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Paradoxical adipose hyperplasia (PAH) is a rare, moderate-to-severe adverse event associated with cryolipolysis (Coolsculpting, CS). Describe the incidence, diagnoses and treatment of PAH, following CS for nonsurgical fat reduction. A multicenter evaluation of all patients who underwent CS treatment between January 2015 and December 2019 at eight Canadian medical centers was conducted. Data abstracted included symptoms, management strategy, outcome, operator characteristics, device characteristics, patient characteristics, body region and