CoolSculpting 101 or What Happened to Linda Evangelista?

By Dr. Jane Weston

Patients have been asking me what happened to Linda Evangelista, the supermodel who recently posted that she was disfigured by Coolsculpting procedures.  While I don’t know any of the details of Ms. Evangelista’s treatments and I haven’t seen her results, I can shed some light on what, I imagine, she has experienced.

Coolsculpting is a non-invasive fat-reduction technology that uses a combination of suction and cold temperature to “freeze” pinchable fat and destroy the frozen fat cells.  It works – most of the time.  Like any procedure, sometimes the results are disappointing and unimpressive and sometimes, fortunately rarely, the results are WORSE than they were before the treatment! This is what happened to Ms. Evangelista. Following her Coolsculpting experience she developed PAH,  Paradoxical Adipose Hypertrophy-  the phenomenon that causes the treated area of fatty tissue to get larger rather than to diminish. 

I know Paradoxical Adipose Hypertrophy can happen – it happened to me.  When I was trying to decide whether or not to bring the Coolsculpting fat reduction technology into our office, all of the staff members had at least one area of their bodies treated with Coolsculpting — including me.  Within a few months, everyone on the staff was happy as could be with the improved contours.  Meanwhile, I didn’t see any significant  improvement at all.  I wasn’t sure.  Maybe I needed another treatment. Bad idea. I treated the same area a second time and I experienced the same thing that Linda Evangelista experienced – Paradoxical Adipose Hypertrophy.  To this day, I have an oval-shaped area, much like the shape of the Coolsculpt applicator, that stands out from the rest of my abdomen. Definitely not the result I was hoping for.

So why would anyone do this and why did I bring the technology into the office?  I can tell you, it’s because it does work – most of the time.  And the majority of patients are delighted with their results. Spend a few hours in the office, comfortably positioned with the Coolsculpt machine and walk away with newly contoured areas where stubborn fat used to be.  So what did I learn?  Here are my take-aways:

  1. Ms. Evangelista is correct – PAH happens.  
  2. There is no magic.  As much as we all want to believe and find a magical technology or procedure – it doesn’t exist.
  3. All procedures have risks.  If you are considering treatment with a technology and are not being informed of the associated risks, keep looking.
  4. It doesn’t really matter if risks are rare – if you are the person who experiences the one-in-a-million complication, knowing that the complication is rare will not make you feel better.  
  5. When choosing your provider, make sure you are going to someone who you can talk to.  Even though things usually go well, on the off chance that they don’t, you want to be sure you can talk to someone who will listen to you and address your concerns.  
  6. PAH tends to be very fibrous making the fat more resistant to traditional liposuction.  That said, ultrasonic liposuction or power-assisted liposuction can successfully treat PAH.