How Is CoolSculpting Done, What Is PAH? Linda Evangelista Says Procedure 'Disfigured' Her

Canadian former supermodel Linda Evangelista has announced she is filing a lawsuit against a body fat removal company after stating a procedure ended up having side effects.

In an Instagram post made on Thursday, Evangelista wrote that she was suing due to the side-effect of the procedure, which she said was performed by the company Zeltiq.

She said the procedure left her "disfigured" and "unrecognizable" and unable to continue her work because she developed a condition known as Paradoxical Adipose Hyperplasia (PAH).

The condition is a rare side-effect of CoolSculpting that causes enlargement of the treatment area afterward.

CoolSculpting, also known as cryolipolysis, is a procedure that aims to reduce body fat in a non-invasive way by using cooling. Non-invasive means it does not involve surgery or cuts, unlike liposuction.

It is relatively new, having undergone animal testing in 2007 and human use approval shortly afterward, according to a Harvard University health blog.

The technique relies on the fact that fat located under the skin is more sensitive to cold injury than other tissue types, so the fat can be targeted without damage to other tissues.

In essence, it involves applying cold temperatures via panels to the area of the body the patient would like fat removed from. This has the effect of freezing and reducing the fat layer under the skin, and the dead fat cells are then excreted from the body. It can take about an hour to treat each targeted body part, Healthline states.

According to the Harvard blog, there have been more than eight million CoolSculpting procedures carried out worldwide.

There are some side effects associated with the treatment. The American Society for Dermatologic Surgery (ASDS) states that the procedure carries risks of redness in the treated area and localized bruising, but notes these are usually short-term.

Another potential side effect is an increase in body fat in the area treated, known as PAH. Healthline states it is not known why this occurs and it appears to be very rare, occurring in less than one percent of cases.

One such case was documented in the JAMA Dermatology medical journal from March 2014 and published again in the PubMed Central (PMC) journal a few months later.

The authors describe the case of a 41-year-old man who had a cryolipolysis treatment on his abdomen and noted three months later that there seemed to be tissue growth at the site and in the shape of the treatment area.

Doctors carried out a scan, which revealed a build-up of fat in the treatment area—a contrast to the desired effect. The man did not choose to have any corrective treatment.

The authors estimated the incidence of PAH to be around 1 in 20,000 treated patients at the time. They said further studies were needed to find out why the disorder develops.

Cryolipolysis
A stock image shows a cryolipolysis procedure being performed. The treatment is a non-invasive method of body fat removal. HDesert/Getty