What is CoolSculpting and Can It Safely Help You Lose Weight?
Millions of people try extreme diets or have surgery every year in an effort to get a slimmer body, but this can be a challenging goal for many reasons, so it's no surprise that cryolipolysis, also known as CoolSculpting, attracts thousands of people every year who are interested in getting rid of body fat without restricting their diet or having surgery.
The U.S. Food and Drug Administration (FDA) approved the use of CoolSculpting in 2010, and in 2019 it was the fourth most popular noninvasive cosmetic procedure in the country. However, in recent months, a public discussion about the safety of this procedure has become vociferous, in large part because Canadian model Linda Evangelista claimed on Instagram that a CoolSculpting procedure had left her "permanently deformed."
Evangelista, whose modeling career soared in the 1990s, revealed that she experienced paradoxical adipose hyperplasia (PAH) after the procedure in a February 2022 interview with People magazine. PAH is a rare side effect of the CoolSculpting procedure that is characterized by areas of increased tissue volume, creating firm bulges in the skin. Health experts say that although the procedure is generally low-risk, this possible side effect is one facory.
Continue reading to learn everything else you should know about CoolSculpting.
How Does CoolSculpting Work?
The process of employing cold temperatures to kill fat cells that are just beneath the skin's surface is known as cryolipolysis. (the name gives it away: "cryo" stands for cold, "lipo" for fat, and "lysis" stands for "destruction").
Despite the fact that the term "CoolSculpting" is frequently used to describe the cryolipolysis procedure, it is actually the name of a particular medical instrument. Most often, a doctor, nurse, or physician assistant performs the process; however, some medical spa staff members are also qualified to do CoolSculpting. For additional information on who is certified to perform the surgery, contact your state's medical board.
What Is the Process of CoolSculpting?
During the operation, a technician will apply gel pads to the areas that need to be treated before running the device over them. They can also draw tissue into the cup using an applicator with a suction.
CoolSculpting uses the same fundamental principles as other fat-reduction procedures like liposuction, various heat and sound-wave treatments (like SculpSure and TruSculpt), and chemical treatments in order to target and destroy fat cells in particular parts of the body (such as Kybella).
The deceased fat cells don't always go right away. According to the makers of CoolSculpting, it could take the body up to six months to digest and eliminate all of the dead fat cells after the procedure.
Who Might Think About CoolSculpting?
According to Alan Matarasso, MD, a clinical professor of surgery at the Donald and Barbara Zucker School of Medicine at Hofstra Northwell in Hempstead, New York, every human is born with a set amount of fat cells. As we put on or lose weight after our teen years, our cells shrink or bulge. The purpose of treatments like CoolSculpting is to undo the affects of aging on the body.
According to Joshua Zeichner, MD, the director of cosmetic and clinical research in the dermatology department at Mount Sinai Hospital's Department of Dermatology in New York City, CoolSculpting is a completely aesthetic surgery and is ineffective as a weight loss method. The technique works best to get rid of little pockets of recalcitrant fat since the freezing temperatures given by the device only reach the top layers of subcutaneous fat. The general body composition of a person cannot be altered with CoolSculpting.
It's crucial to consider CoolSculpting as a fat reduction procedure rather than a weight loss procedure, advises Dr. Zeichner. Visceral fat, or fat around the organs, has been associated to high cholesterol, insulin resistance, cardiovascular disease, and breast cancer; however, CoolSculpting primarily targets subcutaneous fat, which is more likely to be found on the bottom half of the body and is "pinchable."
According to Dr. Matarasso, CoolSculpting may be a suitable alternative for patients who want to reduce subcutaneous fat in a particular location but for whom surgery may be too hazardous (such as organ transplant recipients). However, it can't get rid of as much fat as surgical methods like liposuction, and it won't get rid of any extra skin that might appear after childbirth or a substantial weight loss. According to Matarasso, extra skin needs to be surgically removed.
What Are the Potential CoolSculpting Side Effects?
