At the height of her fame in the 1990s, supermodel Linda Evangelista was often quoted as saying she wouldn’t get out of bed a day for less than $10,000. Now she has revealed that a popular cosmetic procedure has sent her into “the lowest depths of self-loathing”, destroying her livelihood and making her a recluse because of the changes in her body. She is suing for US$50 million.
A procedure called cryolipolysis (or fat freezing) reduces fat over a few months, followed by an initial period of redness where the treatment has been applied.
When Evangelista underwent cryolipolysis, she reportedly experienced a side effect where fat increases rather than decreases in the months following treatment. This is called paradoxical adipose hyperplasia. This complication occurs more frequently in men and more often when older versions of the machine used in the treatment are employed. Manufacturers cite an incidence of 1 in 4,000 cycles, but the actual incidence may be more frequent because patients may not report a complication due to lack of awareness.
Cryolipolysis — often referred to by the commercial name CoolSculpting — has gained popularity in recent years. But those considering it should be aware of the potential for rare complications.
less invasive than liposuction
Prior to cryolipolysis, liposuction was the only effective therapeutic option to remove excess adipose tissue. Because liposuction is an invasive procedure and has inherent risks associated with surgery, cryolipolysis was developed in 2007 to address body contouring as a less-invasive procedure.
The procedure was visualized after the child observed less fat in the cheeks after sucking the ice cubes. Normally the number of fat cells decreases after solidification.
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Unfortunately, the reason for the opposite effect reportedly experienced by Evangelista is not fully understood. The principles differ from some patients’ fat cells, which due to nerve or blood supply issues are prone to act in the opposite way than predicted for the unintended activation of stem cells.
rise in popularity
Body contouring, or body sculpting, procedures are the fastest growing procedures in cosmetic medicine. It is almost impossible to reduce some areas of fat on the body through diet and weight loss. People with diabetes may also seek treatment for areas that have insulin injections and can store fat under the skin.
Non-surgical fat reduction methods include cryolipolysis (often marketed as Cool Sculpting), ultrasound (Vasar Shape and LipoSonics), and radiofrequency (Vanquish).
The number of body sculpting treatment sessions has increased by 68% since 2015. Within body sculpting procedures, cryolipolysis accounted for 45.7% of all body contouring treatments.
Similar undesirable effects – paradoxical adipose hyperplasia – have been reported for non-invasive radiofrequency treatment.
Ultrasound fat reduction has not yet been reported to cause similar adverse effects. However, the fat cells can recover after this treatment, causing it to shrink temporarily in those cases.
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Many patients may not be aware that they have experienced paradoxical adipose hyperplasia because it comes on gradually and can be hidden by normal weight gain. They may also believe that the treatment did not work.
In more noticeable cases, the area drawn into the cooling device, after the redness has settled, will gradually enlarge and spread out as much as it was before treatment began. The growth is not constant and within a few months it reaches a maximum size which depends on the amount of body fat of the patient.
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What is safe for those who want to change their shape?
The definitive treatment for unwanted body fat that cannot be corrected by exercise is liposuction in the hands of a skilled operator.
Liposuction is an invasive procedure with increased risks, including irregularities in the surface and contour of the skin.
Ultrasound therapy may be the safest option for adjusting body size as a primary treatment. It may also be considered for cases of paradoxical adipose hyperplasia, although this may only be a temporary solution. It is advisable to test the treatment on a small area first.
Anytime you change the balance of the body, you run the risk of creating new problems. Especially when dealing with fat. When patients gain weight after fat removal procedures, the fat will spread to other areas significantly more than the treated areas and give this an unusual appearance.
When proceeding with any cosmetic procedure, it pays to be well informed and prepared for unwanted consequences, even if they are rare. Yes, the journey will be longer if there are complications. The trick is not to make a quick fix or let negative feelings about appearance overwhelm you with caution and let a competent doctor advise you.