Good candidate for smart or traditional Liposuction with local or general anesthesia? Which gives the best results? (Photos)

I had a tummy tuck in late 2015.I was 150 pounds. I had a baby in April of 2016 so over a year ago. I gain more weight in the past year since I had my baby. I am around 180 pounds now. I had a consultation with a doctor via email. He said that my back rolls are too deep so they won't go away. He also said I need to lose more weight before I can do this procedure and I should be put under general anesthesia.What are your thoughts on this ?

Doctor Answers 8

Liposuction options

When considering liposuction, it is important to remember the adage "it's not the car, it's the driver."

There are a number of available modalities for fat reduction (with new technologies arising regularly). It is important to seek out an experienced surgeon with a history of results.

Generally speaking all of the liposuction modalities (SAL, PAL, UAL, Laser) are variations on the same theme. Surgeons will have a preference but will typically be able to obtain a consistent result using the tool of their choice.

With regards to your specific question, there is a purported benefit of skin tightening from laser liposuction as the heat stimulates collagen contraction. In my experience, the effect is less dramatic in thicker skinned areas like the trunk (as oppose to the chin/submental area where the improvement can be substantial). Additionally, due to the fact that SmartLipo is slightly less traumatic (in the sense that heat energy rather than mechanical energy is doing much of the work), recovery can be slightly shorter (3-5 days vs. 7-10 days). A skilled surgeon should be able to achieve similar results with the modality of his/her choice.

Liposuction can be performed under local, sedation, or general anesthesia. The decision is made by the patient and the physician. There risks and benefits to both. The ultimate goal is to make you safe and comfortable.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Liposuction options

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When considering liposuction, it is important to remember the adage "it's not the car, it's the driver."

There are a number of available modalities for fat reduction (with new technologies arising regularly). It is important to seek out an experienced surgeon with a history of results.

Generally speaking all of the liposuction modalities (SAL, PAL, UAL, Laser) are variations on the same theme. Surgeons will have a preference but will typically be able to obtain a consistent result using the tool of their choice.

With regards to your specific question, there is a purported benefit of skin tightening from laser liposuction as the heat stimulates collagen contraction. In my experience, the effect is less dramatic in thicker skinned areas like the trunk (as oppose to the chin/submental area where the improvement can be substantial). Additionally, due to the fact that SmartLipo is slightly less traumatic (in the sense that heat energy rather than mechanical energy is doing much of the work), recovery can be slightly shorter (3-5 days vs. 7-10 days). A skilled surgeon should be able to achieve similar results with the modality of his/her choice.

Liposuction can be performed under local, sedation, or general anesthesia. The decision is made by the patient and the physician. There risks and benefits to both. The ultimate goal is to make you safe and comfortable.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

To be under GA or not??

A lot of good questions that you ask

1: GA or no, this is very surgeon dependent and the results that can be achieved are more to do with the body contour expert that you choose rather than GA or awake.

2: I would agree that you will get a certain degree of skin tightening with laser or vaser but that to expect all the deep lines to go away permanently would be a false prophecy.  Realistic expectation will be that the fat will be removed but the skin in the back bra roll is very dense and thick which will not lend itself to significant shrinkage.  It will improve!!! but to a certain degree.

3: body contouring at or close to your idea weight is the most optimal, although fat is being removed, it is can't be a substitute for lifestyle and dietary changes post procedure!

Hope this helps!

Calvin Jung, MD
Houston Physician
5.0 out of 5 stars 27 reviews

To be under GA or not??

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A lot of good questions that you ask

1: GA or no, this is very surgeon dependent and the results that can be achieved are more to do with the body contour expert that you choose rather than GA or awake.

2: I would agree that you will get a certain degree of skin tightening with laser or vaser but that to expect all the deep lines to go away permanently would be a false prophecy.  Realistic expectation will be that the fat will be removed but the skin in the back bra roll is very dense and thick which will not lend itself to significant shrinkage.  It will improve!!! but to a certain degree.

3: body contouring at or close to your idea weight is the most optimal, although fat is being removed, it is can't be a substitute for lifestyle and dietary changes post procedure!

Hope this helps!

Calvin Jung, MD
Houston Physician

Smart Lipo

Thank you for your photos. You might be a good candidate for Smart Lipo. Smart Lipo is performed using a small tube called a temperature-sensing cannula and a state-of-the-art laser, which removes fat from targeted body areas. The energy of the SmartLipo™ laser performs two essential functions: (1) it liquefies fat cells, making them easier to remove; and (2) it heats the skin in the treatment area, triggering a healing response that stimulates collagen growth, leading to smoother results than other types of liposuction. Smart Lipo should not be used for weight loss but for body sculpting and contouring. I recommend getting a in person consultation with a board-certified dermatologist.


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

Smart Lipo

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Thank you for your photos. You might be a good candidate for Smart Lipo. Smart Lipo is performed using a small tube called a temperature-sensing cannula and a state-of-the-art laser, which removes fat from targeted body areas. The energy of the SmartLipo™ laser performs two essential functions: (1) it liquefies fat cells, making them easier to remove; and (2) it heats the skin in the treatment area, triggering a healing response that stimulates collagen growth, leading to smoother results than other types of liposuction. Smart Lipo should not be used for weight loss but for body sculpting and contouring. I recommend getting a in person consultation with a board-certified dermatologist.


