Which procedure is best for each part of the body? Why is it necessary to do both? Can you please explain why some patients use both?
What is the Benefit of Combining Vaser and Smart Lipo?
Doctor Answers (5)
Smart Lipo versus Vaser
Both are purported to enhance skin contraction.
Smart lipo utilizes a very small cannula and laser fiber to deliver the energy. Due to the small size of the cannula, it takes significantly longer to treat an area. Imagine trying to paint a room with a fine paint brush (as opposed to a roller brush).
Vaser achieves delivery of energy through a variety of probes which can still take longer than conventional liposuction but will be significantly faser than Smart Lipo.
So in answer to your question, Smartlipo tends to be used in small localized and delicate areas whereas Vaser is used for larger and deeper fatty deposits where a more agressive treatment is required. Vaser can also be benefiical for areas where the fat is localized by fibrous septa (love handles, male breasts,etc.)
Combining VASER and Smart Lipo
Some doctors advertise that they do both VASER and Smartlipo together. Those doctors feel that they get more skin retraction superficially using the Smart lipo directly under the skin and using VASER to melt the fat in the deeper areas. In my hands, I prefer the VASER. I actually get better superficial skin retraction using VASER than when I use the Smartlipo. There is a Stanford University study published this year which shows a 53% skin tightening effect after using the VASER. I have not seen as much skin retraction with Smartlipo and it takes much longer to get less of an effect. I really feel it is more of the experience, skill and training of the surgeon more than the actual machine that is used.
Is there a Benefit of using Both SmartLipo and VASER
I am a VASER user In my hands, I find the VASER to bring about smooth results with good patient tolerance in all area. I am not a Laser Liposuction user because I have yet to be scientifically convinced that it has ANY advantages over VASER Lipo selection or PAL.
One potential complication with VASER and especially with Laser Liposuction (Smart Lipo etc) has been potential burn injuries to the skin. While combining the procedures does not increase their benefits except potentially to try and heat the skin to get it to shrink more - this can seriously increase the likelihood of skin burns as well.
I agree completely with Dr. Soto. It sounds to me like someone has some bills to pay...
Dr. P. Aldea
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There is no benefit to combining Smartlipo and VASER
Here's a good rule of thumb: if a provider of medical care and/or procedures seems to spend more time talking to you about the machine they use than about their own training and Board Certification, RUN AWAY... They are almost certainly NOT a Board Certified Plastic Surgeon, and are hoping that my wowing you with talk about their fancy new machine, you will lose sight of the fact that, regardless of the technological advancements any of these fancy new machines may or may not represent, it is the surgeon's education, training, and experience that will make the most difference in keeping you safe and achieving the outcome you desire.
I know many skilled and Board Certified Plastic Surgeons that I would trust to operate on anyone I love, knowing they would achieve a safe and reliably attractive outcome with ANY of these devices, because "it's the carpenter, not his tools" that makes the difference. Similarly, the only providers I know of who need to advertise so vigorously that they will use ("not one, but TWO!!") "the latest" machine on you are those hiding the fact that they are not plastic surgeons and therefore are poorly qualified to do liposuction in the first place- with any machine.
Please be careful. Here's a bit more about this that will help you avoid these pitfalls:
Tumescent liposuction, VASER Lipo, Smart Lipo, Cool lipo, Pro Lipo, Slim Lipo, Water Jet lipo...
What does this all mean? If I don't get Smart lipo does that mean I'm dumb? If my surgeon recommends Slim Lipo does that mean he/she isn't a "Pro"? It truly is a ridiculous situation we have come to with regard to liposuction and the number of people trying to cash in on America's desire to be rid of its collective fat.
In well motivated patients, body contour improvement can be a very healthy endeavor, but how is an otherwise intelligent and well-adjusted person to know the difference between a responsible provider of aesthetic services offering them safe options for help with their body contour and a poorly trained and inexperienced provider more interested in their wallet than in your outcome and safety?
It is first important to realize that all of these devices will require you to undergo a liposuction procedure. The only difference is the approach to the treatment of the fat prior to its removal.
