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Richard P. Rand, MD answers: How do I choose between different smartlipo techniques?

I am interested in getting SmartLipo on my stomach mainly and potentially my hips and very small banana rolls.

I am not overweight for my height or size (I'm right at average), but I have always had some problem areas that exercise will not remove. Recently I visited the only 2 doctors in Charlotte who perform SmartLipo and interviewed them based on the recommended questions on this website. However, in doing so I found two EXTREMELY different approaches to the procedure (let's say one seemed more aggressive and the other more conservative). I would really like some of the other professionals who perform SmartLipo to give their feedback so I can make the best decision on which doctor is the best to use. Both doctors prices were about the same. My biggest fear is to have the procedure and end up looking worse than I do now. I want to know if any of these are warning signs to stay away from since both are so different. So here are the differences I'd like feedback on from the professionals:

1. The conservative doctor uses tumescent (local to the area treated) anesthesia; and the more aggressive uses twilight (like they do when you have your wisdom teeth removed)

2. The conservative doctor actually recommended trying to do extra lunges and squats to remove the small banana rolls, which he felt really weren't banana rolls; while the aggressive doctor was quick to say he definitely wanted to do it and never warned against not doing any areas

3. The aggressive doctor would do all three areas at once (just indicating that as long as they didn't go over 1 gallon of fat removed, which was the legal limit he could do multiple); while the conservative doctor was only willing to do one area per treatment (with one month waiting period or more at minimum between treatments)

4. The aggressive doctor recommended walking a mile day of treatment and for two weeks after treatment walking 4 miles each day with no weights; the conservative doctor recommended not exercising cardio for a week after the procedure with no weights or sit ups until 30 days afterwards

5. The aggressive doctor uses 1 stitch for the entrance areas (with 2-3 entrance areas for abdominals); the conservative doctor uses none (with 4-6 entrance areas for abdominals)

6. The aggressive doctor said no swimming for a month after the procedure; the conservative doctor said as soon as the entrance areas scab over and start to heal it was fine to go swimming

7. The aggressive doctor has been doing this since 2006 and does about 55 procedures a month; the conservative doctor has been doing it for 1 year and does about 12 a month

8. The conservative doctor recommends wearing the compression garment for the stomach for 30 days; while the aggressive doctor recommends for only 2 weeks

Note: I haven't heard back from the referral patients from the more aggressive doctor yet but when I spoke to the referrals from the more conservative doctor one of the patients had a very bad experience from the aggressive doctor and went to the conservative doctor for the areas to be fixed. Another referral from the conservative doctor had known second hand people who had bad results/experiences with the aggressive doctor. I have not heard anything bad about the conservative doctor. Also, the more aggressive doctor was not willing to make sure you are satisfied with your results (as per our conversation he would consult if he felt necessary with his colleagues to see their opinion before considering to fix any areas) while the more conservative said that he would go back in, no problem, if not satisfied. Also, any follow up questions I should be asking either doctor? Any ways to check for complaints or lawsuits?


Richard P. Rand, MD
15 months ago

You might be making this decision harder than it needs to be.  Remember that aesthetic surgery is an art form and no 2 doctors have the same talent level.  True talent cannot be taught either. 

If you carefully inspect many photographs from each doctor you should probably see some differences in patients who resemble you.  Choose to go to the doctor whose results look better to you and listen to your gut instinct.  Avoid egotistical or boastful doctors.  Make sure they are both Board Certified Plastic Surgeons and don't hold against one the fact that they might seem conservative - that is usually going to serve you better in most instances.

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