Is CoolSculpting safe? Experts weigh in on the risks after Linda Evangelista says she was ‘deformed’ by the procedure

For those who want to get rid of stubborn fat without going under the knife, in-office procedures like CoolSculpting can seem like an ideal solution. The treatment uses a process called “cryolipolysis” to cool fat cells down to 32 degrees Fahrenheit (0 degrees Celsius) — ultimately destroying the fat cells and revealing results over a matter of weeks. Since CoolSculpting has little to no downtime, many people consider it a winning alternative to liposuction.

But is CoolSculpting as easy a way to remove fat as it claims to be? Supermodel Linda Evangelista warned that the procedure left her “deformed” — prompting many to question whether CoolSculpting is really safe and effective.

In an Instagram post shared Wednesday, Evangelista — who did not share a photo of herself — wrote, “To my followers who have wondered why I have not been working while my peers’ careers have been thriving, the reason is that I was brutally disfigured by Zeltiq’s CoolSculpting procedure which did the opposite of what it promised. It increased, not decreased, my fat cells and left me permanently deformed even after undergoing two painful, unsuccessful corrective surgeries. I have been left, as the media has described, ‘unrecognizable.’”

She went on to share that she had developed “paradoxical adipose hyperplasia,” a risk of the procedure that she was not made aware of before. She has filed a lawsuit against Zeltiq.

Per NBC News, Evangelista underwent seven CoolSculpting procedures between 2015 and 2016. Though she hoped to change small areas of her body through CoolSculpting, which she said was advertised as a "no downtime alternative to liposuction," she found on her last round that she had developed "hard, bulging, painful masses under her skin in those areas." Evangelista, who has not modeled since 2016 due to her experience, is now seeking $50 million in damages.

The CoolSculpting website currently reads, "Rare side effects may also occur. CoolSculpting® and CoolSculpting® Elite may cause a visible enlargement in the treated area, which may develop 2 to 5 months after treatment and requires surgical intervention for correction."

According to Dr. Kirk Lozada, a facial plastic surgeon in Philadelphia, PAH is a known risk of CoolSculpting.

“How often it occurs varies widely, but the manufacturer places the risk at 1 in every 4,000 treatments (0.025 percent). Some reports have the risk closer to 1 percent,” he tells Yahoo Life. “Patients with PAH have an unexpected increase in fat in the treatment area weeks to months after treatment. The area can be painful as well. Typically, the area of increased fat takes a similar shape to the handpiece that was used and gives a rectangular appearance.”

Dr. Lozada explains that PAH that does not resolve may require liposuction to remove the increased areas of fat.

“It is important to emphasize that no treatment is without risk,” he says. “Even a simple lunch-time treatment like Botox carries risks that should be explained and understood. While non-surgical body contouring devices are not ‘surgery’ they are still a medical procedure that carry risks both common and uncommon. Linda Evangelista's case is a good example of something that is rare but real.”

Jill Badalamente, an aesthetician who is certified in CoolSculpting, notes that while CoolSculpting is effective and PAH is rare, it’s important to note more common side effects as well.

“Immediately after a treatment you may have redness and firmness, transient blanching and or mild bruising around the edges of the treated area, as well as tingling and stinging,” she says. “One or two weeks after a treatment you may have redness, bruising, and swelling, as well as tenderness, cramping, sensitivity, tingling, and numbness. Numbness can persist up to several weeks after a treatment.”

For some people looking to lose fat, Dr. Lozada points out that there may be better options depending on the results they hope to achieve.

“With liposuction, there are many more areas in the body that can be contoured effectively. While liposuction does not carry the risk of PAH, it is a surgical procedure and has its own risks associated with it,” he shares. “Kybella is another option for small stubborn areas of fat. Kybella is an enzyme that breaks down fat cells and is injected under the skin. Just like CoolSculpting, Kybella is not a great option for large areas of fat in people who are overweight.”