Laser Liposuction

My doctor said smart lipo is much quicker recovery and all around better than liposuction surgery Is that true?

Doctor Answers 35

Cool Lipo and Smart Lipo from a surgeon's viewAs a...

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Cool Lipo and Smart Lipo from a surgeon's view

As a Plastic Surgeon that uses liposuction and fat-grafting techniques on a regular basis, I am certainly interested in learning about new techniques that may improve upon "traditional liposuction." As a disclaimer, I must say that I do not have personal experience with laser lipolysis devices such as the Smart Lipo and Cool Lipo devices. I read with great interest the one independent, peer-reviewed study I have seen to date that tried to specifically address this question as to the merits of laser lipolysis. The article, "A prospective, randomized, double-blind, controlled clinical trial comparing laser-assisted lipoplasty with suction-assisted lipoplasty," was published in the journal Plastic and Reconstructive Surgery in September of 2006 (this journal is the largest and most respected in the specialty of plastic surgery). See the article's abstract.

This is a carefully planned study that set out to assess the best way of scientifically comparing the laser Smart Lipo laser lipolysis device with standard liposuction by using both techniques in a series of 25 patients (one technique being performed on each side of symmetrical body fat areas). Patients and observers were randomized and blinded as to which side received each treatment to avoid bias. The article's authors concluded that:

"This study failed to demonstrate clinical advantages of laser-assisted lipoplasty over the traditional suction-assisted lipoplasty method... Refinement in laser instrumentation must evolve and prove to be more cost-effective than the traditional method before it can be promoted as a proved technology for the assistance of lipoplasty."

However, while this study concluded that no major clinical differences could be identified between the results of the two techniques, it did identify slightly less post-operative discomfort and suggests less blood loss with laser lipolysis. It was also noted as a disadvantage that the fat cells are rendered non-usable for fat grafting or transfer to another area of the body when subjected to laser lipolysis.

So, in my skeptical view of new technologies, this technique does appear to be effective, but for me it does not yet provide compelling advantages over current techniques. It is notable that plastic surgeons and others in aesthetic medicine are continually bombarded with highly promoted new products, techniques and technologies.

At our 2007 American Society of Aesthetic Plastic Surgery annual meeting, significant ethical and safety concerns were raised about such marketing and business influences in our specialty, and I do believe these are valid concerns. The best assessment tools we have are independent, peer-reviewed, prospective studies such as the one sited above where the authors ideally have no financial interest in the products or technologies being studied (or alternatively where any such interests or compensation are fully disclosed).

In conclusion, it does appear that, in competent hands, laser lipolysis is an effective tool. It is not a tool that I currently use, but I am still interested in learning more about these techniques. I recommend that a patient considering body contouring carefully weigh the training and experience of their surgeon and ask pertinent questions at a consultation about treatment options, risks and anticipated results. Always insist on seeing B&A photos of the physician's own patients and ask how you compare to those patients... With this in mind, I would want the surgeon to use the tools they are most confident and comfortable with.

Laser Liposuction Has Advantages But Surgeon is Most Important

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The most important factor in a good Liposuction result is the skill of your surgeon. See a Board Certified Plastic Surgeon that you trust and follow his or her advice.

I have used SlimLipo Laser Liposuction for almost 5 years and have been pleased with the results. Among surgeons it is still a very controversial topic.

In my hands the benefits of Laser Liposuction are:

  • Skin Tightening-published studies have shown this effect
  • Smooth Skin after Liposuction-in my hands contour deformities are fewer using Laser Liposuction-this is technique dependent but I believe melting the fat first with the laser reduces this problem
  • Less bruising-again technique dependent

The key is finding an experienced Board Certified Plastic Surgeon-there are many inexperienced users out there. An inexperienced user should not be doing Laser Liposuction-the risks of burns and other problems are significant if improper technique is used.

Its not the instrument...Its the surgeon

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1.  Every few years there is a "new technique"  for many things in surgery.  The honest truth is that with liposuction the technique with the best proven long term results and safety is good ole tumescent liposuction.  Which is basically injecting saline and sucking out fat.  

2.  The results are not only delivered by the type of instrument used, which is what the instrument company wants you to believe, but by the surgeon doing the procedure.

3.  The only technique proven to work is regular liposuction.  There is no long term data and equal comparisons to show that laser liposuction is better than regular liposuction.  There is however a higher risk of burning the skin with laser liposuction and nerve damage in the face. 

Dev Wali, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 58 reviews

Smartlipo has advantages over traditional liposuction

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Conventional liposuction is good for to removing greater amounts of fat and typically requires a general anesthesia. However, since this can sometimes leave behind areas of loose skin. For better skin tightening, laser assisted lipolysis is often a perfect complement.

With laser liposuction using Smartlipo MPX, a dual wave length laser is used to remove fat but also tighten the skin by heating the collagen from below. Smartlipo MPX alone usually only requires a local anesthesia, but it can also be used in conjunction with tumescent liposuction to enhance the over all result of conventional liposuction. Patients utilizing the Smartlipo technique are reporting less bruising and less discomfort than patients who had traditional liposuction alone. They are also seeing a greater decrease in the appearance of cellulite in some situations.

