After coolsculpting developed pah what is the best way to remedy this

Doctor Answers 10

PAH is rare but treatable with Liposuction

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I'm sorry to hear that you have developed PAH, or paradoxical adipose hyperplasia. This is an uncommon adverse event after CoolSculpting and appears to occur in one out of 4000-5000 people. I would follow-up with the provider who treated you with CoolSculpting and review your current photos along with the pre-treatment photos. Once a diagnosis of PAH is confirmed, then Zeltiq can help to provide assistance for you to find and have liposuction to treat the area of hyperplasia. Good luck!

Warren Oculoplastic Surgeon


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PAH or Paradoxical Adipose Hyperplasia is not a common outcome after coolsculpting. However, if this has occurred, I would  recommended that you see a board certified plastic surgeon that will evaluate the area and see if liposuction is necessary.

Steven H. Dayan, MD
Chicago Facial Plastic Surgeon
4.3 out of 5 stars 33 reviews


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Paradoxical Adipose Hyperplasia (PAH) is a rare occurrence after cool sculpting.  Unfortunately, at this point I think the only remedy is probably localized Liposuction.  You should coordinate with the practice that performed your cool sculpting treatment and let them recommend someone to evaluate you for actual liposuction.  The cost of this can normally be paid for by Zeltiq, the maker of the cool sculpting equipment.  These  company is also eager to know when these events occur so be sure and follow up on this.  I am sorry that you experienced this unusual occurrence.  Good luck.  Adrienne Stewart M.D. FAAD

Adrienne E. Stewart, MD
Denver Dermatologic Surgeon

After Coolsculpting

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If you haven't already done so, definitely follow up with the office that treated you.  Not only is it important for them to know in general but they can work with you, along with Zeltiq, to get the area corrected.  As of yet, liposuction is really the only way to get rid of paradoxical adipose hyperplasia. Best of luck

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Paradoxical adipose hyperplasia after Coolsculpting

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Hi jg1113,
We published a paper on this rare phenomenon. It can only be corrected with liposuction. It's best to first speak with your treating doctor about this complication. Best of luck.

Elizabeth Geddes-Bruce, MD, MS
Austin Dermatologic Surgeon

PAH after Cool Sculpting

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Please seek a BC Plastic Surgeon to evaluate this. If you want Zeltiq to help make sure you have your before photos, treatment notes and settings. Although not a common side effect it is a known risk of Cool Sculpting. Best of Luck. 

Timothy Treece, MD, FACS
Columbus Plastic Surgeon
4.5 out of 5 stars 24 reviews

Possible PAH

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PAH is usually seen after 5-6 months after a CoolSculpting treatment. The only way to correct PAH is to have liposuction. If the office is a board certified plastic surgeon, then have a consultation for liposuction and also call Zeltiq to report the case.

Robert G. Aycock, MD, FACS
Bay Area Plastic Surgeon
4.7 out of 5 stars 16 reviews

Coolsculpting and paradoxical adipose hyperplasia

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Liposuction is the only way to fix paradoxical adipose hyperplasia. To minimize the risks associated with Coolsculpting ensure that the treatments being performed at a Certified Coolsculpting Practice under a direct supervision of a Board Certified Surgeon with expertise in both liposuction and Coolsculpting. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

After coolsculpting developed pah what is the best way to remedy this

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Thank you for your question. Liposuction is the only way to treat paradoxical adipose hyperplasia. Please speak with your provider and they will help connect you to Zeltiq. Regards,

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 518 reviews

Paradoxical Adipose Hyperplasia

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Liposuction is the only way to fix paradoxical adipose hyperplasia.  Check with your provider and Zeltiq to see if they can help you with this.

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.