In recent years, non-invasive cosmetic treatments have become as routine as a visit to the dentist. Plagued by dark spots from too much sun exposure? There’s an Intense Pulse Light, or IPL, treatment to zap them away just around the corner. Need a little bounce brought back to your visage? Sculptra – a poly-L-lactic acid that, when injected, kickstarts collagen production with natural results that can last up to two years – can be done over a lunch break. Heat lasers, microdermabrasion, Botox injections and other procedures can all easily be folded into everyday self-care routines thanks to their ubiquity, social acceptance and safety track record.
Photo: Ariadna22822. For illustrative purposes only.
But when I was recently offered the opportunity to experience Coolsculpting, a fat-freezing treatment called cryolipolysis, I paused. Despite it being one of the world’s most common body sculpting procedures – it’s been performed well over eight million times around the world– for many, it’s still connected to high profile media reports of Canadian supermodel Linda Evangelista’s rare Coolsculpting complication called paradoxical adipose hyperplasia, or PAH, in which she experienced the reverse effect. While it’s true that in the name of beauty research, I’ll happily offer myself up as a guinea pig – especially as my age creeps up while gravity steadily pulls other parts down – risking potentially putting on extra pounds isn’t one of them. I wasn’t about to go down the rabbit hole, and literally get stuck.
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While the procedure isn’t designed to be a weight loss treatment (in fact, you don’t actually really lose weight, but more on that later), it’s a body shaping treatment aimed at removing small stubborn pockets of persistent fat in otherwise healthy, active people. Those who are broadly within 10 per cent of their ideal weight make for the perfect canvas so, as it turns out, the extra 10 pounds I carry around make me a prime Coolsculpting candidate. As for the supermodel woes: “This is a story that isn’t being told fairly,” says Dr. Thomas Buonassisi, who’s been practicing facial cosmetic surgery for more than 20 years and opened his Vancouver-based 8 West Clinic in 2008. “In medicine, we use science, but in the media, headlines sell and sometimes the information put out there isn’t accurate, so it’s worthwhile to talk about this.”
Vancouver-based Dr. Thomas Buonassisi, a board-certified Facial Plastic Surgeon, specializes in neck-up cosmetic procedures like rhinoplasty, facelifts, blepharoplasty and brow lifts, earning recognition as an expert in his field.
Allergen, Coolsculpting’s parent company, puts the risk of PAH at 1 in 3000, which is about the same odds as getting struck by lightning. Allergan is so confident about the safety of its popular procedure that it offers free liposuction should a patient be one of those statistical outliers. Dr. Buonassisi himself has only seen two cases in his entire career. Dr. Buonassisi frames it this way: “My wife rides a couple hundred kilometres a week on a bike – that’s far more dangerous.”
And so with that, I decided to take the plunge – or, in this case, the purge at Project Skin. Helmed by Dr. William McGillivray – one of the first Canadian physicians to offer laser hair removal, Fraxel laser resurfacing and Thermage skin tightening – the Vancouver, Richmond and Ottawa-based clinic has been performing Coolsculpting for 10 years (and, of note, they’ve yet to see a case PAH). “The ideal Coolsculpting patient exercises regularly and leads a healthy lifestyle, yet still has stubborn fat pockets that they can’t get rid of – gender and age are of little significance,” explains Dr. McGillivray. Although I’m an active tennis player and, despite the occasional lapse with a bag of Twizzlers, I eat pretty well too, but the extra few pounds I’ve carried since the birth of my second child have been dogged and persistent.
Dr. William McGillivray and his wife Bev founded the first Project Skin MD® clinic in Vancouver, partnering with SkinCeuticals to launch North America’s first SkinCeuticals Advanced Clinical Spa in a 6,000-square-foot South Granville facility.
While I may make the perfect candidate, my expectations are still tempered: “Coolsculpting is not a weight management treatment,” says Dr. McGillivray. “In fact, it doesn’t impact weight at all but instead eliminates subcutaneous fat.” Subcutaneous fat is the stuff you can pinch, but it weighs almost nothing while visceral fat is the dense, heavy fat that surrounds our organs. “Think of subcutaneous fat like a bag of cotton balls,” explains Allergen Practice Development manager Meagan Corbett. “When you dump out a bag of cotton balls, you’ve lost volume, but the bag still weighs the same.” In other words, don’t expect the scale to go down, but do expect bulges and squishy bits to shrink anywhere from 10 per cent to 26 per cent. How much really depends on the patient. Those with a significant amount of subcutaneous fat will require more treatments than the typical two while those who exercise regularly and lead healthy lifestyles will see quicker results with smaller areas of concentrated excess fat. Where I sit exactly is unknown, but I’m game to try.
Stripped down to underwear and bra, I’ve left my modesty at the door in the initial meet-and-greet with my technician Justine Trottier. Pictures from every possible angle are taken and catalogued so we can determine the two areas I’d most like to see a reduction in size. The process involves using vacuum applicators that go over the area of the body you’ve designated (underarms, stomach, bra fat, etc), – and in my case, my post two-baby stomach and some rather pesky back “bra fat” that spills out battle it out for first place – and which get turned on in the same way you turn on a vacuum cleaner.
Treatment room. For illustrative purposes only. Photo: Project Skin MD Vancouver
In the treatment room, Justine applies a thick, goopy gel-like pad and then places a vacuum applicator over it, which, when turned on, starts suctioning my squishy stomach in. I imagine this is what sticking a Dyson vacuum on my stomach feels like. The skin gets sucked in and the section of my stomach being suctioned is then spot-cooled down to -11 in a highly controlled process, which is what kills the fat cells underneath: I feel a strange cold sensation for the first five minutes followed by complete numbness until the full cycle is up (35 minutes in total). The only uncomfortable part is when Justine immediately massages my stomach afterwards, which immediately begins to feel like she’s pressing on bruises (but massaging the affected area for one minute increases the potential fat loss by up to 60 per cent). “Some people feel nothing while others feel discomfort – there’s no way to tell,” she says, rather apologetically, as she digs in.
My skin is red immediately after the applicator is removed and raised where the section of skin is being frozen. However, this raised, red patch subsides very quickly – for me on my stomach, within a minute or two, but it’s key to note everyone’s response is different.
Anywhere from one to three months afterwards, those numbed fat cells will crystalize and undergo a process called apoptosis – a naturally programmed cell death. Once the fat cells are dead, macrophages go in and eat the garbage (think Pac-Man) and then the lymphatic system steps in to drain the body of said dead fat cells (what happened to Linda Evangelista is essentially the opposite – her cells proliferated). Once those fat cells are eliminated from the body, the results are permanent, as our bodies don’t create new fat cells past adolescence.
On a midday break from work a month later, I return for my second treatment. This time, the pressing-on-bruises sensation was far less noticeable while I felt literally nothing on my back. And then a full three months later, I return to the camera room for pictures. I’m excited to see the results: although my scale has remained unchanged, I’ve noticed a subtle difference. My stomach is flatter; my sports bras don’t look as unsightly. Justine shows me the before and after and the proof is there. I feel there’s a clearer definition in my stomach now and for my tennis tops, I’m comforted knowing no bulge exists. I’ve got a beach vacation coming up and, for the first time in a while, I think my long-neglected bikini will be making an appearance.
