How is Cool Lipo different than traditional liposuction?

Cool Lipo and Smart Lipo from a surgeon's view

As a Plastic Surgeon that uses liposuction and fat-grafting techniques on a regular basis, I am certainly interested in learning about new techniques that may improve upon "traditional liposuction." As a disclaimer, I must say that I do not have personal experience with laser lipolysis devices such as the Smart Lipo and Cool Lipo devices. I read with great interest the one independent, peer-reviewed study I have seen to date that tried to specifically address this question as to the merits of laser lipolysis. The article, "A prospective, randomized, double-blind, controlled clinical trial comparing laser-assisted lipoplasty with suction-assisted lipoplasty," was published in the journal Plastic and Reconstructive Surgery in September of 2006 (this journal is the largest and most respected in the specialty of plastic surgery). See the article's abstract.

This is a carefully planned study that set out to assess the best way of scientifically comparing the laser Smart Lipo laser lipolysis device with standard liposuction by using both techniques in a series of 25 patients (one technique being performed on each side of symmetrical body fat areas). Patients and observers were randomized and blinded as to which side received each treatment to avoid bias. The article's authors concluded that:

"This study failed to demonstrate clinical advantages of laser-assisted lipoplasty over the traditional suction-assisted lipoplasty method... Refinement in laser instrumentation must evolve and prove to be more cost-effective than the traditional method before it can be promoted as a proved technology for the assistance of lipoplasty."

However, while this study concluded that no major clinical differences could be identified between the results of the two techniques, it did identify slightly less post-operative discomfort and suggests less blood loss with laser lipolysis. It was also noted as a disadvantage that the fat cells are rendered non-usable for fat grafting or transfer to another area of the body when subjected to laser lipolysis.

So, in my skeptical view of new technologies, this technique does appear to be effective, but for me it does not yet provide compelling advantages over current techniques. It is notable that plastic surgeons and others in aesthetic medicine are continually bombarded with highly promoted new products, techniques and technologies.

At our 2007 American Society of Aesthetic Plastic Surgery annual meeting, significant ethical and safety concerns were raised about such marketing and business influences in our specialty, and I do believe these are valid concerns. The best assessment tools we have are independent, peer-reviewed, prospective studies such as the one sited above where the authors ideally have no financial interest in the products or technologies being studied (or alternatively where any such interests or compensation are fully disclosed).

In conclusion, it does appear that, in competent hands, laser lipolysis is an effective tool. It is not a tool that I currently use, but I am still interested in learning more about these techniques. I recommend that a patient considering body contouring carefully weigh the training and experience of their surgeon and ask pertinent questions at a consultation about treatment options, risks and anticipated results. Always insist on seeing B&A photos of the physician's own patients and ask how you compare to those patients... With this in mind, I would want the surgeon to use the tools they are most confident and comfortable with.

More about Cool Lipo

Tumescent liposculpture is a fantastic procedure for shaping the body and removing excess fat entirely under local anesthesia with minimal tenderness and downtime. The addition of Cool Lipo further promotes skin contraction and maximizes treatment results.

The difference between Cool Lipo and liposuction

Cool Lipo™ , without trauma to surrounding tissues, gently melts and liquefies fat. After suctioning the liquid fat out, the Cool Lipo YAG laser is used to pass under the skin to tighten the skin, resulting in a smooth, tightened contour. The physician can easily see a red "guide light" shining (or "transilluminating") through the skin, ensuring the proper depth of the laser, and aiding in smooth, complete application of the laser lipolysis.

In contrast, conventional liposuction is a purely mechanical pushing, pulling, and tearing of the fatty tissue, in order to remove it. An instrument called a "Bruggerman," resembling a wood rasp in the shape of a cannula, is used to manually tear the fatty tissue apart by brute force (the back and forth "scrubbing" you've seen on TV liposuction). This may tear nearby blood vessels, nerves, connective tissue, and may cause skin to become overly thin.  The pieces of fat are suctioned out, and the process cannot be well visualized to guide smooth, even application of this rather rough method. 

With this "conventional liposuction," there is:

• Increased pain
• Increased down time
• Increased bruising
• Often bleeding
• Sometimes uneven results with some pockets of fat missed
• Some areas of skin scarred down to underlying tissue

Very importantly: there is nothing in conventional liposuction to shrink the skin after removing the fat bulk. The skin may or may not retract, or shrink, depending on many factors. Cool Lipo™ integrates skin tightening with the much safer laser lipolysis increasing chances of a good outcome.