CoolSculpting is a non-invasive body contouring treatment that uses extreme cold to reduce the number of fat cells in an area. But it’s also becoming notorious for a side effect called paradoxical adipose hyperplasia–aka the fat cells get larger and harden instead of going away. PAH presents as hard lumps under your skin–because of the treatment applicator shape they can even look like a stick of butter. This happened to supermodel Linda Evangelista and she sued the manufacturer of CoolSculpting for how badly it disfigured her body. They ended up settling out of court. Now a popular YouTuber, Abbey Sharp, is talking about her own experience with this PAH side effect. I watch Abbey’s videos and find them entertaining–she’s a registered dietitian who adapts what celebrities say they eat into more nutritionally balanced meals. (Needless to say, her Gwyneth Paltrow videos are priceless). Here’s what Abbey had to say about her botched CoolSculpting, plus insights from a plastic surgeon:
Abbey was sold on CoolSculpting because it was non-invasive: Sharp — who battled orthorexia, or an obsession with healthy eating, in the past — says she never felt that she had a flat stomach and was told by the med spa that CoolSculpting could help her achieve one. Because Sharp was already slim, she was told that she was an ideal candidate and that her “trouble” spots could be specifically targeted. “That’s how it was sold to me,” Sharp tells Yahoo Life. “It was like, ‘This is a no brainer. It’s less invasive than Botox.’ That’s the vibe I was getting.”
After Abbey’s treatment sessions, things started going wrong: “There were more almost like lumps or bumps that weren’t there before and my body looked uneven,” she explains. “My side started to look more uneven, my lower belly had a bulge that wasn’t on the other side. So I thought, let’s go back and see what we can do about this. I was never told that CoolSculpting could cause any of this — it made absolutely no sense in the context of the way CoolSculpting was described to work.”
More CoolSculpting didn’t fix it: Sharp returned to the med spa, where she was given a free extra CoolSculpting session. She noticed no difference in her body — the lumps remained. It wasn’t until a decade later that Sharp came to believe the still-noticeable bulges were from a little-discussed potential risk of CoolSculpting, known as paradoxical adipose hyperplasia (PAH).
PAH may not be as “rare” as the manufacturer says it is: According to manufacturer data, PAH occurs in 1 in every 4,000 treatments — yet that data may not tell the whole story. Not everyone who experiences PAH will report it to their doctors, who can then report it to Zeltiq. Sharp, for example, was initially unaware of PAH and the connection to her CoolSculpting procedure.
We don’t know what causes PAH: New York City-based plastic surgeon Dr. Chris Funderburk regularly treats patients who have had negative outcomes following CoolSculpting and thinks there are too many unknowns right now. “We just don’t have any good data on this,” he says of the reason why PAH occurs. “We don’t know what settings to use to avoid PAH. We don’t know what generation of machine to use, or paddles, in order to avoid it. It’s all still a mystery, unfortunately.”
In Abbey’s video she talks about looking into surgery to get the lumps removed, but opting out of it because the recovery time would prevent her from being as active as she’d like to be with her two small children. I’m really glad Abbey is talking about this side effect because my suspicion is that it’s more common than 1 in 4,000. I think that the risks of this procedure are not always made clear to patients. Abbey says no one told her about the possibility of PAH as a side effect and a similar thing apparently happened to Linda. That isn’t informed consent, as far as I’m concerned. It’s also wild to me that the medspa just gave her more CoolSculpting when she told them about the lumps–if anything, that would make it worse!
I’m not a surgeon or a doctor but I wouldn’t tell anyone to get this treatment done. The results are modest (a 25% reduction in fat cells is the best case scenario) and not worth the risks. A family member of mine did CoolSculpting and she didn’t get PAH but it also didn’t give her any real results. Abbey’s PAH was minor enough that liposuction probably would have fixed it, but for Linda Evangelista, not even liposuction made it go away. The hard lumps came back. I feel for Linda, and for Abbey. If they had known about the risks of this side effect, they could have at least made an informed decision.
photos are screenshots from YouTube, via Instagram and credit People
This is so fascinating. I see stuff like this and I think to myself, why can’t we just be happy with our bodies?!?!? Like, this woman and Linda Evangelista I’m sure had beautifully shaped bodies before these procedures, but they weren’t happy. I think back to when I was in my teens and 20s and thought I was so fat and had such a disgusting stomach, and damnit! I totally wasn’t and didn’t. So much wasted energy. I can’t even imagine the regret and anger from this happening. I haven’t seen any photos of the lumps, but I know even tiny things can send some people spiraling
I agree, it’s so sad that we aren’t taught to be happy with our bodies when there’s nothing wrong with them! I wish our culture emphasized health and exercise (whatever those are for each person and their body) instead of having the “right” body shape with fat only in the “right” places.