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 72 reviews

Laser Liposuction

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Laser Liposuction, Smart Liposuction are the newest technics introduced in the field of liposuction. It has its own merits especially when liposuctions are done on head and neck areas. Because of skin contraction , smart liposucion is commonly used as an ancillary procedure in  the modern face lift operations. Recovery is als quicker when compared with conventional liposuction.   

Is "Smart liposuction" a smart idea for you?

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currently there is much hype in the media and plastic surgery advertisements about "smart liposuction". without having shown clear scientific evidence of benefits this surgery is marketed to the public in order to sell a new liposuction machine. Unfortunately, smart liposuction does have higher rate of certain complications than tumescent liposuction and I have not seen any evidence that its results are even as good as tumescent liposuction.

Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.4 out of 5 stars 51 reviews

Liposuction depends on the surgeon, not the machine

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While there have been several claims that "smart" liposuction or laser liposuction is "better" than conventional tumescent liposuction, this has not been proven through scientific study.  The boom of new liposuction machines has mostly been driven by the companies that make these machines and the advertising they have spent on marketing these new treatment options, not patient demand because "traditional" liposuction doesn't work.  The other thing that the manufacturers have done is place these machines in several non-plastic surgeons offices with the promise that they could build an aesthetic practice and bring in cash-paying patients. 

The results from liposuction are most determined by who is doing the surgery.  Start with a consult with a plastic surgeon who is certified by the American Board of Plastic Surgery and discuss with them the pros and cons of each different treatment option.

Smartlipo is still Lipo!

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The laser manufacturers have almost outdone themselves with their claims of "quicker recovery, less down-time, less bruising", etc.  In truth, laser-assisted liposuction is LIPOSUCTION--you just add the extra step of applying the laser energy before using the liposuction cannula to remove what has been treated with the laser.

In properly-selected cases, laser-assisted liposuction is used to treat small problem areas under local anesthesia in the office.  This may be part of the reason it's considered to have "quicker recovery" than "regular" liposuction, which is often used to treat larger areas or more concurrent areas at the same time.

You may or may not be a great candidate for laser-assisted liposuction.  Please be sure to see only a surgeon who is certified by the American Board of Plastic Surgery (NOT a "cosmetic surgeon", as they are often not plastic surgeons at all!).  Many "cosmetic surgeons" (family practice doctors, GYNs, general surgeons, internal medicine doctors, ER doctors, anesthesiologists--could be anyone who has now decided to try their hand at lipo!) --many of these doctors can ONLY do laser-assisted liposuction.  If you only have a hammer in your toolbox, then everyone starts to look like a nail.  If the doctor can't offer you options for treatment, go somewhere else--it may  be because they only know one option or can only perform one option.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 46 reviews

Laser Liposuction (SmartLipo, Slim Lipo, ProLipo etc)

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With more doctors, regardless of their training performing liposuction, competing for less patient willing and able to pay for liposuction (due to our country's economy), marketing, exaggeration and plain BS run high and often unchecked.

ALL liposuction procedure do the SAME first step - fill / puff the fat with an (Tumescent) solution of dilute adrenaline and a local anesthetic. After this step is done
- "regular" (Tumescent) liposuction can be done
- Ultrasonic (Tumescent) liposuction (UAL, of which VASER - Liposelection is one type) can be done
- Power assisted (Tumescent) (PAL) liposuction (in which the surgeon holds a reciprocating back-forth moving engine holding the tube) can be done
- Laser Assisted (tumescent) liposuction (such as SmartLipo, Slim Lipo, ProLipo etc) in which a laser fiber is used to cook the fat under the skin after which it is vacuumed just as it is with "regular" liposuction

Laser liposuction takes the longest to do (because of the time n needing to pass the laser heat back and forth through the fat) AND has NOT been demonstrated by ANY studies to be better in any way from the other modalities. BUT - since it is usually used to suction small areas (such as chins etc) comparing the recovery of small areas treat with LAL with much larger areas treat with other modalities is dishonest, at best.

Before you have your liposuction, check your surgeon and make sure he is a real Plastic Surgeon listed at (ALL of whose members are certified by the American Board of Plastic Surgery.) You may be surprised to find your liposuction doctor who made such glowing promises may actually be a gynecologist, ER doc, or a Family Medicine doctor and you should be aware that liposuction is NOT a topic these residencies train their doctors in.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Laser lipo gimmicks

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I've never been the first one on the block to get the latest and greatest device that's going to change the world of cosmetic surgery. I have colleagues that are. But I'm thankful I never got on this band wagon. Having not actually used Cool lipo but having seen some post op patients in need of revision here's what I know.

Standard liposuction uses general anesthesia, for complete patient comfort, tumescent solution to reduce bleeding, small cannulas to minimize contour irregularity and the principle that removal of the deep fat is good with removal of deep superficial fat and to stay away from the skin. Getting close to the skin can cause significant damage.

Cool lipo. Smart lipo and the others use a laser, just a heat source, to melt the fat. In addition they're working off of the principle that facial lasers use which is stimulation of the dermis will create collagen and thus tighten the skin. This means the surgeon must get close to the skin which is against the basic principles of lipo.

I have seen some horrendous results from this technique. Now to be fair it may have been the surgeon but who knows. Stick to what has been tried and true.

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.