Your question brings up important issues regarding credentialing, liposuction in general and Smart
lipo. It's true that any practitioner surgically trained or not can basically do anything in the office setting without being monitored or credentialed in any way. Operating in the hospital environment requires peer review of training and credentials and therefore provides some protection to the public from those practitioners who self proclaim experience and bogus certifications wrapped in slick marketing packages. Many real Plastic surgeons ignore new technologies because they are comfortable with procedures they have used since residency. Also, Plastic surgeons who have experience with both Smart lipo and traditional lipo know that the benefits of Smart lipo are small yet the laser technology used makes the procedure much more difficult to perform leading to a much higher complication rate. Many real Plastic surgeons see these devastating complications due to laser lipo and choose not to do Smart lipo. It could be that Smart lipo is not so smart after all.