I know there’s a lot of support for women especially to do what they feel they need to be happy within themselves, but I don’t think normalizing cosmetic procedures is the right way.
Yup. My mom always used to say me “youth is wasted on the young” and boy, ain’t that the damn truth. I so admire folks who achieve body acceptance at an early age because I wasted so much time criticizing my body instead of appreciating it.
Because billions are made from making us unhappy with how we look and these influencers and reality trash are at the front of the line making money.
Yes, to all of this. I wasted so much time & thoughts on my less than ‘ideal’ body. I was fine! I’m so glad I never had the financial wherewithal to try treatments like this, or lipo, or surgery. Because yes, the ‘improvery’ complex is all about making us feel bad about ourselves so that we will buy this procedure, this dress, this makeup, this undergarment, etc. to look ‘better’.
This is what irritated me with Martha Stewart’s swim suit article. I am not against wanting to feel good about yourself your entire life but why is it striving to keep up a “youthful, thin” appearance the only way, or at least the celebrated way, to do it? It’s exhausting mentally.
Remember when half of Kelly Rippa’s face froze from from Botox? I wish more people would talk about when things go wrong because we really don’t hear about it in proportion to as often as it has to be happening.
I wonder if there are times more “invasive” surgeries are actually safer than “non-invasive” procedures? I was thinking of “non-invasive” rhinoplasties (getting liquid fillers rather than surgery). They are considered very high risk and can result in necrosis.
I worked for plastic surgeons for 15 years and to this very day I STILL remember women coming in with “I have this pudge on my stomach” or “these hips” and on and on. I just kept thinking but you look AMAZING.
I understand the pressure society puts on women (and men!) but my lord, the lengths these folk go to just astounds me
I had CoolSculpt on 4 areas (arms, stomach, inner and outer thighs). I don’t see any real difference. I also did the hyper sculpt on my arms and bum, again no real difference.
I had it done in Argentina so the cost was extremely low, so it wasn’t a massive waste thankfully. But yeah, don’t bother
I had CoolSculpting done on my abdomen a few years ago. I was a good candidate, as I am pretty thin but just had some overlying fat in that area. Now my right side is noticeably flatter, but my left side has a noticeable bump. At first, I thought that it just didn’t “work” as expected on my left side. It wasn’t until these stories came out that I’ve realized what actually happened.
I’ve thought about seeking additional treatment in some way, but I’m much more body positive than I was a few years ago, so I think I’m going to accept it and move on. I’m not in a place where I feel the need to do something drastic to correct it now.
It’s definitely disappointing and I tend to gravitate towards one-piece bathing suits now to hide it. I wish I would have known the risk, but I honestly probably would have ignored them anyway to try to get a flatter stomach the easy way.
I’m moving forward with the attitude that it was a lesson learned for me, and I can educate my daughter on the importance of feeling comfortable with your body in any form.
I am struggling a little with these cases? There are no shortcuts and EVERYTHING comes with risks. Not thinking through risks, especially in cosmetic procedures, is incomprehensible to me, but maybe I am being too harsh? Cosmetic procedures lean heavily on the risk side of the equation because they aren’t necessary; like, you aren’t balancing the risk with something life-saving…. I don’t want to veer at all into victim blaming but would a nutritionist know better than most that there are no short cuts? I just… maybe I am grumpy today?
I think maybe a little grumpy. I think you’re expecting everyone to make logical conclusions while foregoing their emotions (and sometimes the influence of their mental health). Also, in the case with these two, they weren’t informed of this side effect so it didn’t weigh into their decision making.
But yeah, the risk is always there.
I just don’t believe that they were not informed. I believe that they did not read, and that they were not particularly encouraged to read. But you don’t even get a simple painkiller these days without a long description of potential side-effects, and surgery consent forms are long and complex. People don’t read and even when they do they just believe that it won’t happen to them.
To be fair to them, I think the risks are pretty low. When you hear that 3% or 5% of people have complications, I think most of us would never think we would be in that small percentage. I had an IUD and there was a super small % (I think 1-3%) of people who spot/bleed more than 3 months. I bled every day for more than a year and finally had it removed but still 100% recommend it for others.
This Youtuber is such a troll and sociopath and I can’t stand her.
She pretends to stand for body positivity as she has her eating disorder herself, and then makes a ton of money ripping apart other youtubers (mainly women).
Exactly. I watched a few of her videos and she sounds like such a pill. It is all about self-acceptance… and criticizing any person prescribing a diet of some kind. And then off she goes for a procedure, as non invasive as it is. This is trolling to the highest level. I mean the lady can go on and on about how having a spoonful of vinegar in the morning is harmful for teeth and has no value whatsoever and one needs to accept that the body does it’s own thing bla bla bladibla and then she goes off and does this.