Generally speaking, CoolSculpting is a risk-free, safe technique. Mild side effects are occasionally reported and can include pain or a loss of sensation in the area being treated. During the operation, some patients may feel faint, nauseous, or disoriented. They may also experience a rash, swelling, or other discolouration afterwards. But according to Zeichner, most of these adverse effects go away on their own in the weeks that follow the treatment.
According to Matarasso, the technique might occasionally leave uneven divots or ripples in the skin. This side effect, however, is not prevalent; according to one review, it occurred in 0.14 percent of procedures.
Matarasso continues, "CoolSculpting can be unpredictable, and the person having the treatment may be upset if their outcomes aren't what they anticipated."
Understanding Paradoxical Adipose Hyperplasia
Although research has not yet identified the cause, PAH, the side effect that Evangelista reported, is the most well-known moderate-to-severe potential side effect of CoolSculpting. It happens when CoolSculpting causes an increase, rather than a decrease, in fat cells in the targeted area. Following the CoolSculpting procedure, PAH prompts new tissue to develop in the shape of the treated area over the course of several months. According to Matarasso, the new tissue might have a feel that is nearly rubbery and is typically tougher than normal fat. In some circumstances, new fat growth cannot be eliminated by liposuction, and the patient must decide between having the new tissue surgically removed or left in place, according to Matarasso. Blood flow to the affected area may also rise. It's horrible that the person who requested a minimally invasive operation ended up with a large scar, he says.
Limited information is available on those who develop PAH, according to Matarasso. He continues by saying that part of the reason for this is because doctors aren't always doing the surgery because they have to report unfavorable results.
One clinical study raised the possibility that PAH may be underreported; the authors noted that their practice's incidence rate of PAH was substantially greater (2 in 422, or 0.47 percent) than the incidence rate asserted by the CoolSculpting brand (1 in 20,000).
Although the cause is unknown, males may be slightly more likely than females to develop PAH. The study also found that using more recent CoolSculpting units by technicians resulted in a 75% lower incidence of PAH, raising the possibility that the machines themselves may raise the risk of PAH.
Substitutes for CoolSculpting
Cryolipolysis is not limited to the CoolSculpting brand; other comparable technologies provide the same therapy. However, it's not yet known whether one brand causes PAH more or less frequently than another.
Other noninvasive fat removal treatments, like Trusculpt, use radiofrequency devices to "melt" the fat cells. According to Zeichner, injectable procedures like Kybella may be a solution for very small pockets of fat.
For more thorough fat reduction, Matarasso advises liposuction or standard treatments like the "tummy tuck."
CoolSculpting won't ever be as dramatic as liposuction, according to Matarasso. "You could never accomplish more with CoolSculpting on one patient yesterday than I did in an hour."
How to Find a Provider of CoolSculpting
Zeichner and Matarasso concur that if you're thinking about this surgery, it's imperative that you see a qualified medical expert. CoolSculpting is available in nonclinical settings like medical spas. Look for a dermatologist or plastic surgeon who has received board certification; this person will be knowledgeable about a wide range of procedures and treatments and can assist you in determining whether CoolSculpting is a good option for you. Both the American Board of Cosmetic Surgery and the American Academy of Dermatology have searchable directories of licensed doctors in your area. In other words, simply because medical spas provide the service, it doesn't necessarily follow that the staff members there possess the aforementioned required qualifications.
Another word of caution: According to Matarasso, practitioners who are untrained in a variety of fat-loss techniques may exaggerate the capabilities of the tools they have at their disposal. This may be especially alluring to patients who are hesitant to undergo more invasive operations.
The world, he claims, "is a nail if all you have is a hammer." "You should go someplace where you can get options," the person said.
To Sum Up:
Fat cells close to the skin's surface are killed by a device used in the fat-reduction procedure known as CoolSculpting. The outcomes of CoolSculpting, according to experts who perform the surgery, can be surprising and leave patients with mixed feelings occasionally. PAH, a side effect of CoolSculpting that Linda Evangelista allegedly encountered, can occasionally occur. Physicians do not yet fully comprehend why some patients experience this and not others when PAH is present since it causes the formation of extra fat rather than its reduction. Although it might be available at medical spas nearby, experts advise speaking with a certified doctor first before having the treatment.
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