Best Method of Liposuction for the Lower Body?

I need advice on what type of liposuction to get to treat flanks, outer thighs and banana roll? My doctor only does traditinal lipo. Would Smart Lipo, Vaser, etc. be more effective in reshaping the lower body? Thanks!

Doctor Answers 9

Best liposuctions are done by experienced doctors with artistic ability

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All docs do liposuction and it doesn't matter what type of machine is used or what board certification your doc has as much as the experience and artistic ability of the doc himself. Choose your doc wisely and make sure you have a good report with him since he will be the one advising you for the next 4-5 months on what is to be expected along the way.

Don't choose someone who only does it part time or as one of many different procedures he or she does. Those who keep up with the latest advances do not do traditional lipo anymore nor do they do any lipos under general anesthesia either since fine-tuning requires you to be awake and movable in many positions to get the best results. But even old traditional lipo did give some amazing results in some patients. Be sure to feel comfortable with your doc no matter what technique he or she uses.

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Which type of liposuction is best for me?

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Hi there-
Tumescent liposuction, VASER Lipo, Smart Lipo, Cool lipo, Pro Lipo, Slim Lipo, Water Jet lipo...
What does this all mean? If I don't get Smart lipo does that mean I'm dumb? If my surgeon recommends Slim Lipo does that mean he/she isn't a "Pro"? It truly is a ridiculous situation we have come to with regard to liposuction and the number of people trying to cash in on America's desire to be rid of its collective fat.
In well motivated patients, body contour improvement can be a very healthy endeavor, but how is an otherwise intelligent and well-adjusted person to know the difference between a responsible provider of aesthetic services offering them safe options for help with their body contour and a poorly trained and inexperienced provider more interested in their wallet than in your outcome and safety?
It is first important to realize that all of these devices will require you to undergo a liposuction procedure. The only difference is the approach to the treatment of the fat prior to its removal.
Because they all involve liposuction, and this is in fact a surgical procedure, it is very important that you "do your homework" and find a surgeon certified by The American Board of Plastic Surgery who has the years of training in liposuction necessary to give you the safe experience and superior outcome you deserve and desire. Behind the amazing number of machines now available to remove your fat, there has followed an army of their sales representatives and an equally impressive number of providers marketing themselves as "liposuction experts".
What has made them "liposuction experts"? In almost all cases, a few days or weekends training with the salesman for the device or with someone more experienced in the procedure. It is their promise that if you have the device in their possession brought to bear on your behalf, your fat will be gone, your skin will miraculously shrink away, you won't need any anesthesia because the device allows painless removal of the fat, and it can be done on your lunch hour. The only thing I am surprised by at this point is that they don't promise you'll get rich and be more sexually alluring after the procedure too.
Selling the particular device to patients is not unlike someone saying to you that because they will give you access to Tony Stewart's racing car that you will be able to win this weekend's race and make a million dollars. Tony Stewart wins races because he is a great racing car driver AND he has a great car...This is no different.
Getting the best outcome from a body contouring procedure depends most on finding a well-qualified and experienced surgeon, and much less on the device used.
Most of these people are so aggressive in their marketing of these questionable devices because they are, in fact, not trained plastic surgeons but rather are either not physicians at all, or they are doctors with core training which would not have prepared them to do liposuction. Many have read recently about a death in my home state of Florida after a healthy 40ish year old mother had liposuction performed be a rehabilitation medicine doctor. Amazingly, I know of eye doctors (!!) doing liposuction as well- and yes, they market themselves as "liposuction experts".
The particular device used can affect the overall experience, however.
Despite the claims of the manufacturer and the practitioners who plunked down the large sum the device costs, Smartlipo has never been proven to shrink skin better than tumescent liposuction. SmartLipo, SlimLipo, Prolipo, and Coolipo all use a laser to destroy the fat cells, allowing them to be removed by liposuction. My problem with these is that, first of all, as a scientist and doctor I am offended when false claims of benefit are made, and that because the lasers will burn whatever you point them at, I worry that your nerves, blood vessels, muscles, and skin may be injured by the laser.
Bottom line (and in my opinion) -- there is no benefit to these devices, they are expensive (meaning that the cost to you, the patient, will be higher as well), and the risks are higher.
Tumescent liposuction is the gold standard to which all other techniques must be compared. It has been proven to be safe and effective over many years (provided that it is performed by a well-trained surgeon). It involves the injection of a fluid into the fatty tissue layer that causes blood vessels to shrink and the fat to expand, making it easier to remove and lowering the risk of a complication.
VASER lipo involves an additional step, in which the fat (after injection of fluid but before suction is applied) is treated with ultrasound energy. Unlike the laser filaments used in SmartLipo and the other devices mentioned above, the VASER probe is blunt and the ultrasound energy it uses is much more specific for fat, so that the risk of injury to the blood vessels and nerves, as well as the muscles and skin are much lower. This is seen in the patient experience of reduced swelling and bruising.
Each time a new (revolutionary!) liposuction machine comes out, I think the most important questions to ask are not "Does it work?", but rather, "Does it work better than what is already available, is it less expensive (not more), and is it safer than what is already available?"
The VASER (in my opinion) passes this test, while the laser based devices do not.
Having said all of that, I would emphasize that it is the education, training, experience, and skill of the surgeon at the end of the liposuction device that will make the greatest difference in your outcome and safety. There is not substitute for the years of training Board Certified Plastic Surgeons receive in liposuction, directly supervised by other Board Certified Plastic Surgeons. A well trained and Board Certified Plastic Surgeon would be more than capable of achieving a better outcome through tumescent liposuction than any eye doctor with a Water Jet. As in the analogy of Tony Stewart above- a great professional with a great tool (like the VASER) would only make those results and their safety even greater.
Please know that I have no financial relationship with any of these companies and have personally tried each of the discussed technologies myself on patients.

