CoolSculpting, also known as cryolipolysis, is a non-surgical freezing technology that gives patients long-lasting results for spot fat removal. CoolSculpting has become a popular procedure for addressing excess fatty deposits in trouble areas. In some extremely rare cases, this treatment does have adverse effects. Negative outcomes ultimately cause the fat in the affected areas to increase (rather than decrease as intended). This condition is known as Paradoxical Adipose Hyperplasia (PAH). Board-certified plastic surgeon, Dr. Douglas Steinbrech, specializes in Paradoxical Adipose Hyperplasia treatment for men in LA.

As mentioned, PAH is highly unusual, materializing in just 0.005% of cases. However, it seldom occurs in men who undergo CoolSculpting. In these unique instances, patients have unpredictable increases in adipose tissue. This condition is counterintuitive to CoolSculpting’s intended outcome.

What Is Paradoxical Adipose Hyperplasia (PAH)?

PAH specifically occurs in men who have had a negative reaction to cryolipolysis (CoolSculpting). Here is a breakdown of the medical terminology for Paradoxical Adipose Hyperplasia:

Paradoxical:  the tissues that are treated with CoolSculpting react to it by growing rather than decreasing – an unexpected, hence, paradoxical effect.

Adipose: refers to fatty tissues that contain adipose cells, which are more predominant under the skin especially in areas like the abdomen, flanks (“love-handles”), back and thighs.

Hyperplasia: a term that refers to the growth of cells in the tissues, which is typically stimulated by something.

Why Does PAH Occur And What Does It Look Like?

In many ways, treatments like fat-freezing are still in their infancy. As such, there is little known about why exactly PAH takes place. The occurrence of PAH is still somewhat of a medical enigma. However, Dr. Steinbrech and other LA surgeons are constantly studying the best treatment for detecting why Paradoxical Adipose Hyperplasia occurs in men and who might be at risk.

PAH takes place within 6 months following CoolSculpting. Fat accumulation typically presents where the CoolSculpting device was used. Adipose tissue on the affected area swells to a size larger than the original fatty spots prior to CoolSculpting. These areas may be sensitive to the touch.

How Common Is PAH?

The most recent studies suggest that PAH occurs in just 1 of every 500 to 5,000 CoolSculpting procedures. Paradoxical Adipose Hyperplasia is very rare in men.

Who Is At Risk Of Developing PAH After CoolSculpting?

Research suggests that the most common indicators for developing Paradoxical Adipose Hyperplasia include the use of a large CoolSculpting applicator, male sex, Hispanic background, and abdominal location of treatment. Age and other factors have not yet shown to play a role in the development of PAH.

How Is PAH Treated?

Before the condition can be treated, the affected area must first soften for a couple of months after the final CoolSculpting procedure. Paradoxical Adipose Hyperplasia treatment for men in LA typically includes variations of liposuction. In the rare event that a patient’s PAH is extreme, multiple liposuction sessions or a TorsoTuck® (tummy tuck for men) may be required.

Recovery Time

Recovery times for PAH treatment vary but usually take about 4 to 6 weeks (depending on the severity of the patient’s condition). Results can be seen by the end of this recovery period. Following surgery, Dr. Steinbrech advises that patients avoid strenuous activity as well as wear an abdominal binder to maximize healing and ultimately, results.

How To Determine If You Have Paradoxical Adipose Hyperplasia

Patients with PAH notice increased size or fullness at the spot where the CoolSculpting applicator was used. Typically, swelling occurs and there is an increase in fat in the affected area. After several weeks, this swelling does not reduce on its own. This is a sign that the patient has developed PAH. During a consultation, Dr. Steinbrech will assess whether or not a patient does in fact have PAH and how to potentially treat it.

Book Your Consultation

For more information about Paradoxical Adipose Hyperplasia treatment for men in LA, please contact our office. Prospective patients may set up a consultation or speak with one of our patient advisors. Based on the findings from your consult with Dr. Steinbrech, you will be able to review the treatment options for PAH.


  1. Kelly ME, Rodríguez-Feliz J, Torres C, Kelly E. Treatment of paradoxical adipose hyperplasia following cryolipolysis: a single-center experience. Plast Reconstr Surg. 2018 Jul;142(1):17e-22e.
  2. Keaney TC, Naga LI. Men at risk for paradoxical adipose hyperplasia after cryolipolysis. J Cosmet Dermatol. 2016 Dec;15(4):575-577.
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