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

Liposuction Candidate--Body Contouring, Diet, Exercise, Surgery, VASER HI DEF 4D Liposculpture, Tummy Tuck, Skin Removal

For best results, it is recommended to be at your ideal or stable weight before getting a sculpting liposuction procedure. Liposuction is not a weight loss procedure, rather it is for sculpting and defining and removing problem areas that cannot be removed with weight loss and diet / exercise alone. With skin laxity, a tummy tuck or lifting procedure could be performed at the same time as hi definition liposuction which will give you the best results for body shaping and sculpting. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 202 reviews

Liposuction Candidate--Body Contouring, Diet, Exercise, Surgery, VASER HI DEF 4D Liposculpture, Tummy Tuck, Skin Removal

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For best results, it is recommended to be at your ideal or stable weight before getting a sculpting liposuction procedure. Liposuction is not a weight loss procedure, rather it is for sculpting and defining and removing problem areas that cannot be removed with weight loss and diet / exercise alone. With skin laxity, a tummy tuck or lifting procedure could be performed at the same time as hi definition liposuction which will give you the best results for body shaping and sculpting. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 202 reviews

I am a huge fan of Smartlipo but it is NOT a way to lose weight

you need to increase your exercising and dieting and not expect any type of liposuction to reduce your total body fat. Smartlipo done in the office can help but not eliminate all of the extra fat. I do this for almost all of my liposuction cases since i do not have to put patients asleep. This nearly eliminates the risk of blood clots and also saves on the cost of an anesthesiologist. 

Smartlipo is a great tool but you will get a much better result if you also work hard to get a better body.

good luck

david berman md

I am a huge fan of Smartlipo but it is NOT a way to lose weight

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you need to increase your exercising and dieting and not expect any type of liposuction to reduce your total body fat. Smartlipo done in the office can help but not eliminate all of the extra fat. I do this for almost all of my liposuction cases since i do not have to put patients asleep. This nearly eliminates the risk of blood clots and also saves on the cost of an anesthesiologist. 

Smartlipo is a great tool but you will get a much better result if you also work hard to get a better body.

good luck

david berman md

Your back fat is dense and removing it with lipo can be uncomfortable by any method

Back fat is commonly dense and fibrous. This sometimes makes it uncomfortable for you to have it done fully awake. You don't necessarily need general to be asleep. My anesthesiologists prefer IV sedation (twilight anesthesia) which is safer for long cases and has a quicker recovery. You would need a consult in person to determine if your fat is dense. If it's soft, you should be able to tolerate local without any issue. Your back rolls may not go away completely because there is more skin than there is room for the skin to shrink once the fat is removed. Weight loss might improve this, but it's not essential to the lipo procedure. Smart lipo won't work any better than regular lipo, but it will create more scar tissue in the fat layers that might make it difficult or impossible to do a lipo touchup in the future if you need one. The results have nothing to do with the technology that is selected, but rather with the skill and artistry of the surgeon.

Your back fat is dense and removing it with lipo can be uncomfortable by any method

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Back fat is commonly dense and fibrous. This sometimes makes it uncomfortable for you to have it done fully awake. You don't necessarily need general to be asleep. My anesthesiologists prefer IV sedation (twilight anesthesia) which is safer for long cases and has a quicker recovery. You would need a consult in person to determine if your fat is dense. If it's soft, you should be able to tolerate local without any issue. Your back rolls may not go away completely because there is more skin than there is room for the skin to shrink once the fat is removed. Weight loss might improve this, but it's not essential to the lipo procedure. Smart lipo won't work any better than regular lipo, but it will create more scar tissue in the fat layers that might make it difficult or impossible to do a lipo touchup in the future if you need one. The results have nothing to do with the technology that is selected, but rather with the skill and artistry of the surgeon.

Surgical Options and Results

Liposuction is an option for you but your results may not be exactly what you're hoping for because of the existing skin laxity especially around the bra rolls. Your upper abdomen will likely decrease in size. You need a consult in person to establish a plan and realistic expectations. Local verses general anesthesia doesn't matter when it comes to results in these areas but it does effect your recovery.   

Surgical Options and Results

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Liposuction is an option for you but your results may not be exactly what you're hoping for because of the existing skin laxity especially around the bra rolls. Your upper abdomen will likely decrease in size. You need a consult in person to establish a plan and realistic expectations. Local verses general anesthesia doesn't matter when it comes to results in these areas but it does effect your recovery.   

Good candidate for traditional Lipo 360 including your upper back.

Hi, I think you are a good candidate for traditional liposuction under local anesthesia.  Depending on the elasticity of your skin you might have some sagging skin, which can be fixed via a back lift also under local anesthesia.  Thank you.

Good candidate for traditional Lipo 360 including your upper back.

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Hi, I think you are a good candidate for traditional liposuction under local anesthesia.  Depending on the elasticity of your skin you might have some sagging skin, which can be fixed via a back lift also under local anesthesia.  Thank you.

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.