I am really losing my patience with this society. We are so careful with this imbalance (because we want to not hurt people) that we end up moving our standards to pathological levels of self-hate. This is immensely effed up.
I’ll stand by the corner on my own.
Ugh, she sounds terrible. I’ve just become aware that there are a whole group of social media people whose only content is to mock other social media people. I get it on some level but if that’s your entire content it’s just so . . . depressing. I’m all for social commentary and even dark humor but you have to be a whole different level of bitter to do nothing but that day in and day out.
I agree with you. I’ve seen some of her reviews for other people’s “what I eat in a day” videos and she’s so adamant about having each and every meal you eat be PERFECTLY balanced between all macros and nutrients that it just screams disordered eating. (It’s just common sense that as long as everything is more or less balances over the whole day/couple of days, you’re fine.) You don’t need perfect composed bites every single time — aka it’s okay if you just have a piece of fruit for an afternoon snack or whatever, you’re not “doing it wrong” if you don’t have yogurt and nuts or whatever to make sure everything’s even all the time. It’s just not a practical way of doing things, especially if you’re on the go, etc.
Her whole vibe is “know-it-all that would NEVER trust charlatans” so the fact that she decided to do this procedure at all, much less at a freaking med spa vs a real doctor is so telling. It’s the kind of choice she would be holier than thou about on her own channel.
This seems like it happened years ago for both of them. I’m wondering if they weren’t informed bc the medspas didn’t know?
Anyway I’m glad you wrote about this bc I’m on a weight loss journey right now and my stomach has always been my trouble spot. To the point that I looked like a teddy graham. Like you could see my ribs but I still had a significant gut in comparison. I was thinking about this at the end of my journey, but now I’m thinking, after 39 years, just accept that I’m never going to have a flat stomach.
There is no way they were not warned. I can believe that they did not read the fine print and that the complications were down-played, but those potential complications were known from the beginning and anything medical has attorneys all over it. As I said before, I just think that none of think that we’re going to be the 1-3 in a 100 that has a problem.
I think they didn’t read the fine print cuz any procedure even a minor dentist visit you have to sign that you’re aware of the risks so they can’t say they weren’t warned.
I’ve never in my life had a flat stomach, even as an anorexic teen. Some of us are just built that way, and it’s OK. Good luck, Steph.
@Josephine: probably the same as reading the tiny print possible side effects on your medications. You read them (I do, at least), but there’s so many & they’re so dire & you’ve got this prescription so you risk it anyway. I imagine something that doesn’t even require a medical degree to do makes a lot of people more comfortable than perhaps they should be.
I am a physician and I can’t tell you how hard my patients roll their eyes when I insist on going over the horror reel of extremely bad complications that almost never happen. I tell them guess what it’s gonna happen to someone someday and I want your radar up early on if it’s you. Then I finish the reel while they continue to roll their eyes.
Even for the hey this kind of sucks and there’s about 10% that it happens to and if it does then you need to…. blah blah.
They don’t want to hear any of it.
There are people who are very happy with their cryolipo outcomes. But you don’t hear from them, probably because it’s more fun to have people think they achieved the fat reduction through virtue and hard work and enough kale to feed a zoo for a day.
I lost a lot of weight very fast (I was 18 years old and to this day I don’t understand how it happened) and the skin of my inner thighs kind of sags. It doesn’t matter how much I work out, the skin keeps sagging. Surgery is very risky and I’ve been advised against it by plastic surgeons.
However, CoolSculpting was recommended to me as a way to help reduce the size of my thighs. At no point did they ever, EVER, comment on the risks involved. I had this done in 2019 on my inner and outer thighs and lower hips/stomach. I guess I was lucky because I haven’t seen anything amiss since then. Results were minimal so I didn’t bother with more sessions (It’s also pretty expensive). I guess one of my thighs sags more than the other but this was always the case.
After everything we now know, I would advice against it. I know accepting our bodies is what we should do, but it’s easier said than done. CoolSculpting is, to me, not worth the risk.
Go on a diet! Do low(er) carb! Working out and eating healthy works! I know on every post they’ll be someone who says they can’t lose weight with traditional methods. But geez, we don’t need these crazy fads. We really don’t.
Josephine, I totally agree with you. You couldn’t even take an aspirin if you took to heart all the possible things that could happen to you (by law, listed on the label). Even if it were less than 1%, they’d still be legally liable to tell you. And, yes, I too would believe I would not fall into that very small percentage of people who did have very bad reactions.