By María Luisa Paúl
Her name was synonymous with '90s glamour. Her face - likened to Sophia Loren's - splashed across magazines. Her tall and lithe silhouette featured on every catwalk. But supermodel Linda Evangelista's life took a turn in 2015, almost vanishing completely from the spotlight.
Last September, Evangelista explained the reason for her retreat through a statement on Instagram, saying a cosmetic treatment had left her "permanently deformed" and "brutally disfigured."
After years in the shadows, the Canadian model - known for walking the runways for the likes of Gianni Versace and Thierry Mugler - sat down with People magazine for her first public photo shoot since the procedure. Now 56, she said she was done hiding her body.
"I loved being up on the catwalk. Now I dread running into someone I know," she told the magazine in the interview published on Wednesday. "I can't live like this anymore, in hiding and shame. I just couldn't live in this pain any longer."
Back in 2015, Evangelista tried Zeltiq's CoolSculpting - a Food and Drug Administration-approved noninvasive procedure that shrinks fat cells by freezing them. According to a lawsuit she filed in September against Zeltiq Aesthetics, Evangelista went to seven sessions - targeting her chin, thighs, back and bra area - from August 2015 to February 2016.
After a few months, the model realised that not only was the procedure not working, but it "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," Evangelista said in the statement.
Evangelista told People that she began noticing protrusions in the areas she was treating. Eventually they grew, hardened and then turned numb.
Desperate to solve the problem, the model turned to dieting and exercising - to no avail.
"I tried to fix it myself, thinking I was doing something wrong," she said. "I got to where I wasn't eating at all. I thought I was losing my mind."
Her doctor told her she had developed paradoxical adipose hyperplasia, or PAH - a rare side effect in which the body produces new fat cells to replace cells that are frozen by CoolSculpting. According to a July study published in the Aesthetic Surgery Journal, the risk of PAH in those undergoing the treatment is about 1 in 2 000 treatment cycles. In 2014, the first study written about the condition found that it affected 1 in 20 000 patients.
"The disparity between incidence rates found within the literature indicates that PAH is likely being underreported and misdiagnosed," the researchers wrote.
According to Evangelista, the doctor who diagnosed her with PAH contacted Zeltiq, which offered to pay for liposuction treatment. However, she alleges that the company offered the corrective surgery free-of-charge but on the condition that she signed a confidentiality agreement.
Declining to do so, she said she paid for the two liposuction rounds herself - procedures she deemed "painful" and "unsuccessful" in her September Instagram post.
Now Evangelista is seeking compensatory damages of $50-million.
Medical technology company Allergan Aesthetics, which acquired Zeltiq in 2017, referred The Washington Post's request for comment to CoolSculpting's safety information website.
"Rare reported side effects can include Paradoxical Hyperplasia (PH), severe pain or late-onset pain and continue to be well-documented in the CoolSculpting information for patients and health care providers and sample consent form given to health care providers to use with patients," according to the website.
Over 11 million CoolSculpting treatments have been carried out worldwide. In 2020, the Aesthetic Society ranked nonsurgical fat reduction, which includes CoolSculpting, among the most popular noninvasive cosmetic treatments in the United States, with some 140,314 procedures performed - up from 129,686 in 2019.
The pandemic has proved to provide the perfect storm of conditions for a spike in cosmetic treatments - with plastic surgeons across the globe reporting an unprecedented increase in the demand for procedures.
"We believe there were several factors that came together to drive aesthetic surgery even during the pandemic - the boom in video calls and more opportunity for discreet downtime," Herluf G. Lund Jr., president of the Aesthetic Society, said in a news release last year.
But Evangelista's story, taking light during a plastic surgery boom, has opened a debate about expectations for women's ageing and the impossible beauty standards they are held to.
At the height of her career, Evangelista was favoured by designer Karl Lagerfeld and frequently featured in his Chanel campaigns. She appeared in more than 600 magazine covers and was famously quoted saying she "wouldn't get out of bed for less than $10,000." In later years, she faced the pressure of getting older in front of the spotlight, she said.
"Why do we feel the need to do these things [to our bodies]?" a tearful Evangelista told People. "I always knew I would age. And I know that there are things a body goes through. But I just didn't think I would look like this."
For those who may be undergoing the effects of a botched treatment or a decline in self-confidence, Evangelista said she hoped sharing her trauma could help them feel less alone.
"I hope I can shed myself of some of the shame and help other people who are in the same situation as me," she told People. "That's my goal."