In the 90s, a particularly amazing and accomplished group of elite models dominated all magazines, TV spots, catwalks and after-parties. Comprised of industry heavyweights and well-known names like Naomi Campbell, Christy Turlington and Cindy Crawford, most of this so-called “dream team” have enjoyed long careers and enduring relevance to this day. But one of the most prominent faces of the era says there’s a reason she doesn’t work like her peers – and it’s not her choice. Last week, in an Instagram post detailing her fight, Linda Evangelista said that a CoolSculpting procedure had left her “permanently deformed.” The popular fat freezing treatment, which is regularly performed in medical spas and beauty centers, left the model “brutally disfigured.” Evangelista says that while the FDA-approved treatment is supposed to target and eliminate persistent fat cells, these sessions, performed five years ago, would have had the opposite effect – leaving the legendary supermodel with a condition called paradoxical fat hyperplasia, or PAH.
“[CoolSculpting] increased, not decreased, my fat cells and left me permanently deformed even after undergoing two painful, unsuccessful corrective surgeries, ”shares Evangelista in his statement, detailing a lawsuit against parent company CoolSculpting, ZELTIQ Aesthetics, for what his lawyer described in a follow-up post as “failure to adequately disclose potential risks and side effects to consumers”. Evangelista says she has developed one of these serious side effects, PAH, and calls it ruining life. “PAH not only destroyed my livelihood, it put me in a cycle of deep depression, deep sadness and lower levels of self-loathing. In the process, I became a recluse. Indeed, Evangelista’s public appearances have been virtually nonexistent in recent years – and any photos she posts of herself typically feature a scarf, hat, or filter that obscures the face.
Evangelista’s first post immediately caught fire, with fans, celebrities and commentators quickly weighing in on the situation and showing their support for the 56-year-old model. Much of what made the allegation so disturbing is how common a CoolSculpting procedure is – some estimates claim more than 8 million treatments have been performed worldwide, and past celebrity clientele includes Jennifer Aniston, Khloe Kardashian and Mariah Carey.
“It’s extremely oversold technology,” says Dr. Paul Jarrod Frank, renowned cosmetic dermatologist and medical director of PFRANKMD. He says that while CoolSculpting is generally effective with a science backed technique, some patients are much better candidates than others – and this is where things can get tricky.
Dr Frank says that while he keeps a CoolSculpting machine in his office, he only likes to use it on relatively young patients with good skin elasticity and the type of localized “spongy, pinchable fat” that responds. the better at processing. Freewheeling use of the treatment, he says, means he’s seen a lot of patients with previously failed CoolSculpting attempts. “At best, they didn’t have any results, but more often than not they had multiple complications,” says Dr. Frank. He says that although the alleged Evangelista disease, PAH, is rare, he generally sees uneven shedding of fat and ridges. But it’s more than just a procedure gone awry – Dr Frank says patients are often sold high promises and expectations by those without the proper medical expertise. “Unfortunately, this is a huge result of the medspa culture – many of the people administering the treatments these days are estheticians who are not licensed healthcare professionals.”
It is true that CoolSculpting machines are much more likely to be found in a medical spa – a hybrid setup for typical spa-like treatments like facials and massages combined with high-tech treatments and injectables like Botox and fillers. While medical spas are operated under the direction of a supervising physician, the technicians who actually administer the treatments are typically estheticians, who undergo around 600 hours (or around six months) of training as well as additional certifications for tasks such as than using different machines. While estheticians are trusted and respected members of the beauty community, it’s important to know that they’re not medical professionals – and when it comes to some potential side effects, many feel more out of this world. comfortable undergoing more invasive or more extensive treatments in a doctor’s office.
As for Evangelista’s PAH, Dr Frank says that although the disease is rare, it is also underreported. Doctors are still not sure exactly what causes it, but it is believed to be the result of the activation of stimulatory stem cells, triggering fat cells to multiply. “It happens in the area where the applicator is placed and can sometimes appear outside the margins of where the applicator is placed, but it’s usually localized in the treatment area,” says Dr. Frank. He adds that this usually happens when a patient undergoes too many CoolSculpting treatments in a short period of time – and the fact that CoolSculpting is typically sold in bundled cycles can make it an easy trap to fall into.
Like most beauty procedures, freezing fat is certainly not without risk, especially if done in a location without proper medical supervision. However, if a doctor agrees that you are a good candidate, treatment can be both safe and effective. It is simply crucial that patients and administrators understand the pros, cons, and potential serious side effects.
