No, once fat cells are destroyed or removed, they cannot come back! Fat cells, or adipocytes, are derived from stem cells which stop forming during our teenage years. That is the reason why children who grow up obese are more likely to be obese as adults- they generated more fat cells! Once that process is complete, we have a finite number of fat cells in our body. The reason we change size is that fat cells are designed to store fat, so they can be tiny, or grow in size by a 100-fold or more! When we have a procedure that removes fat like liposuction, SmartLipo, or a tummy tuck, the fat cells can't come back. Similarly procedures like Coolsculpting and SculpSure which destroy fat cells and cause them to die and be removed by the body, also are considered permanent. However, remember that the fat cells that remain in the area or in untreated areas can still grow by 100-fold, so that is why it is important to maintain a healthy diet and weight after your fat-removing procedures! Hope this helps and best of luck on your journey!