• Dr. K

Is Coolsculpting safe? What the heck happened to Linda Evangalista?


OK, some of my earliest memories are of sitting in my mom's retail store reading Elle Magazine and she "claims" my first work was Chanel though I find that hard to believe given the weird pronunciation. In any case, Linda Evagalista's gorgeous brows and flawless complexion were the definition of supermodel in my eyes, so when I heard she had been "disfigured" by CoolSculpting my heart hurt a little for her and for one of my favorite procedures to perform and have performed on me. It's such a treat to watch an annoying bulge that will not change no matter what I do just shrink down gradually over a few weeks as though I somehow figured out the holy grail of workouts.

So first of all, how does Coolsculpting even work and what the heck is paradoxical hyperplasia? Coolsculpting is a noninvasive procedure in which a very cold (-11 degrees) applicator is placed on a fat bulge for 35-45 minutes. The cold causes such a shock to the fat cells that it causes them to activate an internal kill switch. This kill switch is turned on in about 30% of the fat cells and none of the important surrounding tissues. The process happens slowly, over 3 months. Paradoxical Hyperplasia occurs when the fat cells not only survive the injury of being frozen, but responds by making scar tissue and new fat cells. This causes an enlargement in the area you were trying to get rid of in the first place in the shape of the applicator. No one knows why this happens, but it's very rare! Less than 1% of procedures lead to this complication and it typically occurs within the first 6 months. The only known risk factor is male sex, though it can happen in females as well. We CoolSculpt all day, every day and I have never seen a case! The only treatment is liposuction or surgery. There are rumors that the company that owns CoolSculpting pays for the fix if the case is proven to be PAH, but I don't know if that is typical or not. Thankfully it's not a like threatening procedure, but no one wants more fat in an area they paid to have less!

All of that being said, my heart goes out to gorgeous Linda Evangalista (and yes, she is still gorgeous) and I hope she is able to get through this whole ordeal soon and feel good about herself!



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