Should I get liposuction plus tummy tuck or SmartLipo?

Traditional liposuction would be my recommendation for the saddlebags you have.  The need for a tummy tuck is based on how much extra skin you have in your lower abdomen and how tight and flat you want it and how much tolerance you have for a scar.  There is NO WAY that Smartlipo, or any other lipo, can give you as tight and flat a result as a tummy tuck.  So ask yourself what is the result you really want to get and proceed.

SmartLipo has a purpose for smaller areas but it has not been proven for substantial areas like for your "major saddlebags." We would recommend more proven techniques at this time for such significant areas.

Do you really want to undertake the cost, time, and emotional resources for an unproven technique that may leave you dissatisfied?

The doctor you saw who described SmartLipo as a gimmick is probably correct.

The dictionary tells us that a gimmick is something that has a special feature that makes it "stand out" from the rest. It's just that the special feature is of little relevance or use.

With SmartLipo, there are a few such "special features" that its advocates tout. If you look at them one at a time, they are either not unique, or their advantages have not been shown.

• There is a major push in the SmartLipo marketing campaigns to suggest that it is somehow less invasive than standard lipo. Yet, incisions are still made, and cannulas are passed under the skin. In fact, the presence of a laser that creates thermal injury inside the body is itself more invasive than standard liposuction and creates the potential for other problems.

• There is also a push to describe SmartLipo as something that is done on patients that are awake. But so, too, can all liposuction techniques be done on awake patients. There are pros and cons in terms of costs, risks, comfort, and ability to contour the body that must be considered with anesthesia, but SmartLipo holds no special advantage in this regard.

• Advocates say that the aspirate is less bloody or that there is a better yield of fat, but they offer no studies that show this. I asked the company for this data, and even they don't have it!

• Proponents also say that it tightens skin. However, there is no evidence at all -none whatsoever- in any medical publications of which I am aware - that shows that this actually happens. I asked the company for evidence of this, and all they offered was anecdotes. And in medicine, anecdotes don't count! Anecdotes are just opinion, and are shaped by personal bias. Doctors do not make decisions on such a basis.

At the most recent American Society for Aesthetic Plastic Surgery meeting in May '08, the physician who presented on SmartLipo concluded that no advantages of it has yet been proved. The only advantage he saw was a marketing advantage.

So, to the extent the special features have not been proved, for all we know, they are of little or no relevance. And that - according to Noah Webster- is a gimmick.