Is CoolSculpting Safe? Everything You Need To Know About The Controversial Fat-Freezing Treatment
After supermodel Linda Evangelista shared a series of Instagram posts, stating the non-invasive procedure had left her “deformed,” Bazaar reached out to Dubai-based plastic surgeon, Dr. Dany Kayle, for professional insight on the safety of social media’s favourite body contouring treatment
Is CoolSculpting Safe? One of YouTube’s star beauty vloggers first put CoolSculpting on my radar years ago, when I was in my late-twenties and dealing with the changes many adults experience as their supersonic teenage metabolism makes its exodus; fortunately, I have always been slender in nature, though as I became a “proper adult” I did start to notice unwanted, ahem, mass in certain areas of my body, pockets of fat I couldn’t train away at the gym in areas often referred to as “stubborn”. It was hardly noticeable, but while I’ve always had a healthy relationship with my body, it did bother me.
While I briefly entertained the idea of CoolSculpting, I never ended up trying out the treatment. As more influencers of all ages – some barely in their twenties – continued to share content as they underwent the procedure, touting it as a safe and pain-free way to remove fat with little downtime, IG storying the entire process, it appeared to firmly weave its way into mainstream non-invasive cosmetic treatments, similar to fillers and botox.
It wasn’t until Canadian supermodel Linda Evangelista shared a series of heartbreaking social media posts last week, stating how she had been “deformed” by the popular treatment, that we began to question whether CoolSculpting was actually safe.
Earning the nickname The Chameleon for the ability to change her look, she is best known for starring in George Michael’s music video for “Freedom! ’90” alongside fellow supermodels Naomi Campbell, Christy Turlington, and Cindy Crawford; being Steven Meisel muse and, allegedly, stating she doesn’t “wake up for less than $10,000 a day.”
In the past few years, she’s become quite recluse and withdrawn — and now, the world knows why.
I reached out to Dr. Dany Kayle, plastic surgeon and founder of Dr. Kayle Aesthetic Clinic Dubai, to ask him all the questions we at Harper’s Bazaar Arabia had about the non-invasive treatment, that appears to have some scary side effects for a small percentage of patients.
Harper’s Bazaar Arabia (HBA): A lot of people are now questioning whether Coolsculpting is safe. Is CoolSculpting Safe? Can you share your thoughts on this non-invasive procedure?
Dr. Dany Kayle (Dr. DK): I have never offered this treatment at my clinic for two main reasons. For one I, personally, do believe that the results that are claimed to be achieved using this technology [therefore it] doesn’t make it cost-effective. Also, I knew that there were risks such as Paradoxical Adipose Hyperplasia (PAH) associated with the treatment.
Furthermore, there can be other side effects with the treatment, such as contour irregularities, skin and soft tissue atrophy, and asymmetries; and as uncommon as these risks are, I felt that given patient safety is paramount to my team, these associated risks – rare as they may be – were still too great to potentially subject my patients to.
HBA: How common is Paradoxical Adipose Hyperplasia (PAH), the side effect supermodel Linda Evangelista claims to have experienced from the treatment?
Dr. DK: The technology behind CoolSculpting, cryolipolysis, is designed to chill tissue to the point where fat cells crystalize, disintegrate, and leave the body as waste, helping a treated area marginally slim down. Usually, this is exactly what happens. In a small number of cases, however, as in the case of PAH, instead of gradually shrinking, the bulge after CoolSculpting actually gets bigger and usually becomes firmer than surrounding tissues, sometimes having a “stick of butter” appearance that actually resembles the shape of the CoolSculpting applicator.
We don’t exactly know why PAH happens to certain patients, and reports on its incidence vary depending on what studies you read. For instance, in some reports manufacturers claim it is estimated at 0.0051% or 1 in 20,000, other manufacturers’ reports claim it is more like 1 out of 4,000 treatments, but research journals have claimed an incidence of 0.47%, which is almost 100 times greater than certain manufacturer’s reported incidence. In any case, while this is still an incidence rate of less than 1%, it concerns me as a physician any time we see a rise in complication rates with a procedure—particularly one with such strong claims of safety and ease.
