When our patients come to us for a consultation about fat removal, they often ask us about CoolSculpting. Our answer has always been that we don’t offer CoolSculpting (also known by its scientific term, Cryolipolysis), because in our experience it is much less effective than liposuction. It doesn’t remove the unwanted fat in one go but rather requires repeat treatments, it can be rather uncomfortable if not painful, and it simply doesn’t yield great results like liposuction. (Read more about liposuction vs CoolSculpting here.)

In addition, we have recently been learning about a disturbing – if relatively rare – side effect of CoolSculpting. CoolSculpting, it turns out, may not simply be less effective than better fat removal options such as liposuction. CoolSculpting can actually have a reverse effect on the areas treated, resulting in fat accumulation rather than reduction. Since an increase in fat is definitely not what you have in mind when thinking about fat removal options, we wanted to shed a little more light on this.

In a nutshell, and without using too much medical language, a 2014 study outlines several cases of patients who had an adverse side effect after their CoolSculpting treatment. This side effect was the accumulation of tissue in the area the fat freezing was performed. In these cases, there were notable enlargements of the abdomen instead of a reduction. This condition is called Paradoxical adipose hyperplasia or PAH. It is not yet known if there are any common risk factors, although it has been observed that this occurrence is more common in male patients. (To read the details about this study, we refer to this article for more information.)

CoolScupting has been very popular in recent years for several reasons. It is a non-invasive procedure, making it very attractive to those who shy away from full-on surgery such as a tummy tuck, or from even minimally-invasive surgical procedures such as liposuction. And CoolSculpting has also been very heavily marketed by the device manufacturer, prompting many doctor’s offices to include it in their offering to take advantage of the massive advertising push.

But it is important to remember that cryolipolysis aka CoolSculpting is a relatively new procedure whose risks and side effects are not yet fully understood. Although the observed incidences of hyperplasia are rare, they are very real cases of real people who thought they could make their bodies look better and instead faced additional problems. And it’s not entirely understood how to “fix” it if it happens. In those cases, the fat actually continues to accumulate, so there is no true resolution for the condition.

Until this procedure is better understood, we would not want to take the chance of undergoing it ourselves. Would you?

Our plastic surgeon, Dr. John Rosdeutscher, prefers to continue using liposuction to help patients remove unwanted and stubborn pockets of fat. It has been a successful and low-risk procedure for decades, and the patient outcomes speak for themselves. Even though PAH as a negative outcome of CoolSculpting needs further research, it has been shown that liposuction as well as tummy tucks can be used to treat it. If you have previously undergone CoolSculpting and have experienced hyperplasia, please schedule a consultation at NuBody Concepts so that we can help you develop a treatment plan.

And if you haven’t undergone CoolSculpting, we highly recommend our Aqualipo procedure as the safest most effective fat removal solution.



Jama Network: Paradoxical Adipose Hyperplasia After Cryolipolysis

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NuBody Concepts helps women and men of all ages transform their bodies with liposuction, plastic surgery, and facial aesthetics. Our services focus on affordability, a great patient experience, and a fast recovery. Visit us in Brentwood or Germantown, TN.  Learn more>>