Lipo alternatives or is surgical lipo best for me?

Hi.  I would recommend more of a surgical approach with liposuction or SmartLipo.  SmartLipo has the additional benefit of likely more skin tightening than just traditional regular liposuction, although that is still a good option.  I am curious as to why you would be worried about liposuction on the body when you are going through an arguably bigger or at least similar surgery recovery-wise by having a breast reduction done and are okay having liposuction on other areas.  But that is really only a question that you could answer.  Noninvasive options could include CoolSculpting and Emsculpt, but I think you would be expected to get a better result with surgery such as liposuction to treat it more thoroughly.  I would recommend consulting with a board certified plastic surgeon with good experience in all of these areas including liposuction as well as the noninvasive options.  Good luck and take care, Dr. Howell

you need a surgical improvement -- liposuction, internal heating and possibly skin removal or tightening.  vanquish, coolsucpting, TrusculptID will do very little. hormonal optimization will help a lot (see link). I suggest a comprehensive approach with surgery, weight loss / hormones, exercise, diet. 
You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

While I understand your concerns and anxiety about liposuction, is important to look at the big picture. Traditional liposuction has been around for over 35 years with a very high rate of satisfaction and relatively low rate of complications. It truly is the gold standard for removal of fat from areas of your body resistant to diet and exercise. The so-called “non-invasive“ treatments such as Vanquish and CoolSculpt have quite a high rate of dissatisfaction because of the length of time needed to see results and minimal improvement. I recommend first embracing a realistic and sensible diet and exercise program, and then reassess your body and consult with a board-certified plastic surgeon with regard to possible liposuction for troublesome areas. Best of luck.