Regarding: "Smart Lipo Under General Anesthesia on Multiple Areas
Can Smart Lipo under general anesthesia be performed on multiple areas? What are its advantages and disadvantages?"
I wholeheartedly agree with my colleagues Drs. Rand and Law on the supposed value of SmartLipo. Despite being in the market for over 5 years we have YET to see a SINGLE scientific, double blinded study which conclusively demonstrates any benefits over all other modes of Liposuction. All such claims are commercial hype.
As our economy continues to suffer, less and less people are willing to have Cosmetic Surgery and many are looking for cosmetic salvation. If you look at the history of paranormal fascination, mediums and communicating with the dead, it is always high at times of national stress; The Civil War, WWI, The Great Depression, WWII, Vietnam and even now.
American now more than ever WANT to believe in the impossible. In operations that do not exist. The idea that a "laser" can be slipped under your skin, moved about painlessly and - poof - the fat is gone, the skin is tight and smooth and, most importantly, there are no major potential complication associated with this is sheer fantasy.
As the number of plastic patients has shrunk, some of our colleagues in Plastic Surgery and many non-Plastic surgeons who literally practice plastic surgery have adopted these "magical" techniques to attract patients. These machines are expensive (around 150,000) and the cost must be recovered by additionally expensive touting their superiority to a believing audience which is eager to entrust their bodies and fat to the most recent "laser magic".
In real life, ALL liposuction procedure start by infusing the fat with a swelling (Tumescent) solution and end by passing a a hollow steel tube (cannula) hooked to high vacuum to rip and remove fat. The ONLY fundamental difference (beside which cannula's are used and the way they are used) is what is done BETWEEN the swelling solution and the lipoSUCTION.
- In standard Liposuction, there is no intermediary procedure.
- With the VASER LIPOSELECTION, the fat is broken up by application of ultrasound.
- With Laser Liposuction (SmartLipo etc), the fat is literally cooked with a hot laser fiber (as are other structures that are found in it such as nerves, lymphatics and blood vessels). In other words, wherever the laser goes, it cooks everything in its path without preference or selection. (Which in itself should raise a lot of question about what happens to these coagulated structures and their impact on healing and the ability to fight infection).
Ethically, Plastic surgeons should choose the liposuction technique and the anesthesia technique best suited for each patient. Such choices are not available to non-Plastic surgeons performing liposuction because no free standing outpatient or hospital same day surgery facility would credential them to operate within their walls where the full range of anesthesia options are offered. (No certification by The American Board of Plastic Surgery - No Plastic Surgery operating privileges).
Anesthesia for liposuction should be that which best suited for THAT particular patient. It should NOT but commonly is a one size fits all matter when you are only offered either local (tumescent) anesthesia with or without sedation. Just because the non-Plastic surgeon performing liposuction is not allowed to operate in outpatient surgery centers or hospital, his patients should not have to endure local anesthesia or local anesthesia with sedation REGARDLESS of the size of the area(s) to be treated. So - choose your Plastic surgeon carefully.
Because real board-certified Plastic surgeons can operate in ALL facilities and can therefore offer their patients the full range of anesthesia options, from local or local with sedation (for a small area) to general anesthesia, if the patient so desires and the doctor agrees, for large or multiple areas of liposuction.
As regards your options - you know who you are and how much discomfort you can tolerate. Make sure you are open with your surgeon and make sure your requirements and needs are followed.
Good Luck.
Dr. Peter Aldea