If a small pocket of facial fat is melted with a laser, must the fat be removed with liposuction? If not, what happens? Does the fat simply eventually melt back and smooth out? How long would such a healing take?
Must Fat Melted with a Laser Be Liposuctioned?
Doctor Answers (7)
Does melted fat need to be suctioned
Not all fat that is destroyed needs to be suctioned. Small amounts of melted fat can be left behind to be absorbed by the body. Occasionally larger amounts of this fat can calcify or form cysts. Areas of dead fat may produce a fibrotic response creating a firm nodule.
Small amounts of fat left after Liposuction not threatening
Small amounts of fat left behind do not pose any threat. No one knows what kind of threat, if any, is posed by leaving a larger volume of broken up fat cells (as is left after either VASER liposelection or Laser (SlimLipo, Sciton Prolipo or Smartlipo). Usually fat gets broken down and transported to the liver. But we do not really know -- the work is being done now.
Most of us liposuction such fat because we are MORE comfortable doing so -- NOT because there is evidence either way.
Lasers and fat
Laser lipolysis is a technique that melts the fat. It is always accompanied by more traditional methods of fat removal like liposuction to aspirate the melted fat.
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Fat is best aspirated after Laser Treatment
I will allow very small areas to absorb on their own after laser treatment (I use SmartLipo MPX) but there will be prolonged swelling if larger areas are done.
So laser-assisted lipo is usually followed by suction. The suction is usually easier, as the melted fat can usually be more easily removed with less trauma and a smaller cannula.
Melted fat with or without liposuctions
This is currently being explored by the FDA testing external ultrasonic energy (Ultrashape) which liquifies the fat and no liposuction is performed. The body redistributes the triglycerides and the liver metabolizes these byproducts. Stay tuned for the outcome of the study.
Laser Liposuction systems
Yes there are "laser" liposuction systems. One company actually claims that it is possible to apply low level laser energy to the outside of the body and this will remove fat. While I am not so sure about the later claim, laser liposystems incorporate a laser that does damage fat cells. These systems also suck fat out of the body.
Now here is where things get interesting. It is unclear if it matters exactly how you injure fat cells: laser them, cauterize them, inject them with detergents and bile salts (meso therapy) or simply rasp them with the business end of a liposuction cannula. All of these methods injure fat cells and cause volume loss. What is clear is that much more fat is injured that is removed at the time of liposuction.
Injured fat cells are ultimately removed by the body's healing mechanisms. It is clear that much of the effect of liposuction is actually from this mechanism rather than by what is sucked away at the time of the surgery. So yes, if one introduced the right laser into a fat space in the face and blasted away, the body would eventually remove all of the damaged fat cells even if nothing was removed at the time of the initial procedure.
Melted fat removal
All the laser liposuction devices were FDA approved with the fact that the melted fat was liposuctioned at the end of the procedure. As such if it is not removed, it is being used "off label" However, many plastic surgeons are doing just that. The melted fat eventually is absorbed and broken down inthe body. It takes between 3 to 5 months to get the final result.