in the exact shape and location of where the applicator was placed. best of luck!

Thank you for your question.
PAH is not rare after Cryo Lipolysis and is being increasingly recognized. You should have your Plastic Surgeon examine you and see if it has indeed occurred. The treatment, fortunately is fairly straight forward. Most people respond very well to Liposuction alone. Please discuss all your concerns with your Plastic Surgeon who can help you. All The Best !

I appreciate your concern and your question. Let me assure you that PAH is extremely rare, and the symptoms you are describing are not commonly associated with PAH. I do find it interesting that the doctor that performed your CoolSculpting treatment is not familiar with PAH, however. Since you have also had two ineffective CoolSculpting treatments with this provider, I recommend you find a board-certified dermatologist that specializes in non-surgical body contouring treatments like this. Through a thorough consultation and discussion of your concerns and goals, you should receive a treatment that is effective for you.

Dear KOC23Thank you for your question!  PAH can present in different ways .  It is difficult to assess what your condition is - without seeing you and seeing pre photos .With Warm RegardsTrevor M Born MD

PAH is a rare occurrence (

Paradoxical Adipose Hyperplasia, also known as PAH, is a rare complication that can occur after a CoolSculpting procedure. When PAH occurs, it is typically characterized by a large, firm and heavy area that appears where the CoolSculpting applicator was placed. The only way to treat PAH is with liposuction to remove the buildup. 

Although PAH is very rare with an incident of 0.0051%, doctors that perform the procedure should be aware of what PAH is and how to identify it. If your doctor is not familiar with the condition, and if you have not been satisfied with the results you have achieved thus far, it might be time for a second opinion. I recommend scheduling an in-person consultation with a board-certified dermatologist who has extensive experience in the CoolSculpting treatment to determine the right treatment plan for you. 

Thank you for the question. PAH is rare condition secondary to CoolSculpting. It can be treated by liposuction and it is best to consult with a board certified plastic surgeon. Good luck.