Which liposuction technique is best to treat the lower body?

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There has not been one study that convinced me that any one technique or use of equipment when doing liposuction, is better than the others. Is there less bruising with one technique than the other, and if so, does that produce a clinically significantly different result in the long run? Is there any true dermal or subcutaneous tightening as a result of the laser-assisted liposuction, more than the extent from traditional tumescent liposuction? I have not been convinced of this based on scientific studies. Possibly more need to be done.

You may get a most wonderful result by having a board-certified plastic surgeon or dermatologic surgeon peform the liposuction regardless of the instrumentation.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Liposuction and results

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Any form of liposuction can achieve equal results in my opinion. It is not the wand but the magician that waves the wand that creates the magic.


Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Best results for liposuction.

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The best results for liposuction are achieved by surgeons with a great deal of experience and the patient they are operating on. The type of machine makes little difference and is mainly a marketing tool. Choose your surgeon wisely and you should be very happy. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Traditional liposuction is great.

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"Traditional" tumescent liposuction has the best track record for safety and good results.  The others are mostly about marketing.  The individual surgeon is much more important than which machine is used.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Smartest lipo techniques

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An enormous amount of marketing money is spent trying to convince people that certain "brand names" of lipo are best. Smart lipo, for example, is only one version that uses a laser, and these are often hyped as being "less invasive" and a "safer alternative" to lipo.

However, since they use the laser in addition to the liposuction procedure, they are by definition more invasive and carry additional risks; and since they are liposuction, they are not an alternative to lipo but just another way of doing it. Similar for VASER ultrasound.

All of these are useful tools in the right hands but as the other responses have pointed out, it is choosing the right hands that is most important. What works best in the lower body is the same as what works best on the upper body.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Best method of Liposuction

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It has been said and bears repeating that it is not the tool but the hand and brain that use the tool that make all the difference in the outcome.

As regards Liposuction, we ALL use tumescent solution AND I like the VASER but have seen nice results from friends who use Power Assisted Liposuction (PAL). I share the view that Smart Lipo is way over-rated and over-hyped.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Liposuction technology isn't as important as the surgeon and your own body

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By all means, the most important factors that determine the outcome you will get from liposuction are the surgeon's artistic ability and experience, and the quality of your tissues and their elasticity.

If you have an excellent plastic surgeon and if your skin is healthy and elastic and if you can point to specific areas of interest rather than having generalized obesity, you will have a nice result. A modified tumescent technique is the gold standard, no studies have ever shown the "laser lipos" to be any better.

No surgeon and no technology can give you a great result if you are not a great candidate.

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.