Tumescent Liposuction Vs. Smart Lipo

Which is better between Tumescent Liposuction and Smart Lipo? Or does it depend on area where the fat is being removed from? Is one better for one area of the body while the other better at a different area?

Doctor Answers 27

Smart Lipo is no match for VASER safety and effectiveness

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Hi there-

I could not possibly agree more than I do with Dr. Aldea...

Tumescent liposuction... VASER lipo..... SmartLipo.....Cool lipo... pro lipo....Slim lipo... Body 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 their 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. In fact, I see at least one patient every month with severe contour deformities and injuries after being treated with one of these devices by a local "liposuction expert".

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.

Tumescent Liposuction ("Apples") vs. Smart Lipo("Oranges")

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Contrary to what you may hear, TUMESCENT is basically a mode of anesthesia NOT a liposuction technique.

ALL competent liposuction surgeons use tumescent technique in liposuction (they fill the fat areas with a solution of either Saline / or Ringer's Lactate mixed with Epinephrine (to reduce bleeding) and Lidocaine (to reduce pain). Once vasoconstriction and anesthesia are established, the liposuction can begin. However, some body areas and patient preference call for putting the patient to sleep while others do not. Dermatologists cannot put patients to sleep and prefer to do liposuction only with tumescent technique while plastic surgeons can CHOOSE which patients would do better asleep and which should be done only with tumescent solution.

SmartLipo is a much hyped laser-assisted (LAL) technique which as YET to prove that it matches much less is better than any other liposuction method (traditional tumescent, power assisted or VASER). Despite several studies and a recent embarrassing demonstration at a live surgery conference in Miami (Baker-Gordon) SmartLipo is no match to VASER.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Tumescent Lipo with the micro cannulas can't be beat

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Smart lipo is ok in the right hands but it has a history of occasionally dimpling or puckering, which I don't like. Tumescent techique liposuction under local anesthesia with micro cannulas is the golden standard which all others are compared to now. It is more time consuming and more expensive but so worth it.

Any form of liposuction can have good results if done by an experienced doctor in that form of liposuction. You need to consult with several docs and find the one you feel the most comfortable with.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

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What is the Gold Standard in Liposuction?

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I have been performing liposuction for 25 years. Over the years I have seen different types of liposuction come and go. The most widely used type of liposuction and the liposuction that has been around the longest is Tumescent Liposuction. Tumescent Liposuction is considered the 'Gold Standard' to which all other forms of liposuction are compared. None of these new forms have proven as effective as Tumescent liposuction. Some of these so called new and improved  forms of liposuction have even ended up being dangerous and have lead to severe complications for the patients. For this reason, I am always suspicious and cautious of new procedures that are being touted as the latest and greatest.  Before I incorporate any new procedure into my practice I like to make sure that it is best for my patients and that it is a procedure with a long track record of success. Patient safety is always my priority.  I have found no form of liposuction superior to Tumescent Liposuction.  It is important to keep in mind that ultimately, what is most important in the Liposuction procedure is the skill and experience of the surgeon doing the procedure.

Francis X. Fleming, MD
Kennewick Plastic Surgeon
4.5 out of 5 stars 18 reviews

Tumescent liposuction is not better than SmartLipo

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Tumescent liposuction is not better than SmartLipo, because the tumescent technique for liposuction refers to the use of fluid to swell the treatment area during liposuction surgery and administering a local anesthetic and epinephrine which causes the blood vessels to constrict.  This may seem like semantics, but the tumescent technique is really what most experienced plastic surgeons use when doing conventional liposuction.  SmartLipo refers to laser assisted liposuction where local anesthesia is often used and a  smaller volume of tumescent fluid is required because it is a less traumatic procedure and ,therefore, less anesthetic is required.  With SmartLipo there tends to be less swelling and bleeding than with conventional tumescent technique.  I have extensive experience with both techniques and have found that patients, in general, have less bruising, swelling and find it more comfortable than with traditional tumescent liposuction.  Although good results can be had with both techniques, when it comes to patient comfort and satisfaction,  Smartlipo is often the preferred technique in my practice. In addition, SmartLipo is particularly beneficial where additional skin tightening is required, such as the neck, arms, abdomen and inner thigh area.  Surgeons that do not embrace new technology often do not have the experience to make an unbiased comparison between techniques.  

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 72 reviews

Tumescent liposuction

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Tumescent liposuction is the technique to which all other methods are compared. It is safe and effective. First there is injection of fluid into the fat that causes blood vessels to shrink and gives pain relief which minimizes the amount of additional anesthesia required.  All of the other techniques use tumescent fluid, and are followed by the suction component of the tumescent liposuction.  The only difference is that laser, smart, jet, power, tickle and all of these other tools add a step in between the tumescent and the suction to melt or otherwise break up the fat.  This extra step is not necessary to achieve good results, it adds risk, and is often a gimmick.  

Focus on the doctor, not the technique.

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The fact that there are so many branded procedures and so many doctors referring to their own unique method to me indicates that for the most part, the liposuction "options" available today have more to do with marketing than medical science. SmartLipo is a brand name that's pretty well known, but the most important thing for the quality of your results is the experience and skill of your surgeon. I find that tumescent modified liposuction is still the best option for effective body contouring available today. For the best results, find an excellent board-certified plastic surgeon who performs plenty of liposuction. Skill and experience are more important than gadgetry.

Glenn M. Davis, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 77 reviews

Smart lipo vs. other types of lipo

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It's not the machine that makes the difference.  It's the surgeon that makes the difference!

For example, if I gave you the very paint brush that Leonardo daVinci used to paint the Mona Lisa, would you, all of a sudden, be a master painter?  Of course not!

The key to good results with liposuction is an experienced surgeon who does a lot of liposuction.  The technologies (laser, ultrasonic, PAL, water-jet) are basically equivalent.  There's a lot of marketing spin from the manufacturers - this makes it difficult for consumers to sort things out....


Best wishes!

Tumescent Technique Is Part Of Smartlipo

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The term, tumescent liposuction, refers to the use of a fluid infiltration into the area to be suctioned. It is today a part of every type of liposuction procedure performed to both lessen the amount of blood loss and to numb the area. It is not a separate and distinct form of liposuction as many patients believe. It is a liposuction technique, not a liposuction method and is in no substantative way responsible for the outcome or success of the procedure.

Tumescent means mode of anesthesia

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Many people have the same misunderstanding. Tumescent is the mode of anesthesia, not the liposuction. Most physicians doing liposuction use tumescent fluid to numb the areas.

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 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.