Controversy of VASER Lipo

Question

I've done a lot of research regarding VASER and its use specifically addressing irregularities from prior surgeries and there seems to be two schools of thought: 1. Avoid VASER like the plague regardless of who's hands its in. It will make things worse and.. 2. VASER is fine for correcting previous lipo contour irregularities as long as settings are low and in the hands of an experienced provider. So which is it? I'm trying to fix a botched BodyTite procedure and so confused.

Robert Poe, MD · Answer

In general, Vaser can help to correct irregularities from previous liposuction better than other methods. Of course every case is different, but Vaser is better for revisions which largely consist of fibrotic fat from the previous liposuction as well as residual fat. The irregularities can be smoothed out by liquifying and removing more fat, but deep depressions are hard to correct with any method. Again this is a general observation and is variable from case to case depending on the location and degree of deformity.

Giuseppe Fiore, MD · Answer

Hi,
Thanks for your question.
Sorry to hear about that. 
Without pictures I am not able to give you a specific answer. The options are surgical or not surgical and this depends of the case. 
It is important to make a face to face medical/surgical assessment where the surgeon will assess the skin irregularities/ indentations , possible asymmetry, skin elasticity and fat distribution. 
In some cases a revision with Vaser liposuction and/or Power-assisted liposuction with or without fat graft can reduce the skin irregularity and smooth the areas of previous liposuction. 
I would advice to make an appointment with a with a surgeon expert in body contouring and skin tightening procedures for a medical/surgical assessment in order to make a bespoke surgical or medical treatment. 
Hope this helps, 
Dr Fiore

Anuj Purbey, MBBS · Answer

Thank you for reaching out and sharing your concerns. It's understandable that you're feeling confused given the divergent opinions on VASER and its efficacy in correcting previous liposuction irregularities, particularly following a botched BodyTite procedure.

The conflicting views you've encountered are indicative of the complexities involved in cosmetic procedures and the subjective nature of outcomes. While some caution against VASER due to potential complications, others advocate for its use under the careful guidance of experienced practitioners.

In such cases, I highly recommend seeking consultations with multiple qualified and experienced cosmetic surgeons who specialize in revision procedures. They can provide you with personalized assessments based on your specific situation, medical history, and desired outcomes.

During these consultations, don't hesitate to ask questions about their experience with VASER, their approach to addressing irregularities, and their success rates in similar cases. Additionally, request to see before-and-after photos of patients who underwent revision procedures using VASER.

Ultimately, the decision on whether to proceed with VASER should be made collaboratively between you and your chosen surgeon, based on thorough discussions and a clear understanding of the potential risks and benefits.

I hope this helps guide you in the right direction, and I wish you the best of luck in achieving your desired results.

Darryl J. Blinski, MD · Answer

Like most issues in any discussion there are pluses and minuses. For me VASER is a weapon that in the wrong hands hurts more than it helps. Postop VASER complications are very very hard to fix if even able to fix them. So be very careful out there.

Mats Hagstrom, MD (license on probation) · Answer

VASER has the potential to be very aggressive. for that reason when patients are treated poorly and this device is used for disfigurement is usually extreme.
There’s certainly no benefit in having power as distant devices when doing finesse work like revision work.
To me the equipment is in significant. The only thing that matters is the skill of the surgeon.
There are only two variables that determine liposuction results and I suggest patients focus on those two variables because they are the ones that make the difference. all other variables are insignificant.
The two variables that determine what results are going to look like our patient candidacy and the scale of the surgeon. What equipment is used, the use of compression garments a postoperative a massage or any other variable is Insignificant to the two primary variables that matter, Candidacy and skill of the surgeon.
Revision Liposuction is extremely difficult to do and many times more difficult than primary Liposuction.
Often improvements cannot be made or the potential for improvements is limited.
Results can easily be made worse in an attempt to improve the outcome.
The importance of provider selection is very important when it comes to Liposuction but it is extremely important when it comes to revision work.
I’ve seen lots of people have outcomes made worse in an attempt to improve poorly done liposuction results.
You didn’t include pictures so we can make an assessment.
Liposuction results are permanent and irreversible.
If the first treatment was aggressive is a chance of improving the outcome goes down precipitously.
Treatment options generally come down to revision liposuction, fat transfer, a combination of the two and occasionally cutting out the problematic area by converting the procedure to a skin tightening operation like a tummy tuck.
I suggest patients scheduled at a minimum of five in person consultations and consider rescheduling more for having regular Primary Liposuction.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
An experience provider should have no difficulty showing you at least 50 that’s a before and after pictures of commonly performed procedures like liposuction.
In reality I highly experienced surgeon that should have hundreds or even thousands of before and after pictures especially of how many areas like the abdomen.
Bring pictures of your own body and ask providers to show your previous patient who had similar body characteristics to your own in the before pictures.
These are the general recommendations I get for those seeking a primary Liposuction.
For revision work you’re not going to have providers have nearly as many before and after pictures of revision work because your vision work is not nearly as common as primary Liposuction.
Generally the best providers at revision work is going to be those who are the best at primary Liposuction.
The one difference is when fat transfer is needed to correct the outcome in which case you need to vett providers for fat transfer experience.
The time to be selective and focus on finding the right provider should be before the first procedure.
A substantial number of patients with poor Liposuction results are not candidate for any significant improvement.
You need to have a clear understanding of your candidacy for revision surgery.
Assessments are difficult and quality assessments can only be done by sufficiently experienced and talented providers.
For someone needing serious revision work five consultations may be totally insufficient to find the best provider.
When is out slow down and schedule more consultations.
If you try to focus on what’s the best equipment you’ll get lost by focusing on variables that are irrelevant and miss the variables that matter the most.
For example if you are under the belief that VASER is the way to go and the most talented Liposuction Revision specialist happens to live next door but it doesn’t use that device and you’ve completely missed the opportunity of finding the best provider.
Most plastic surgeons are not particularly good at Liposuction and mist plastic surgeons think they’re better at Liposuction then they actually are.
Define providers who have truly mastered this procedure takes significant work and effort. I personally do not believe you can properly vet providers or get a quality assessment by anything other than a thorough in person consultation.
Best,
Mats Hagstrom MD

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