The CoolSculpting experience of Alice Hart-Davis

The difference between the 2015 photo and the 2017 photo is the real shocker. In 2015, Linda Evangelista looked like her 1990s supermodel at the Met Gala, with bright eyes, a sharp jawline and raised hair. Arriving in Tokyo in 2017, dressed in loose black layers and several sizes larger, her famous contours so softened that she looked, by her own admission, “unrecognizable,” after a fat-freezing procedure intended to expel extra fat had the opposite effect and caused untold suffering.

Why on earth would Evangelista risk a procedure that could cause this? I have had this treatment – CoolSculpting – several times and I can tell you that when it works well, it is fantastic. I had an unruly lump on my lower abdomen sucked up into a treatment cup the size of a large butter dish and subcooled to the point where the fat cells began to die off. It’s not comfortable – it’s hard to breathe with half your belly wedged in what feels like icy jaws, and the cold is blisteringly hot until your flesh goes numb. Then when they remove the device half an hour later and roughly massage the ice-crystallized fat, it’s agony (although thankfully it’s quick).

Afterwards, you go home with a strange, chilly lump in your belly that gradually thaws and then shrinks over the next three months as up to a third of the treated fat simply disappears from your body. I had my inner thighs done, my love handles . . .

Fat freezing began as a body contouring treatment, but the development of mini-applications means it can now also be used to remove fat under the chin, which is a great way to reduce a thick double chin.

I tried the same treatment as Linda Evangelista. Ik heb deze behandeling – CoolSculpting – verschillende keren ondergaan en ik kan je zeggen dat het fantastisch is als het goed werkt.

Alice Hart-Davis

So what exactly happened? CoolSculpting is the best-known fat freezing brand with the best safety and efficacy data, but like all medical cosmetic adjustments, it can have side effects. You may experience bruising after treatment, perhaps acute pain in the treated area for a few days. Much worse is paradoxical fatty hyperplasia (PAH), which is what happened to Evangelista, where the treated area becomes swollen and enlarged – and stays that way. It is very rare, but certainly not unheard of. A 2014 article in JAMA: The Journal of the American Medical Association laid out the details and noted that it occurred in only 0.0051 percent of patients – or 1 in 20,000.

These side effects are not mentioned in the PhD literature, but they are all in the fine print on the consent form that everyone must sign before undergoing the procedure – but how often do we all read to the bottom of the fine print in our rush to get into the treatment room? Evangelista claims she was not informed of the possible complications before treatment.

What baffles me is how Evangelista went from her usual fantastic self at the Met Gala in 2015 to the need to try this fat-burning treatment a year later. From what she said, it seems she was treated under her chin and on her body in 2016. Because the treatment went wrong, those treated areas would have grown into raised, solid blocks, each in the shape of the particular treatment head.

Was I just lucky when I tried it? Maybe. I have friends who have had problems with it and I’ve heard from many people on social media that it didn’t work for them, but I haven’t met anyone who has had PAH.

Dr. Sach Mohan does. He is a top aesthetic practitioner and has been offering CoolSculpting for 11 years at Revere, his clinic on Harley Street. “When a patient develops paradoxical fatty hyperplasia, the procedure initially appears to be a success, but after a few months, the results seem to disappear and be replaced by a firmer, collagen-rich form of the applicator used.

“It is a very unfortunate situation in which Linda was apparently unaware of the risks of the procedure and subsequently experienced them, but it is so small that in the 11 years that Revere Clinics has been performing CoolSculpting on thousands of patients, we have experienced only nine such cases, of which only five patients opted for successful corrective surgery [met liposuctie]. However, posts on social media indicate that the problem is not with CoolSculpting, but with the two corrective surgeries Linda has undergone. The procedure to correct this is not technically difficult; it is a type of liposuction.

“Typically, the patient signs a consent form outlining all the risks associated with any procedure, including CoolSculpting. We will always tell our patients that CoolSculpting is still one of the safest, most effective and most studied non-surgical treatments for fat reduction.”

What do we learn from this? For heaven’s sake, do research on any procedure you are considering. Choose a good, experienced doctor. Ask him or her what can go wrong, how often it goes wrong and what he or she can do about it if the worst happens. And read the fine print.

Alice Hart-Davis. (2023, 24 september). I tried the same CoolSculpting treatment as Linda Evangelista. The Times. Accessible at this link.

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