In a move that shocked us and reignited debate about the safety of cosmetic surgery procedures, legendary '90s supermodel Linda Evangelista recently shared her experience of complications following a fat freezing treatment. In an Instagram post, Evangelista described how she was left "brutally disfigured" and "deformed" when she developed paradoxical adipose hyperplasia (PAH) following a procedure — a risk she says she wasn't made aware of beforehand.
Procedures like the one Evangelista had freeze fat cells in the body. "Later on your body breaks them down and excretes them through normal systems," described Dr Munir Somji, founder of Dr MediSpa, on Instagram. He explained that it actually has a good safety rating in the long term but that there are rare side effects. PHA is what Evangelista experienced and happens when new fat cells grow in the same or other areas of the body once the frozen cells have been broken down, said Dr Somji.
Whether you've paid attention to the story (which currently involves a lawsuit) or barely given it a glance, it highlights the all too real risks that can accompany cosmetic procedures — surgical or not. In fact, campaigners have warned that the general lack of regulations for the nonsurgical procedure industry means that it has become like a "Wild West". So why does it all matter? Here are some statistics for context: the UK's cosmetic surgery industry is worth an estimated £3.6 billion, with nonsurgical procedures accounting for £2.75 billion of that. Nonsurgical cosmetic procedures include the likes of Botox, chemical peels, laser hair removal and lip filler but interest is also rising in body tweakments such as body contouring, fat freezing, lasers for slimming and body filler for cellulite.
Body contouring treatments are particularly popular – more so than ever in 2021, confirms Dr Rekha Tailor, a leading nonsurgical cosmetic specialist and founder of Health & Aesthetics. Body contouring is a fat freezing treatment that leads to permanent fat reduction. The procedure (which typically takes around 75 minutes) is said to be non-invasive with no downtime. Areas of treatment include the stomach, thighs, hips, arms and buttocks but also the face, such as the chin and jawline. World-leading aesthetic surgeon and founder of One Aesthetic Studio, Dr Jonquille Chantrey, has performed hundreds of major body contouring surgeries. She says it's predominantly non-invasive fat reduction that her clients seek now but that all procedures have their pros and cons.
Dr Chantrey frequently carries out correction work for those who have undergone body treatments. These clients, she says, are often left with scars, uneven areas and lots of disappointment. Yet the popularity of these procedures is high and a scroll of social media will give you a glimpse into their colossal appeal. Search #bodycontouring on Instagram and you'll be delivered 1.2m posts, while fat freezing videos on TikTok have racked up 24.7 million views and counting. Some of these aren't for the fainthearted, such as this video posted by @TheRealTikTokDoc. It shows a woman with horrific blisters, second degree burns and a swollen face following a fat freezing procedure. "Yep, you can totally get burned," said the doctor. He added that if not treated right, you could see permanent scarring alongside other complications. He concludes that the only fix for this is surgery.
The British Association of Aesthetic Plastic Surgeons (BAAPS) recently warned of "worrying data" that revealed "serious complications, psychological distress and permanent disfigurement as a result of fat freezing treatments, marketed as low risk and with celebrity endorsement." They say that Evangelista's brave decision to share her experience prompted them to release data from their three-year audit into problems from fat freezing treatments that have required surgery to fix. Of those documented in the audit, two people reported feeling suicidal because of the issues they'd faced. Nine eventually had liposuction and another four needed surgery for skin necrosis, which is when the skin dies and needs to be surgically removed. BAAPS didn't hold back in their comments about celebrity endorsements and deals on treatments. They say this entices people to try fat reducing procedures without thinking thoroughly about the risks.
In recent years we have been encouraged to practise self-love when it comes to our bodies. But it's no mean feat. Let's be clear: there are a multitude of reasons why people opt for cosmetic procedures and there are countless instances of treatments being done safely and well. But when care and research into the procedures is lacking, the results can be disastrous. Fat freezing isn't the only treatment to set tongues wagging, either. Off the back of popular lip filler procedures, body filler for cellulite tends to be sought-after among millennials. It is estimated that 80-90% of women have cellulite and while it's entirely normal (and more common after the menopause or due to genetics), it can be a point of insecurity for some. The burgeoning treatment aims to reduce the mottled skin effect and consists of two to four sessions of injecting filler, which is then absorbed by the body. Over time, the treated area is said to be reshaped and skin appears smoother.
