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MDLinxThe Paradoxical Side Effect of CoolSculpting: Melt Away the Pounds or Freeze Them in Place?

How Reliable is CoolSculpting? A Deeper Look at the Rare Complication

CoolSculpting, a non-invasive fat reduction method, has achieved fame for its remarkable ability to freeze away unwanted fat cells. Despite its promise of quick results, physicians need to be mindful of a rare but serious complication called paradoxical adipose hypertrophy (PAH), which has seen an increasing number of reports in recent years. The widely varying incidence rates of PAH, and notable public experiences of disfigurement, call for a critical examination of this popular procedure.

Key Points:

  • CoolSculpting uses cryolipolysis to freeze fat cells, generating more than $2 billion in revenue.
  • Incidence rates of paradoxical adipose hypertrophy (PAH) range from 0.033% to 1%.
  • Risks of PAH include multiple cryolipolysis sessions, abdomen treatment, and male patients.
  • CoolSculpting reduces fat in targeted areas by 10% to 25% over two visits.
  • PAH, occurring 2 to 6 months after treatment, results in fatty tissue growth and possible disfigurement.
  • Supermodel Linda Evangelista publicly shared her disfigurement experience after CoolSculpting.

Additional Points:

  • CoolSculpting is produced by Allergan Aesthetics, a part of AbbVie.
  • FDA-approved, the procedure targets areas including the chin, back, abdomen, and thighs.
  • PAH may need medical intervention, with liposuction as a potential corrective measure.
  • Monitoring patients for up to 1 year after treatment is recommended for potential complications.


  • CoolSculpting offers a promising solution to fat reduction, but the risk of PAH requires serious consideration. Transparency about potential complications and emphasis on alternative weight loss strategies are crucial in patient management.

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Did You Know?
A 2018 investigation evaluating 398 patients over 3 years reported an incidence rate of 1% for paradoxical adipose hypertrophy (PAH) following cryolipolysis, highlighting a significant discrepancy with other reported figures.

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