What,if any, is the difference between a Tumescent lipo & smart lipo triplex? Which has better results?

I had tumescent about 2yrs ago & it was on, but I have a bit of loose skin & grab fat, considering a do over!

Doctor Answers 8

Tumescent Lipo and Smart Lipo

Tumescent liposuction, or traditional liposuction is just a general term that describes the process of injecting a solution of saline, epinephrine, and lidocaine to hydrate and anesthetize fat prior to suctioning.  Smart Lipo refers to emulsifying or liquefying the fat using a special laser device.  In both cases, the tumescent fluid is used.  Also in both cases the fat is usually thensuctioned out at the end.  The main difference is that using the laser, fat tends to come out smoother and can be a more gentle process.  Loose skin can be improved with Smart Lipo since the heat generated can tighten skin.  However, if you have significant loose skin, you may be a candidate for a skin excision procedure.  I would recommend consulting with an experienced Smart Lipo surgeon, who also does skin excision procedures like tummy tucks to get an honest opinion.  Good luck on your journey!

The difference between tumescent Lipo and smart Lipo

You ask a very common question which I hear almost every day. Tumescent refers to putting in a considerable amount of fluid into the subcutaneous tissues. All Lipo suction is now tumescent . In the past it wasn't and there was considerably more bleeding associated with the procedure. With over more than 25 years experience with Lipo suction I have used every different form including conventional, ultrasound, and laser.  For redo liposuction ultrasound or laser is much better than conventional. In my office I use both, but I think that laser liposuction which is the smart Lipo would be the best for a redo. The laser allows penetration of the scar tissue and by changing  the  setting the underside of the skin can be heated which creates for more shrinkage of loose skin. 

Andrew Kaczynski, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 106 reviews


Thank you for posting your question. Tumescent lipo is the standard procedure nowadays and it just refers to the fact that tumescent liquid is placed into the area undergoing liposuction. The liquid numbs the area and constricts blood vessels to reduce post-procedure bruising. Smart lipo, on the other hand, is an advanced three wavelength liposuction technique. By gently heating the overlying skin, laser liposuction induces new collagen production and skin contraction. This is especially effective in the loose skin. Smart lipo by itself cannot removed as much fat, but many physicians combine the two procedures to tighten up loose skin and yield better results.

Jan Zemplenyi, MD
Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Tumescent just refers to how much fluid is placed before doing the lipo.

Tumescent just refers to the fact that a significant amount of fluid is placed in the body just before beginning the liposuction. it is not an exact number but means that at least a moderate amount of fluid (lidocaine, epinephrine and bicarb) is placed in the body part. 

Smartlipo Triplex refers to the excellent laser lipo system made by Cynosure to melt the fat and then liposuction it out of the body.

david berman md

David E. Berman, MD
Sterling Plastic Surgeon
4.9 out of 5 stars 76 reviews

ReDo Liposuction

Areas of the body where liposuction have been previously performed typically will have fibrous (scar) tissue in the fatty layer beneath the skin. In the past performing a redo liposuction with conventional tumescent liposuction meant quite a bit of bleeding and difficulty for the surgeon performing the operation. With the Smart Lipo MPX and Triplex the proper settings can be chosen to seal blood vessels to minimize the bleeding during lipsuction. The Smart Lipo device also provides an added benefit of skin retraction or tightening that tumescent lipo alone can not provide.


Liposuction is one of the most common, as well one of the most commonly misunderstood cosmetic procedures performed by plastic surgeons. Liposuction, or suction assisted lipectomy (SAL) as it is also known, allows a surgeon to contour a patient’s shape and address those areas resistant to diet and exercise. It is not a weight loss procedure and is best performed on patients who are at or near their target weight. Common target areas include:

·      Abdomen/Flanks (“love handles”)

·      Hips/Thighs/Legs

·      Upper arms

·      Back

·      Buttocks

Traditional liposuction or SAL (Suction Assisted Lipoplasty) is typically performed under sedation/general anesthesia. The procedure involves the use of a hollow metal tube called a cannula, which is inserted via series of small incisions. These cannulas are first used deliver a combination of local anesthetic and vasoconstrictor (to minimize bleeding). Once anesthetized, the cannula is used to disrupt the fat cells for subsequent aspiration. This technique can be augmented through the use of ultrasound or power (vibration) facilitating fat aspiration. These are employed at the surgeon’s discretion.

SmartLipo is a relatively new technique that allows the physician to use a laser to liquify and remove excess fat while tightening the skin the in the area. A cannula outfitted with a small laser fiber melts the fat which is then removed with suction using traditional liposuction methods. The procedure can be performed under local anesthetic only and is purported to be relatively atraumatic resulting in faster recovery times. However, it is more limited by an ability to address multiple areas as the local anesthetic is delivered to a smaller more focused area to ensure minimal discomfort for the awake patient.

The primary difference between SmartLipo and traditional liposuction is the use of the laser facilitating the fat removal. Rather than manipulating the cannula to manually break up the fat cells, the laser melts the excess fat. This is supposed to allow for a gentler, less invasive procedure with less discomfort, less bruising and swelling, and a quicker return to normal activities. The laser also helps to tighten the overlying skin in the treated areas.

Once either procedure has been completed, the patient will be given a special compression garment to reduce swelling. On average, patients are able to recover from SmartLipo within two to four days, but they will be advised to avoid rigorous activity for at least week. The recovery period for traditional liposuction is typically one to two weeks.

To determine which technique is right for you, consult with a board certified plastic surgeon. Most importantly, the success of your surgery will not be dependent on the technology employed, but rather the experience of the surgeon performing the procedure.

Donovan Rosas, MD
Westchester Plastic Surgeon
5.0 out of 5 stars 7 reviews

Go With The Best-VASER HI DEF

I understand you're considering a re-do. Your question was tumescent or smart lipo, but I  suggest VASER HI DEF liposuction for body shaping and tightening. I suggest seeing an expert. All forms of liposuction are tumescent. I find that VASER in combination with ultrasound gives the best results in shaping and tightening.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

What,if any, is the difference between a Tumescent lipo & smart lipo triplex? Which has better results?

Hello and thank you for your question!

Look, Tumescent lipo in general, is a type of lipo that will use a lot of fluids before the procedure to make sure the skin is detached from the fat and also makes sure that the amount of fat that is taken out is of great amount. Smart lipo is a laser assisted liposuction. It has great results with patients that need more skin to be retracted or those that will not be submitted to other procedures. Lipo triplex is a procedure that is very similiar to the Tumescen, however you need to understand that the one that will be best for you deoends on your needs. So send us photos so we can better evaluate your need and see which one is best for you.

Please visit a board certified plastic surgeon for further advice and the best, safest results.

Good luck!

Enriquillo Clime Rivera, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 3 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.