Troy Pittman, a board-certified Washington, D.C.-based plastic surgeon, said he’s “not surprised” about the news that Evangelista experienced PAH.

According to a July study published in the Aesthetic Surgery Journal, the risk of PAH in those undergoing CoolSculpting is approximately 1 in 2,000 treatment cycles, while the estimate in the first paper on PAH, published in 2014, was 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.

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