Is Smart Liposuction really smart?

Rian A. Maercks, MD
Article by
Miami Plastic Surgeon

Heavy spending of industry marketing dollars has caused an evolution of patients to ‘consumers.’  After being flooded with marketing information from the radio, television and magazine editorials patients start to seek out a procedure instead of seeking out a qualified health care professional and the doctor-patient relationship falls out of the equation.  This is the perfect setup for disaster.  Procedures that are indeed invasive and can have horrible complications are presented as spa treatments much like a haircut.  Belief is placed in the machine or trade name.   This environment creates a perfect situation for untrained, unqualified practitioners to claim expertise at procedures for which marketing dollars have already created demand.  What follows is a rush of low income healthcare professionals eager to jump outside their true scope of practice to generate ‘customers’ and revenue.

‘Smart liposuction,’ the commonly used name describing laser-assisted liposuction,  is the perfect example.  The arguments for Smart liposuction are claims of smaller incisional ports, less recovery and skin tightening.  All of these claims seem attractive on the surface but are really deceiving.  Sure, the canula used in “smart liposuction” is small, but a trained surgeon that practices liposuction and fat transfer will have an array of canulas smaller and bigger than the laser canula, and there is good reason for this.  There are many potential pitfalls to liposuction and a practitioner must understand the indications for using thin, thick, short, and long canulas as well as when an energy modality is indicated (ie laser, ultrasound or mechanical).  If only a “smart canula” is used in a patient needing significant deep fat reduction, the treatment will be less than ideal.  On the same note “less recovery” claim is also deceiving.  If one were to use a conventional canula without laser the same size as a “smart canula” and performed the same technique, one could expect near identical bruising swelling and recovery from both.  In short “smart liposuction” has less recovery simply because less is done.  This translates into less downtime and LESS RESULTS!!!  Plastic surgeons have been studying laser assisted liposuction and carefully comparing it to conventional liposuction in search of definable advantages.  To date the conclusions are that laser assisted liposuction is more tedious, time consuming and thus less effective then conventional and no advantages have been discovered in any of the above categories.

At The Maercks Institute, I instead uses ‘intelligent liposuction.’  Intelligent liposuction has a lot more to do with the hands holding the device than the device itself.  Intelligent liposuction is simply a HistiocentricTM  approach which involves carefully assessing the patients requests and concerns, the attributes of the patients body and tissue qualities and selecting the safest and most effective modalities for that patient.  Intelligent liposuction is a combination of one or many of the following: conventional tumescent liposuction with large canulas for deep large volume fat reduction, small canula liposuction for superficial fat removal and contouring adjacent areas, Ultrasound Assisted Liposuction (UAL) for tight fibrous areas, zones of andherence and areas of poor skin quality where deep heating may convey benefit as well as external energy delivery  for tightening( Infrared light heating) and even laser assisted liposuction for patients that have minimally sized problem areas and still desire this modality after education of its true attributes.

Remember that liposuction IS surgery!  Remember “minimally invasive” is one of the most misunderstood phrases of our time!  The area of surgical intervention with liposuction is much larger than most open surgical procedures!  Surgery is very different from a haircut and should involve a true doctor-patient relationship that you believe in!  Choose intelligent liposuction with well trained hands connected to a well trained brain over ‘smart liposuction!’