HBA: Every cosmetic procedure – invasive and non-invasive – comes with its own set of potential risks and side effects. Why aren’t more people aware of Paradoxical Adipose Hyperplasia? Is this side effect unique to Coolsculpting?
Dr. DK: I believe PAH is at risk of occurring with any cryolipolysis or fat freezing treatment, such as Cool Sculpting (which is the best known out of this genre of treatments).
For the most part, CoolSculpting itself has a good safety record. The majority of patients experience mild side effects such as redness, tingling, and numbness, which go away after a few days and the claimed benefits of these treatments – weight loss, inch loss and a more svelte physique – are often hugely attractive for patients who want to achieve body perfection. Few people really research what can go wrong and, in any case, most believe the drastic side effects will not apply to them.
HBA: Is there anything a patient can do to reduce their chances ofexperiencing Paradoxical Adipose Hyperplasia post-treatment?
Dr. DK: PAH has an incidence of less than 1% and no single unifying risk factor has been identified; further studies are needed to characterise the pathogenesis and histologic findings of this adverse occurrence.
Paradoxical Adipose Hyperplasia is not temporary and cannot go away, even with continued diet and exercise. PAH can develop in several weeks or months after the initial treatment.
Fortunately, PAH is fully treatable with liposuction. However, patients who develop the condition have to live with a conspicuous bulge for at least six to nine months until the fat softens enough to remove it safely. This can be hard on a patient both emotionally and physically, especially considering they sought out fat reduction in the first place to address an aesthetic issue that now appears worse.
HBA: Are there any other non-invasive cosmetic procedures where Paradoxical Adipose Hyperplasia is a potential side effect?
Dr. DK: PAH causes a gradual enlargement of the treated area. It occurs when the stimulus (the freezing of fat cells) activates a reactionary process in the fatty tissue that thickens and expands the fat cells rather than breaking them down and allowing the body to process and remove them. PAH is only known to occur following a cryolipolysis procedure. In general, PAH typically cannot be confirmed until about 6 months post-procedure, as patients come to realise that they are getting bigger in the exact shape of the applicator
HBA: What are the next steps for someone who has experienced Paradoxical Adipose Hyperplasia? Is there a way to reverse the side effect?
Dr. DK: Treatment is best delayed until the affected area has softened, which normally occurs in six to nine months after the initial cryolipolysis procedure. Liposuction is the preferred method of treatment, but in some cases, abdominoplasty may be necessary.
HBA: Are there any safer alternatives to Coolsculpting?
Dr. DK: Absolutely. For those who wish to have non-invasive treatment, there are two options I recommend.
VelaShape is a body contouring treatment that’s been cleared by the FDA for the circumferential reduction of the thighs and abdomen. The most commonly treated areas are the thighs, buttocks, upper arms, and stomach. It can also reduce excess fat and mildly sagging skin under the chin. This treatment uses a combination of four modalities: infrared light, bipolar radiofrequency (RF) energy, mechanical massage, and gentle suction. The suction brings the skin closer to the energy source inside the handheld device, working with the massage to help relax and stretch the stiff fibrous bands under the skin that cause the dimpling and orange peel texture known as cellulite. The infrared and RF energies heat the skin, tightening tissue and making fat cells shrink and, in some cases, die. The heat reduces skin laxity by tightening the existing underlying dermal collagen fibres and stimulating collagen and elastin production, which builds more firmness and elasticity over time.
There is also laser lipolysis. It is performed under local anesthesia using a laser to melt the fat while simultaneously tightening the skin. Once the fat is melted, suction is applied to manually remove the fat from the area.
It’s important to remember that fat reduction achieved with non-surgical technologies is only predictable down to a general area and provides minor improvements. For most patients, the more detailed, dramatic results possible with liposuction are well worth taking a few days off. Liposuction can safely, thoroughly, and precisely remove fat to strategically sculpt a beautiful, natural shape to an area, when performed by an experienced, skilled cosmetic surgeon. When it comes to cost, liposuction can end up costing less than non-surgical alternatives in the long run. A cosmetic surgeon can determine exactly how much fat to remove to achieve your desired results in one procedure, whereas with non-invasive treatments, it’s common for patients to need a course of treatments to achieve their desired results
Lead image: Larry Busacca (Getty)
