In a recent Orange County Register article about the layoffs at Cynosure, the chairman of the UCI Department of Dermatology predicted tough times ahead for laser liposuction, which he considers of little use to patients. He said, "the super-bloated market in laser lipo devices will hit rock bottom in 2009, and good riddance. They were always a marketing tool, and did little to advance the science of the art, or provide benefit to the patients." Is Laser Lipo a passing fad on the way out?
Laser Assisted Liposuction - Just a Fad?
Doctor Answers 11
Laser lipo promotion
SmartLipo has enjoyed wonderful success from a marketing standpoint. It is a "hot and exciting" buzzword among those seeking body contouring.
Because of its popularity, many surgeons have purchased or leased SmartLipo equipment in order to meet this demand of the patient population.
A scientific comparison of SmartLipo versus traditional techniques published in the premier plastic surgery journal found no discernable difference between body areas treated with the two different techniques.
Much more important than the technology assisting the liposuction (power assisted, ultrasound assisted, or laser assisted), is the experience of the surgeon performing the procedure.
Laser assisted lipo benefits
It is inconceivable to me that Smartlipo would not be beneficial. Certainly ultrasonic liposuction is beneficial. The ultrasonic cannula, which is inserted after tumescence is carried out, melts fat that is then removed (aspirated) by traditional liposuction.
In Smartlipo, we are using a very small fiber optic cable that conveys the laser energy, which definitely melts fat on contact. There is no way that this cannot contribute to loss of fat and a better shape.
The biggest problem that I can see is that because this fiber optic cable is very small, Smartlipo should be reserved for small pockets of fat, anywhere on the body. The reason why a dermatologist is quick to condemn Smartlipo is that because dermatologists are NOT surgeons, they have no other tools at their disposal.
I would estimate that out of 10 patients who come in for consultation seeking Smartlipo, I only recommend Smartlipo to 2 of 10 patients. The other 8 of 10 patients are better candidates for ultrasonic liposuction or a tummy tuck - neither of these can be done by dermatologist.
This is why it is better to seek a plastic surgeon for Smartlipo, since he/she will have other options in addition to Smartlipo. Like any good tool, it is best used selectively and clearly is not to be used on everyone who has more fat than they want.
Laser Assisted Liposuction Maybe a Fad
Laser Liposuction Maybe More Hype than Benefit over Traditional Liposuction. In general I agree with the statement made in your note.
Benefits of Laser-Assisted Liposuction in my opinion are more theoretical than real.
The primary benefit of laser-assisted liposuction is that the recovery period has been touted as less painful, and you may experience less swelling and bruising. I have not seen any difference. The theory is that because the laser used to disrupt the fat cells it causes less trauma to your tissues than mechanical removal—but the surgeon still does have to get under the skin and remove the fat. It generally takes me longer to use laser assisted liposuction and there is the danger of heat generation and a burn complication.
Laser-assisted liposuction has not been demonstrated to produce better results than tumescent ("traditional") liposuction.
The #1 consideration—for both pain & swelling and your ultimate result—is your choice of surgeon. A skilled, experienced surgeon will give you the best surgical outcome with minimized pain and recovery time. I suggest looking up surgeons who are certified by the American Board of Plastic Surgery
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FYI: Studies on Laser Asssisted Lipolysis in Plastic Surgery Literature
Conclusions: No major clinical differences for suction-assisted lipoplasty versus laser-assisted lipoplasty were found.
Higher concentrations of free-fatty acids after laser-assisted lipoplasty must alert us to possible hepatic and renal toxicity. (Plast. Reconstr. Surg. 118: 1032, 2006.)
Laser lipo works
I initially did not believe in laser lipo. The first generation of laser lipo was weak and could deliver only 6-8 watts of energy. The latest machine delivers 36 watts and does melt the fat. I do have the machine and all my patients been very happy.
One thing that you should consider is the operater. Machines and tools are important but your surgeon is more impotant than the tool. A good plastic surgeon will get excellent results with traditional lipo and also with laser lipo. The advantage of the laser lipo is shortened down time and increased precision.
