Linda Evangelista says she was 'brutally disfigured' after CoolSculpting. What is it?

Supermodel Linda Evangelista is opening up about how a cosmetic procedure kept her out of the spotlight for years. 

Evangelista wrote in an Instagram post Wednesday she was left "brutally disfigured" after CoolSculpting and found herself in a "cycle of deep depression."

"To my followers who have wondered why I have not been working while my peers' careers have been thriving, the reason is that I have been brutally disfigured by Zeltiq's CoolSculpting procedure," Evangelista wrote.

On Tuesday, she filed a lawsuit against Zeltiq Aesthetics seeking $50 million in damages. Zeltiq Aesthetics did not immediately return USA TODAY's request for comment. 

"I have been left, as the media has described, 'unrecognizable,' " she wrote. The former model said she underwent two corrective surgeries to no avail. 

What is CoolSculpting? 

According to Medical News Today, CoolSculpting is an FDA-approved fat reduction process that uses "freezing temperatures to break down fat cells." During the process, skin is vacuumed into a device that cools the fat cells. 

“Coolsculpting is the No. 1 non-invasive fat reducing procedure in the world,”  says plastic surgeon David Rapaport, who performs the procedure in his Manhattan office. "People don’t all want liposuction (because) it is a somewhat invasive procedure, it can be painful. You can have bruising.” 

Andrew Ordon, who has held a plastic surgery private practice for more than 30 years and hosts "The Doctors," says he doesn't use CoolSculpting in his practice because the results are "unpredictable." 

"You don't know exactly what is going on below the skin," Ordon says. "I prefer to do liposuction because in my hands it's a more controlled, predictable technique." 

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Are adverse reactions to CoolSculpting common?

"It increased, not decreased, my fat cells and left me permanently deformed," Evangelista stated.  

She said since the surgery she has developed Paradoxical Adipose Hyperplasia, which according to a 2014 medical journal case report, is an adverse reaction to CoolScultping that results in the cells growing in the treated area.

According to her lawsuit, Evangelista "was in good physical shape and at a healthy weight and body mass index prior to using ZELTIQ’s CoolSculpting System." 

"Beginning in August 2015 through February 2016, Ms. Evangelista underwent seven treatments using the ZELTIQ CoolSculpting System for the intended purpose of breaking down fat cells in her abdomen, flanks, back and bra area, inner thighs and chin," the lawsuit states. 

"Following the final round of CoolSculpting treatments, Ms. Evangelista noticed that the areas treated with the CoolSculpting System were getting larger, not smaller, as they had after her previous CoolSculpting treatments."

On the CoolSculpting safety information page, Paradoxical Adipose Hyperplasia is listed as a possible side-effect. The safety information site suggests "surgical intervention, such as liposuction, for correction."

The suit states the supermodel was not aware PAH was an "adverse effect associated with use of the CoolSculpting System."

Rapaport describes Evangelista's condition as a “rare complication” that only occurs in “one in several thousand people" who have had the procedure. 

"PAH has not only destroyed my livelihood, it sent me into a cycle of deep depression, profound sadness and the lowest depths of self-loathing," Evangelista wrote on Instagram. 

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Fashion designer Brandon Maxwell commented: "I’m so sorry you have had to endure something so painful. As someone who idolized you growing up, and still does to this day, I have always recognized you as someone who was physically beautiful, yes, but more importantly you really shone bright from within." 

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