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Aggressive Vs Conservative Smart Lipo

I am interested in getting SmartLipo on my stomach mainly and potentially my hips and very small banana rolls. I am not overweight for my height or size (I'm right at average), but I have always had some problem areas that exercise will not remove. Recently I visited the only 2 doctors in Charlotte who perform SmartLipo and interviewed them based on the recommended questions on this website. However, in doing so I found two EXTREMELY different approaches to the procedure (let's say one seemed more aggressive and the other more conservative). I would really like some of the other professionals who perform SmartLipo to give their feedback so I can make the best decision on which doctor is the best to use. Both doctors prices were about the same. My biggest fear is to have the procedure and end up looking worse than I do now. I want to know if any of these are warning signs to stay away from since both are so different. So here are the differences I'd like feedback on from the professionals:

1. The conservative doctor uses tumescent (local to the area treated) anesthesia; and the more aggressive uses twilight (like they do when you have your wisdom teeth removed)

2. The conservative doctor actually recommended trying to do extra lunges and squats to remove the small banana rolls, which he felt really weren't banana rolls; while the aggressive doctor was quick to say he definitely wanted to do it and never warned against not doing any areas

3. The aggressive doctor would do all three areas at once (just indicating that as long as they didn't go over 1 gallon of fat removed, which was the legal limit he could do multiple); while the conservative doctor was only willing to do one area per treatment (with one month waiting period or more at minimum between treatments)

4. The aggressive doctor recommended walking a mile day of treatment and for two weeks after treatment walking 4 miles each day with no weights; the conservative doctor recommended not exercising cardio for a week after the procedure with no weights or sit ups until 30 days afterwards

5. The aggressive doctor uses 1 stitch for the entrance areas (with 2-3 entrance areas for abdominals); the conservative doctor uses none (with 4-6 entrance areas for abdominals)

6. The aggressive doctor said no swimming for a month after the procedure; the conservative doctor said as soon as the entrance areas scab over and start to heal it was fine to go swimming

7. The aggressive doctor has been doing this since 2006 and does about 55 procedures a month; the conservative doctor has been doing it for 1 year and does about 12 a month

8. The conservative doctor recommends wearing the compression garment for the stomach for 30 days; while the aggressive doctor recommends for only 2 weeks

Doctor Answers (4)

Choosing a SmartLipo Doc

+5

You asked a very good question. It can be extremely difficult to distinguish between two doctors doing the same procedure, particularly when they are telling you to do different things!

But I think I can help you...

The best results in liposuction are done by the best surgeon. Period. Whether it is tumescent, standard, VASER, Lysonix, power, or SmartLipo, it is the surgeon and not the technique. I promise.

There has never, ever, been any study which showed a notable difference in outcome between the procedure done by the same surgeon. But---there is a huge difference between surgeons!

So open yourself up. I know your questions were all about choosing a SmartLipo doc, but what you are looking for is a great result, it is not a particular procedure. Even an orchestra doesn't hire a violinist just because he owns a Stradivarius! The better violinist will always sound better, even on an inferior instrument (and there is no evidence whatsoever that shows any advantage to SmartLipo over the other techniques).

There are many excellent plastic surgeons in Charlotte. Go to the website shown below and look in its surgeon finder. Not only are all the docs there certified by The American Board of Plastic Surgery, but they are also members of ASAPS, the most exclusive group of cosmetic surgeons in the United States.

Remember, what you want is brilliant lipo, not Smartlipo! And it is the surgeon that will make the difference.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 29 reviews

Choosing a liposuction physician

+4

These are excellent issues to bring up- I'll address them individually below, but my overall recommendation is to find a plastic surgeon with proper training and certification by the American Board of Plastic Surgery with whom you are completely comfortable- neither of these physicians may be right for you. A lot of information can be found on this website, or the website of the American Society of Plastic Surgeons. All members of this organization are properly trained and have the highest level of certification. Check outhttp://plasticsurgery.org/ if you need help finding other surgeons...

1. Tumescent anesthesia is a type of local anesthesia pioneered by dermatologists. This is an excellent modality for minimal and localized liposuction, but for significant results in areas of the abdomen, thighs, and love handles, I would recommend a more significant type of anesthesia. Additionally, I would strongly suggest that the anesthesia is performed by a licensed anesthesiologist or experienced and licensed nurse anesthetist. The fluid used as part of liposuction have significant effects on the type of and rate of IV infusion, as well as type and dose of drugs given. I always play it on the safe side and have an experienced professional other than myself administering anesthesia, so they can ensure my patient’s safety from that standpoint and I can concentrate on performing liposuction.

2. Here I agree with the physician that says that lunges and such are not going to help. Fat is lost through systemic mechanisms of aerobic exercise, combined with metabolic aspects of diet. Fat is not lost in one particular area by exercising that area.

3. Three area liposuction, with adequate and monitored anesthesia, is OK as long as the amount of fat removed is not "massive" which is usually thought of as over 3-5 liters. This again relates back to the fluid shifts that can be problematic with large volume liposuction and this needs to be considered carefully in your planning.

4. I agree with the physician who does not recommend significant exercise following your procedure. I usually tell my patients not to do anything that makes them sweat for at least 2 weeks following any procedure. In all surgery, blood vessels are cut and clotted, and you do not want to raise your blood pressure until these vessels are healed, in order that you avoid postoperative bleeding problems.

5. Stitching the access incisions is really rather irrelevant- I would not use this as a criteria for choosing a plastic surgeon.

6. I agree with no swimming for a month- I have my patients shower shortly after surgery, but I don't like them submerging in water until I'm certain that all the wounds have healed, and that their skin is "water tight". Scabs on the incisions are not enough!

7. I have known excellent surgeons who are relatively new to procedures, and very experienced surgeons who I would not have operate on anyone I knew. What is important is that surgeons attention to detail, safe approach, and proper training. I would STRONGLY urge you to make sure that whoever operates on you is a real Plastic Surgeon and certified by the American Board of Plastic Surgery.

8. I have my patients wear compression garments for at least 3 weeks, and then for another 3 weeks at night. I would think that the physician that suggested a month would be closer to my preferences.

As far as your note goes, it sounds as though you know a couple of bad things about the aggressive physician by reference and not that much about the conservative one. I would rather go with a relative unknown as opposed to someone who was a known entity but not in a good way! What sounds more appropriate, to be honest, is to continue your search until you find someone who is properly trained and certified, with whom you are very comfortable. Good luck!

-Dr. L

Adam David Lowenstein, MD, FACS
Santa Barbara Plastic Surgeon
5.0 out of 5 stars 24 reviews

You might be making this decision harder than it needs...

+2

You might be making this decision harder than it needs to be. Remember that aesthetic surgery is an art form and no 2 doctors have the same talent level. True talent cannot be taught either.

If you carefully inspect many photographs from each doctor you should probably see some differences in patients who resemble you. Choose to go to the doctor whose results look better to you and listen to your gut instinct. Avoid egotistical or boastful doctors. Make sure they are both Board Certified Plastic Surgeons and don't hold against one the fact that they might seem conservative - that is usually going to serve you better in most instances.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 49 reviews

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Choosing the right doctor for liposuction, smart laser liposuction

+1

Wow. What a quandary. Based on your questions, I would choose the non aggressive doctor. He has more experience and his answers are in keeping with my experience of 10,00 surgical cases.This book, a best seller, might help you with decision. "don't Choose A Cosmetic Surgeon Without Me". Google it or get it on amazon.com

 

Barry Lycka, MD
Edmonton Dermatologic Surgeon
4.5 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.