Coolsculpting and the price of ignorance

You need more than a “cool” name to develop a medical procedure. When you look at treatments that promise to make you more attractive, please remember that the human body is very complex.

So how about that stupid “scientist” that invented “coolsculpting” This is a crazy procedure that cools down a part of the body in the expectation that fat tissue will die and be reabsorbed by the body without side effects. Isn’t that crazy? But there are many “plastic surgery” procedures that are crazy and people still go for them. The assumption is, of course, that a cool name will have solid medical evidence behind it. But it usually doesn’t. You don’t need solid evidence to start selling a medical procedure. And then, you find yourself signing below a text that warns you about possible complications. You are signing away your body and your life.

Enter Linda Evangelista, an extraordinarily beautiful woman who decided she could beat fat and aging. Did she forget that fat is made of live cells. She trusted her doctor and ended up “disfigured”. Surprise! Her body and fat did not behave the way she wanted them to.

Fat is very important for the shape of our body and face. We may complain about wrinkles etc. as we age, but don’t just blame the skin itself, many changes to the shape of our face are caused by the loss of fat under the skin.

What is “coolsculpting”? It consists in freezing the skin and the tissue underneath it, killing it. The naive belief is that the fat cells will die and the body will reabsorb the dead tissue, decreasing fat without surgery. But you don’t need surgery to stress the body in a violent and invasive way. This is what some women find out: their bodies respond to this major stress in unexpected ways. One of them is “paradoxical adipose hyperplasia”. Instead of losing fat, there is an accumulation of adipose tissue and this effect doesn’t resolve spontaneously.  More common effects include temporary erythema, edema, and mild pain. The mass of fat tissue is usually more disorganized, with fat cells of varied size, and increased vascularity. Paradoxical adipose hypertrophy seems to be more frequent in men. The dirty secret? “Paradoxical adipose hyperplasia is a rare complication of cryolipolysis that may occur more frequently than in the manufacturer’s reported data.” 

In short: respect your body. It’s not a cartoon, it contains real cells. Kill cells and the reminder will react.

Another: don’t assume that because a procedure has been “approved” by the FDA, it’s safe.

If we live long enough we will have to go through a number of procedures (teeth will break, organs will be damaged, etc.). So let’s avoid unnecessary surgeries and “non-invasive” procedures. You don’t need to penetrate the body with a scalpel or a needle to cause damage, and “non-invasive” is not an honest description of all those “treatments”.

References

Jalian HR, Avram MM, Garibyan L, Mihm MC, Anderson RR. Paradoxical adipose hyperplasia after cryolipolysis. JAMA Dermatol. 2014;150(3):317-319. doi:10.1001/jamadermatol.2013.8071

Kelly ME, Rodríguez-Feliz J, Torres C, Kelly E. Treatment of Paradoxical Adipose Hyperplasia following Cryolipolysis: A Single-Center Experience. Plast Reconstr Surg. 2018 Jul;142(1):17e-22e. doi: 10.1097/PRS.0000000000004523. PMID: 29952891.