Paradoxical adipose hyperplasia is a rare complication of cosmetic procedures that use cooling administered through the skin (such as CoolSculpting) to shrink fat deposits (cryolipolysis) in the body. In paradoxical adipose hyperplasia, the treated area becomes thicker and firmer than it was prior to the procedure. Signs and symptoms can include
- visible deformity,
- uneven fat distribution, and
- areas of lumps or knots of hardened tissue.
The condition has been reported in less than 1% of patients undergoing cryolipolysis.

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References
Nikolis, A., and Enright, K.M. "A Multicenter Evaluation of Paradoxical Adipose Hyperplasia Following Cryolipolysis for Fat Reduction and Body Contouring: A Review of 8658 Cycles in 2114 Patients."
Aesthetic Surgery Journal 41.8 (2021): 932–941.