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How should my stomach feel 2 weeks after CoolSculpting?

Dr. Dean Kane Q & A CoolSculpting - Model

Q. I must admit, I’ve been reading to many negative reviews and Googled too much. I’ve convinced myself that I may develop Paradoxical Adipose Hyperplasia. I know…it’s too early to see results, and stop Googling! But what should I feel like? I had a large applicator on lower abdomen and the small applicator on top. Right now I’m hoping it’s just swelling, but my stomach is bigger than before. When I sit down I actually have a roll of fat that hangs over. My stomach feels firm…is this normal?

A. Thank you for this question! Many patients raise similar concern!

CoolSculpting is tried and true but like any medical procedure, there are limitations.

Two Processes Filling the Use of the CoolSculpting (CS) Applicator

I have observed 2 distinct processes filling the use of the CoolSculpting (CS) applicator.

  1. Apoptosis is the discovered effect causing the non-surgical permanent fat cell loss. Fat cells are more sensitive to low temperatures and stimulates the DNA to destroy the affected cells.
  2. The swelling and redness you are experiencing is associated with a positive side-effect called inflammation. Inflammation is the bodies response to injury. Initially, there is swelling and increase blood flow called hyperemia; therefore the redness. This goes through a dynamic process eventually forming collagen and other structural proteins which creates shrinkage of the injured tissues.

At this time you are experiencing the inflammatory effects early in the healing process.

While the DNA of the fat cells are reprocessing toward a defined death, there is a less than 1% chance where the DNA process goes awry and stimulates growth instead. This occurs at times in other cell mis-griwths such as PIH  (post-inflammatory hyper-pigmentation) and HTS (hypertrophic scarring). This isn’t visualized for 6 to 12 weeks.

PH or paradoxical (adipose) hyperplasia will tend to be fullest and firmest at 12 weeks. And persists rather than diminishes.

I believe you are showing over-concern. A fitted compression garment over the swollen area and daily lymphatic style massage will help. Revisit your CS specialist at 6, 9 and 12 weeks to monitor the swelling.

Should PH occur, Zeltiq, CoolSculpting’s corporation provides assistance in the options for its care. They will not begin the process until 12 weeks following the CS procedure.

I hope this helps. All the best!


This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

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