Cosmetic conundrum: Nip and tuck – Digging into the origins of CoolSculpting


After the treatment, Evangelista said, she developed a condition known as paradoxical fat hyperplasia, or PAH, in which the tissue in the treated area grows, hardens and stays that way. PAHs are sometimes referred to as the “stick of butter effect” because they can look like a stick of butter hidden under the skin; the enlarged fabric matches the long, thin shape of the CoolSculpting applicator.

“PAH not only destroyed my livelihood, it put me in a cycle of deep depression, deep sadness and the lowest levels of self-loathing,” Evangelista wrote. She filed a lawsuit Tuesday against Zeltiq Aesthetics Inc., the Allergan subsidiary that markets and licenses CoolSculpting devices, saying the company “intentionally concealed” the risks and “failed to adequately warn” consumers, including Evangelista, about them.

CoolSculpting is an outpatient treatment, approved by the Food and Drug Administration, that is designed to kill fat cells near the surface of the skin by cooling them in a process known as cryolipolysis. Scientists first came up with the idea behind the technique in 2008, based on the existence of a rare phenomenon that afflicts children, called Popsicle panniculitis.

When some young children suck on popsicles, their cheeks develop permanent divots because the cold damages nearby fat cells. Likewise, doctors noticed in 1980 that when women go horseback riding in the cold, they sometimes lose fat around the thighs. CoolSculpting, however, is not intended to help people lose significant amounts of weight. “It’s not a weight loss treatment,” said Dr. Paul M. Friedman, a dermatologist in Houston and director of the Dermatology & Laser Surgery Center there. It “is intended for stubborn pockets of fat that do not respond to diet and exercise in patients who are at their ideal body weight,” he said. Authorized by Zeltiq Aesthetics, CoolSculpting can be administered by physicians, typically dermatologists or plastic surgeons. After applying gel to the skin to protect it from damage, the doctor will use special applicators to cool the skin to just above the freezing point in fatty areas such as chin, abdomen, thighs, arms , the back or under the buttocks. The cold, which is administered to the skin for 30 minutes to two hours, “kills fat cells without damaging surrounding nerves, muscles or skin cells,” said Dr. Whitney Bowe, a New York-based dermatologist. .

Over the next one to six months, the fat cells die off, Dr Bowe said, and patients typically see a reduction in fat in the treated areas of about 20%; patients will often have two or more treatments on the same area to reduce fat by 40 to 50 percent, removing small bulges and making the area look more toned. Treatment plans typically range between $ 600 and $ 3,000, said Dr. Bowe. More than eight million CoolSculpting treatments were administered in the United States in 2019, according to the CoolSculpting website. The American Society for Aesthetic Plastic Surgery reports that American board-certified plastic surgeons performed 129,686 non-surgical fat reduction treatments in 2019, a category that includes CoolSculpting as well as treatments that use ultrasound to kill fat. fat cells.

Moyer is a NYT reporter © 2021

The New York Times

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