Is traditional liposuction outdated?

The new alternatives to traditional liposuction, such as SmartLipo, are using very effective aggressive marketing techniques to promote their products.

Usually these procedures are offered by non-plastic surgeons who have done a short course in doing the procedure and then set loose on the public. They are also used by plastic surgeons who wish to promote their practices.

Only small areas can be treated with local anesthesia in the office with safety. But the proponents will claim that they can do large areas under local, in the office, and that it is safer than general anesthesia. This is clearly misleading.

The costs are much higher for these new procedures, without the benefit of anesthesia.

Get an opinion from a Board Certified Plastic Surgeon who has been doing liposuction for years, and compare, before proceding with a new highly marketed procedure.

Traditional liposuction combined with a modified tumescent technique is still the gold standard for liposuction. Do not be deceived by all the cleverly named "newer" techniques promising more than they can deliver.

No "new" technique can beat properly performed traditional liposuction and make a marginal candidate for liposuction have a great result. The key to obtaining a great result is to go to a real plastic surgeon who has excellent artistic sculpting skills and ask for a realistic evaluation of how well your skin will shrink after liposuction. If you don't have good elasticity, they should tell you because you won't get a great result no matter what technique is used.

Just yesterday, I evaluated a patient destroyed by Smart Liposuction done by a general surgeon (the kind of doctor who would remove your appendix or gall bladder). He told her he was a national trainer for Smart Lipo but he had NEVER been trained in plastic surgery himself at all.

"Buyer beware!!" holds true more in liposuction than in almost any other cosmetic surgical arena because so many non-qualified physicians are tempted to do it because it looks simple and often these are the people promoting the "latest and greatest" lipo techniques.

Traditional liposuction is still the gold standard of treatment.

There are many good scientific studies comparing traditional liposuction with some of the newer techniques. In one study published by Fodor and Watson (Plast Reconstr Surg. 1998 Apr;101(4):1103-16; discussion 1117-9.), ultrasound assisted liposuction and traditional liposuction were used in the same patients. Using several different analysis techniques (including blinded patient and observer analysis) they were unable to find a difference in the two techniques. One study of laser assisted versus conventional liposuction by Prado's group (Plast Reconstr Surg. 2006 Sep 15;118(4):1032-45) showed no significant difference in clinical indicators between the two groups.

To determine the merits of a procedure, visit the link below and search for peer reviewed scientific articles to determine if a procedure is good. Companies will produce studies which only show the best part of a product, not the down side. The best peer reviewed scientific articles will have double blinded controlled studies. This means that the participant and the evaluator will not know what procedure is done. In this way, an unbiased decision can be made as to the results.

The underlying principles of laser and ultrasound assisted liposuction are sound. With advances in technology, differences may become evident. For now, the use of additional technologies is a physician-dependent decision. The key is to find a physician who is comfortable performing liposuction, is trained and experienced in the procedure, and is able to produce reproduceable desired results.

Traditional liposuction should be dead. . . if used alone.

Unless someone can't afford a laser, there is no reason to not use it. Some of the older guys won't find it useful or practical to invest in a device costing as much as a new laser. . . but the results speak for themselves. With less downtime and tighter skin, it's a wonder everyone hasn't started using something in addition to their traditional techniques. (I bet they would have someone use a laser if they were getting the procedure done on themselves.)

The best method to perform SmartLipo, Vaser, or any laser liposuction is to follow up with traditional liposuction aspiration. This will allow one to visualize the sculpted region, remove liquified contents, and reassure the patient that the area was adequately addressed.

Each of the techniques you mention have their place, and none are suitable for all patients.  Traditional Liposuction works well for significant areas that can not be adequately treated by any other technique.