I see unhappy patients from local doctors that have jumped on the demand for the laser lipo and perform laser lipo on everybody. There are patients who are not candidates for the laser lipo and need a tummy tuck.
The other key issue is that your surgeon should suction after the laser lipo to remove damaged and melted fat. If you leave these damaged cells behind, it will take very long time to see the result, and you will also have more scarring.
Power-assisted liposuction is best
I used to think there was nothing to Smartlipo or laser liposuction, until I tried it. For anyone who has done a lot of liposuction, they know the feel of how a cannula moves through various tissues in the body. Having performed extensive ultrasound, power-assisted and traditional suction lipectomy, my hand can feel the difference with Smartlipo.
Each type of liposuction has it place and is useful for different indications. The Smartlipo cannula moves very smoothly through the subdermal plane and like butter through the subcutaneous tissue. This is great for awake patients because you do not have to be aggressive with the liposuction to get nice results. After running the Smartlipo cannula through the tissues, following with the traditional liposuction cannula is also much easier.
You can see the difference in the lipoaspirate as well. Smartlipo is time consuming and really is only good for small areas (neck, arms, lower abdomen, flanks). For major liposuction, I still feel power-assisted liposuction is the best. I hope this is helpful.
Laser assisted lipo is just a technology for liposuction
Laser Lipo was always one of the modalities of liposuction (Ultrasound, mechanical etc...and not a super technique that will make other modalities obsolete.
The areas that the laser Lipo might have some additional benefits are body areas requiring skin tightening in addition to some Lipo on a small scale. The neck seems to be the best example. Trying to place the laser Lipo above other technologies in general is not a fair statement. The key is the user.
Laser Lipo: is it worth it?
That's what they claim but it has yet to be proven. I have had one patient who went to another surgeon who offered this technology about two years ago and she was dissatisfied with the results. It is slightly more delicate but that's not always good and it may not be sufficient and will take more time. I know that doesn't make all that much sense but let me give you a simple example which will help to clarify.
You have a standard size room that you want painted. Do you want to pay for someone to paint it with a standard 8 inch roller brush and get the job done in a reasonable time? OR would you rather have them paint the entire room with a 1/8' fine detail brush? I am sure the latter will be more precise and get every little corner but can you imagine how long that would take? Does that make any sense?
I know this may be oversimplified but it is hard to explain the difference.
I hope this helps
Laser lipolysis is just a great marketing tool
I think it is a great marketing tool and nothing more. The skin tightening component really doesn't show anything to me in the pictures that I have seen of long term follow-ups.
Laser assisted liposuction hype
The hype surrounding laser assisted liposuction procedures is not unlike the same hype that surrounded ultrasonic liposuction, a procedure which is now defunct. Implying the the laser's thermal energy is capable of causing better skin shrinkage is the same erroneous claim that was made by the ultrasonic advocates. No studies have scientifically shown this benefit to the patient.
For good reason, the newer laser assisted devices don't want to do these studies because when formal international scientific comparisons were done comparing ultrasonic liposuction and traditional liposuction, no significant benefits were found to justify going to ultrasonic as the standard procedure. It was interesting after this to see the multitude of companies promoting ultrasonic lipo machines at the national plastic surgery meetings one year that suddenly disappeared by the next year. I predict that the same senario will happen to Smart lipo and others like it.
The other downfall of Smart lipo will be that it is primarily performed by non-Board Certified Plastic Surgeons. Many doctors who have no formal plastic surgery training have decided to get out from under decreasing insurance reimbursements for care in their field of medicine and have been brought into the wave of Smart lipo mania. I have personally seen several problems in patients who had Smart lipo done by General Surgeons (those who will remove your appendix or gall baldder) whose results were terrible and it was clear that they just didn't know what they were doing. Smart lipo as a company would have been "Smart" if they had restricted its use to real plastic surgeons.
In the end, if you are an excellent candidate for a great liposuction result, you will get it using traditional modified tumescent liposuction done by a Board Certified Plastic Surgeon. If you do not have good skin elasticity and thus are not a good candidate for a great result, no liposuction technique, Smart, laser assisted or otherwise will give you a great result.