Because they all involve liposuction, and this is in fact a surgical procedure, it is very important that you "do your homework" and find a surgeon certified by The American Board of Plastic Surgery who has the years of training in liposuction necessary to give you the safe experience and superior outcome you deserve and desire. Behind the amazing number of machines now available to remove your fat, there has followed an army of their sales representatives and an equally impressive number of providers marketing themselves as "liposuction experts".
What has made them "liposuction experts"? In almost all cases, a few days or weekends training with the salesman for the device or with someone more experienced in the procedure. It is their promise that if you have the device in their possession brought to bear on your behalf, your fat will be gone, your skin will miraculously shrink away, you won't need any anesthesia because the device allows painless removal of the fat, and it can be done on your lunch hour. The only thing I am surprised by at this point is that they don't promise you'll get rich and be more sexually alluring after the procedure too.
Selling the particular device to patients is not unlike someone saying to you that because they will give you access to Tony Stewart's racing car that you will be able to win this weekend's race and make a million dollars. Tony Stewart wins races because he is a great racing car driver AND he has a great car...This is no different.
Getting the best outcome from a body contouring procedure depends most on finding a well-qualified and experienced surgeon, and much less on the device used.
Most of these people are so aggressive in their marketing of these questionable devices because they are, in fact, not trained plastic surgeons but rather are either not physicians at all, or they are doctors with core training which would not have prepared them to do liposuction. Many have read recently about a death in my home state of Florida after a healthy 40ish year old mother had liposuction performed be a rehabilitation medicine doctor. Amazingly, I know of eye doctors (!!) doing liposuction as well- and yes, they market themselves as "liposuction experts".
The particular device used can affect the overall experience, however.
Despite the claims of the manufacturer and the practitioners who plunked down the large sum the device costs, Smartlipo has never been proven to shrink skin better than tumescent liposuction. SmartLipo, SlimLipo, Prolipo, and Coolipo all use a laser to destroy the fat cells, allowing them to be removed by liposuction. My problem with these is that, first of all, as a scientist and doctor I am offended when false claims of benefit are made, and that because the lasers will burn whatever you point them at, I worry that your nerves, blood vessels, muscles, and skin may be injured by the laser.
Bottom line (and in my opinion) -- there is no benefit to these devices, they are expensive (meaning that the cost to you, the patient, will be higher as well), and the risks are higher.
Tumescent liposuction is the gold standard to which all other techniques must be compared. It has been proven to be safe and effective over many years (provided that it is performed by a well-trained surgeon). It involves the injection of a fluid into the fatty tissue layer that causes blood vessels to shrink and the fat to expand, making it easier to remove and lowering the risk of a complication.
VASER lipo involves an additional step, in which the fat (after injection of fluid but before suction is applied) is treated with ultrasound energy. Unlike the laser filaments used in SmartLipo and the other devices mentioned above, the VASER probe is blunt and the ultrasound energy it uses is much more specific for fat, so that the risk of injury to the blood vessels and nerves, as well as the muscles and skin are much lower. This is seen in the patient experience of reduced swelling and bruising.
Each time a new (revolutionary!) liposuction machine comes out, I think the most important questions to ask are not "Does it work?", but rather, "Does it work better than what is already available, is it less expensive (not more), and is it safer than what is already available?"
The VASER (in my opinion) passes this test, while the laser based devices do not.
Having said all of that, I would emphasize that it is the education, training, experience, and skill of the surgeon at the end of the liposuction device that will make the greatest difference in your outcome and safety. There is not substitute for the years of training Board Certified Plastic Surgeons receive in liposuction, directly supervised by other Board Certified Plastic Surgeons. A well trained and Board Certified Plastic Surgeon would be more than capable of achieving a better outcome through tumescent liposuction than any eye doctor with a Water Jet. As in the analogy of Tony Stewart above- a great professional with a great tool (like the VASER) would only make those results and their safety even greater.
Please know that I have no financial relationship with any of these companies and have personally tried each of the discussed technologies myself on patients.