LIPOSUCTION: “Smart Lipo,” Laser Liposuction, “Vaser” Liposuction, and the truth.

Lane Smith, MD
Article by
Las Vegas Plastic Surgeon

As a busy plastic surgeon in Las Vegas, I am frequently amazed and dismayed by the often inaccurate and exaggerated claims made about supposedly “new” plastic surgery procedures and technologies.

Unfortunately, more than any other field of medicine, cosmetic surgeons rely on a certain amount of competition to obtain patients. The patient has to want your product; and, as a cosmetic surgeon there is great pressure to obtain patients who want surgery.

In attempt to “win” patients, unscrupulous doctors or medical companies may make claims are made that are exaggerated or inaccurate or even completely false. The general premise is to create an illusion that a particular doctor has a new product, new surgery or new technology that is vastly superior to his or her competitors and implies that the patient must come to him or her for this “special” plastic surgery.

As the current president-elect of the Rocky Mountain Plastic Surgery Society which covers eight western states ( NV, UT, MN, AZ, WY, ID, NM, and CO), I have had the privilege of working with many fine Board-Certified Plastic Surgeons in these many states. I can speak with authority when I say the vast majority of these surgeons are honorable and hard working, giving good service and reliable information to their patients and public. None-the-less, I am frequently confronted by patients who have been misled and are unhappy.

Lately the current hype is in the area of liposuction. Almost daily there is some claim made about “Smart lipo,” “Laser Liposuction,” or Vaser liposuction. There are claims made that there is no bruising with these types of liposuction, or no pain, or very little pain, or better skin tightening or better results.

The “Smart Lipo is a trademark of Cynosure. Is uses a laser fiber to burn away some of the fat cells. In an effort to sell these machines there has been a lot of press and hype about the results obtained with this type of liposuction machine. While there may be a slight benefit for small areas such as the submental area (the small area of fat under the chin), even the company admits it is not really useful for large areas such as a thigh or abdomen. Also there is a risk of burns with this laser that does not exist with traditional or tumescent liposuction. It is important to know, that no matter what you name a type of liposuction machine, be it “Smart Lipo,” or Genius Lipo or any other name; the machine only as smart as the person using it. Experience, surgical skill and artistic talent always trump any type of liposuction machine.

VASER is a registered trademark of Sound Surgical Technologies. It is a form of ultrasonic liposuction that has been present since the mid 1990’s. Initially ultrasonic liposuction was hoped to be superior to tumescent liposuction. I was trained using mostly ultrasonic liposuction. We hoped that the skin tightening would be better. With time, this was not shown to be the case. Instead, there appeared to be little to no advantage to ultrasonic liposuction, but the there did seem to be an increased rate of complications such as seromas (fluid collections) and numbness. The biggest complication was a risk of burns, which does not happen with tumescent liposuction. Because there was little or no advantage to ultrasonic liposuction and an increased risk of complications, surgeons slowly abandoned ultrasonic liposuction. However, due to marketing, there appears to be a resurgence in the number of surgeons using ultrasonic liposuction. Whether or not VASER is a better form of Ultrasonic liposuction remains to be shown. Once again, the skill and talent of the surgeon are much more important than the machine he or she uses to perform the liposuction.

In my opinion, tumescent liposuction is still the safest method that produces consistently safe, good surgical results. Much more important than the type of liposuction machine that is used, is the skill of the surgeon performing the liposuction. When deciding on liposuction, chose a surgeon with experience, skill and good credentials. Do not be fooled into choosing a surgeon because he or she advertises they have some better machine or type of procedure than someone else. Most likely, if they have to make such claims, they are in fact, in need of patients.