Dr Tailor adds that although body filler can work well for some, it can be dangerous in the wrong hands. "As with any medical procedure there are risks," says Dr Tailor. "They include but are not limited to bleeding, bruising, swelling, allergic reaction, nodule formation (growth of abnormal skin tissue), accidental blood vessel injection (which could cause a life-threatening blockage) and contour irregularities (uneven results)." She describes seeing countless "less than satisfactory treatments" over the years, where clients have visited another clinic and undergone a procedure only to come away unhappy. She attributes a lot of these mishaps to inferior procedures (many of which are linked to under-qualified technicians) and the use of copycat tools, which can be highly dangerous.
In this TikTok video, an aesthetician is seen injecting a patient's hips with a very long needle, much to the fear of commenters, who are shocked by how big it is. Antonia Mariconda, founder of Safety in Beauty (an organisation which aims to protect and inform those seeking cosmetic and beauty procedures), says it's frustrating to hear that injectables are often touted as non-invasive. "That's not true," she reveals. "People take less time to research a procedure than choosing a pair of Louboutins, a new sofa or kitchen tiles. That should put everything into perspective." Injectable dermal filler can occlude blood vessels, which could prove to be a catastrophic emergency. Filler is also known to result in lumps, cysts, swelling and bruising. Even in expert hands, things can go wrong, but limited regulations are a real issue within the UK aesthetics industry. It's interesting to note the trickle-down effect this has on the workload of reputable medical practitioners. "Rather than focusing on providing the most appropriate treatments for patients, many practitioners are having to use their time to reverse 'botched' procedures, or rectify results in other ways," explains Dr Uma Jeyanathan, founder of Uma Skin Clinic.
Body filler isn't the only desired treatment among younger generations. On TikTok, Dr Paul Jarrod Frank recently made a video warning prospective patients about the effects of fat dissolving injections. They use acids which, he says, "supposedly melts fat in the neck and jowls". He goes on to say: "I hate this stuff. It's very expensive, unpredictable results, takes multiple treatments and is extremely traumatic and causes swelling." Dr Frank stitched his video with a clip filmed by a TikToker who had undergone fat dissolving injections. He says that she would be swollen like she is in the clip for at least a week or two and will need multiple treatments done monthly. In many cases the puffiness subsides but as Dr Frank points out, it's difficult to tell how your body might react to injectable treatments. Some TikTokers have blasted fat dissolving injections for making them look like a "bullfrog" thanks to severe swelling, while others report intense pain. A handful claim to have experienced nerve damage and "lopsided" smiles weeks after treatment. Though experts say side effects like these are not likely to be permanent, they can be discouraging and often embarrassing for many.
Considering the many innovations in the aesthetics industry, the demand for cosmetic procedures is not likely to slow down any time soon. If you're thinking of having something done (whether surgical or nonsurgical), where do you begin? Firstly, seek out a qualified medical professional and check their credentials thoroughly. Doctors can be looked up via the General Medical Council register and nurses via the Nursing & Midwifery Council register. You should also see if the practitioner is on a register accredited by the Professional Standards Authority (PSA), such as Save Face.
Research is vital and Mariconda stresses the importance of placing reputation above price. "Never choose price as a defining factor in any decision. Reputation matters; the education, qualifications, experience and outcomes of a practitioner should define your choices." She continues: "Don't be afraid to ask them questions, such as how they deal with complications, how many they have dealt with and what their procedure is. Ask to see evidence of things that matter, like insurance and before and after images. If they refuse, walk away." Lastly, whatever you do, don't rush a decision. A consultation is imperative, stresses Dr Jeyanathan, who explains that many of her clients will see a few different professionals before landing on one that is right for them.