When CoolSculpting Makes Fat Worse

CoolSculpting has become the #1 non-invasive fat reduction procedure. It is popular because it can be done in the office and promises easy recovery. It can be as expensive as liposuction surgery but usually only gets rid of 10-20% of the fat calls. Unless you experience what a patient of mine experienced. A condition called paradoxical adipose hyperplasia which means “reverse effect of fat growth”.

The Patient’s Story:

“I had three CoolSculpting treatments at my dermatologist’s office. My upper abdomen got fatter and fatter. It affected my breathing and my clothes became too tight. I looked deformed and I thought I was going crazy. I asked the CoolSculpting technician what happened. She told me she did not know and she never offered for me to see the doctor. I decided to get a second opinion which led me to Dr. Morgan. She explained the problem and recommended that I have liposuction of the entire area.”

“I had the liposuction surgery and I am so pleased. I can wear a smaller size in clothes and I can breathe again!”

What Happened?:

The idea behind CoolSculpting is that extreme cooling of the skin and fat makes fat dissolve. Paradoxical adipose hyperplasia has the exact opposite effect. The fat cells grow and grow with each CoolSculpting treatment. You need liposuction to get rid of this hyperplastic fat. No one is sure why the condition occurs but the theory is that some people have fat cells that have evolved to hold more fat when it gets cold as a winter survival mechanism.

Paradoxical adipose hyperplasia was thought to be rare but it is clear that it is much more common than is reported. This is because it is not documented in the published studies. Published studies are usually done at academic hospitals or related facilities. CoolSculpting is usually done at a private medical office or medi-spa. The procedure is commonly not performed by a physician. The condition is also not life-threatening. Therefore, these factors can lead to the condition not being diagnosed and the patient not being aware that it is a possibility

A Few More Things:

Paradoxical adipose hyperplasia is more common than reported, more common in men and more likely to occur in people who are overweight. Liposuction is the “gold standard” for major fat reduction. CoolSculpting is FDA approved and very popular but my impression it is better for very small areas of fat.