Smart Lipo vs. Traditional Lipo

Question

I'm trying to decide between Smart Lipo and traditional Lipo. I want to do my inner knees and inner thighs. My plastic surgeon that does my Botox and filler says that Smart Lipo is just marketing/gimmick thing. He also doesn't do Lipo with just a local. I don't have very much fat to remove. Would love to hear some honest opinions about the difference between the two options and recovery. I cannot miss more than a day of work. Thank you!

Harry T. Haramis, MD, FACS · Answer

I have rarely performed traditional liposuction alone for over the past 10 years. I routinely use Smart Lipo (laser) and Vaser (ultrasound), which are light years beyond and give far superior results.Either can be done under local and allow difficult areas such as inner thigh and knee to be easily treated under local. There is less bruising/swelling, easier recovery and added benefit of skin tightening. Personally, I would never treat these areas with only traditional liposuction- that risks lumpiness and poor results.An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Spero Theodorou, MD · Answer

Smart Lipo uses tumescent solution. This solution is used to minimize blood loss and also provides anesthesia to the tissues. When you add the laser to the mix to melt the fat and tighten the skin you have SL. When you dont, you have traditional tumescent lipo. Smart Lipo is typically done awake. Hence the benefit also. There is no need for you to undergo anesthesia for such a small area and incur the risk. Downtime is 24-48  hours with SL. You can do it on the weekend eg saturday and go back to work on Monday since with local anesthesia it wears off fast.  The bottom line is the skill of your plastic surgeon and their experience with the SL triplex machine. Also look if they teach other plastic surgeons in the technique and if they are certified training center by Cynosure the maker of the SL equipment.  Good luck. You are on the right track.

Bruce E. Katz, MD · Answer

Thank you for your question. It’s hard to determine without an person consultation but I would definitely recommend Smart Lipo. There are many benefits in doing SmartLipo vs traditional liposuction. The laser used in SmartLipo reduces your risks for bleeding and infection, which can significantly minimize postoperative complications. Also SmartLipo recovery generally doesn’t require the same amount of down time as traditional liposuction. SmartLipo uses incredibly small incisions, and thanks to advanced laser technology, reduces damage to tissue surrounding the treatment area. SmartLipo also tightens the skin whereas traditional liposuction does not. I recommend getting a in person consultation with a board-certified dermatologist.

Reza Tirgari, MD · Answer

Truthfully, for the majority of people, regular ie. traditional tumescent liposuction is enough.  This is especially true for people without a large amount of fat, for whom skin tightening won't be an issue.
The main selling point for SmartLipo has been the additional "skin tightening" that results.  Many experienced liposuction practitioners have found that this benefit is oversold and that there isn't much of a difference.  The main issue should be the skill and experience of the physician rather than the type of lipo performed.
Also, it is preferable to have your liposuction performed under local anesthesia.  Your recovery, and return to work, will be much faster and with fewer potential complications.

Jon Ver Halen, MD, FACS (license suspended) · Answer

Hello and thank you for your excellent question. In general, Smart Lipo versus traditional lipo are suitable for different patients, and different situations. When I have patients who are having ONLY liposuction, I typically use the laser to add some additional fat reduction and skin tightening (as has been suggested elsewhere). When I am combining the liposuction with another surgical procedure, like an abdominoplasty (i.e., tummy tuck), I am much more conservative with the laser since the skin tightening component is performed with the surgery. With regard to liposuction under conscious sedation, it is really a factor of 1) how much work needs to be done, and 2) what you are comfortable with. If you have a lot of areas that need to be suctioned, then you may want a general anesthetic. Similarly, if you have a low pain tolerance, then you may want a general anesthetic (as oral sedation is good for most, but not all pain concerns. Any surgical decision should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 
 
 Best,
Jon Ver Halen, MD FACS 
 Harvard educated plastic surgeon

Ken Knott, MD - Account Suspended · Answer

I must agree with Dr. Berman about the advice provided to you from your doctor favoring regular liposuction over Smart Lipo.  I can assure you that it is not a gimmick, to the contrary, it is most likely the best option for you. The are a number of reasons that I make that statement. First, for people wishing to remove residual fat from problem areas, Smart Lipo is the very best option because it doesn't require general anesthesia which is a risk factor in and of itself. Local anesthesia is used to numb the area being addressed and even though the patient is awake, they are typically sedated to a moderate degree. Regular liposuction is a very traumatic procedure that requires a much longer recuperation time than Smart Lipo plus it is a more costly procedure.
The procedure includes pre-procedure screening with labs, measurement for compression garments and signing of consent forms. Prescriptions are provided for sedation to be taken the day of the procedure. The procedure itself takes varying periods of time depending upon the areas to be addressed, but for most, the time is usually about 2 hours from start to finish. The compression garment(s) are then donned and the patient is given post procedure instructions and allowed to leave provided they have a driver present. The patient is typically seen one to two days later. The compression garment stays on 24/7 for two weeks except to bathe or wash the garment.

David E. Berman, MD (retired) · Answer

It is always the doctors who don't have the Smartlipo equipment and have never used it, that say that it is just a gimmick. Smartlipo has the added advantage of a fiberoptic laser that both melts fat and also heats up the skin (so that you get some skin tightening). After this step is done, liposuction is carried out. you sound like you would be an excellent candidate. See a board certified Plastic Surgeon, with lots of experience in Smartlipo. I do all of my Smartlipo (over 670 cases) under local anesthetic, usually with oral sedation (sometimes with no oral sedation)  and thus avoid a general anesthetic and the associated fees.david berman md

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