Big Saddlebags & Belly: Get Liposuction and Tummy Tuck or Just SmartLipo?

Weight 136 and 5'1, looking to get rid of major saddlebags and mini-tummy that sags down. Work out 5-6 days a week. One Dr. says do SmartLipo,  the other one says it is a gimmick and to get lipo and a tuck. How does one make the best decision?

Doctor Answers 22

SmartLipo is a gimmick

The doctor you saw who described SmartLipo as a gimmick is probably correct.

The dictionary tells us that a gimmick is something that has a special feature that makes it "stand out" from the rest. It's just that the special feature is of little relevance or use.

With SmartLipo, there are a few such "special features" that its advocates tout. If you look at them one at a time, they are either not unique, or their advantages have not been shown.

  • There is a major push in the SmartLipo marketing campaigns to suggest that it is somehow less invasive than standard lipo. Yet, incisions are still made, and cannulas are passed under the skin. In fact, the presence of a laser that creates thermal injury inside the body is itself more invasive than standard liposuction and creates the potential for other problems.
  • There is also a push to describe SmartLipo as something that is done on patients that are awake. But so, too, can all liposuction techniques be done on awake patients. There are pros and cons in terms of costs, risks, comfort, and ability to contour the body that must be considered with anesthesia, but SmartLipo holds no special advantage in this regard.
  • Advocates say that the aspirate is less bloody or that there is a better yield of fat, but they offer no studies that show this. I asked the company for this data, and even they don't have it!
  • Proponents also say that it tightens skin. However, there is no evidence at all -none whatsoever- in any medical publications of which I am aware - that shows that this actually happens. I asked the company for evidence of this, and all they offered was anecdotes. And in medicine, anecdotes don't count! Anecdotes are just opinion, and are shaped by personal bias. Doctors do not make decisions on such a basis.

At the most recent American Society for Aesthetic Plastic Surgery meeting in May '08, the physician who presented on SmartLipo concluded that no advantages of it has yet been proved. The only advantage he saw was a marketing advantage.

So, to the extent the special features have not been proved, for all we know, they are of little or no relevance. And that - according to Noah Webster- is a gimmick.

Los Angeles Plastic Surgeon
4.6 out of 5 stars 48 reviews

SmartLipo not necessarily the best choice

SmartLipo has a purpose for smaller areas but it has not been proven for substantial areas like for your "major saddlebags." We would recommend more proven techniques at this time for such significant areas.

Do you really want to undertake the cost, time, and emotional resources for an unproven technique that may leave you dissatisfied?

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 41 reviews

SmartLipo versus Liposuction

When considering doing liposuction or body contouring surgery, liposuction should be done smartly by smart plastic surgeons that use the right instruments or technology. The way to obtain the best results in liposuction and body contouring surgery is to seek a Board Certified Plastic Surgeon that has expertise in body sculpting. It is not the use of new, yet improved technology such as SmartLipo that has a high index for marketing, but very low index for science and therefore has a propensity for problems.

Choose your surgeon wisely to get the best results you want in body contouring surgery, specifically in liposuction.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 62 reviews

Smartlipo alone will not give you tummy tuck and remove big saddlebags

The answer to your question is to consult 2 board certified plastic surgeons and evaluate their opinions.

Laser liposuction like Smartlipo and Slimlipo can provide excellent results when done by experienced talented plastic surgeons who know how to use these new technologies. I have used laser assisted liposuction fror 3 years and have had excellent results. Skin tightening is impressive and more impressive is the smooth skin after laser lipo without the skin irregularities often seen after standard liposuction.

If you have significant loose skin on your tummy then a tummy tuck is likely what you need. If you have primarily fat and mild to moderate loose skin then properly performed laser liposuction, Smartlipo, Slimlipo or Coolipo will suffice.

The key is choosing an experienced, board certified plastic surgeon who has a good reputation and whom you feel you can trust.

Lax skin will have to be excised with Tummy Tuck

It sounds as if you have lax skin, at least to the lower abdomen. The Smart Lipo advocate is trying to convince you that it can tighten the lax skin. This is often touted by advocates of the technique, but this effect is very minimal, if present at all. If you have lax skin to the lower abdomen, you will need to have it excised, meaning a tummy tuck. There is no alternative for skin that has lost its elasticity.

If the skin tone is also poor to your saddlebags, you will require excision of that skin as well, a procedure called a "flank-plasty." If the skin tone here is good, liposuction is the answer.

Good Luck!

Jeffrey Horowitz, MD
Bel Air Plastic Surgeon
4.8 out of 5 stars 24 reviews

Smartlipo does not replace a tummy tuck

Smartlipo may or may not be a smart choice for you. No type of liposuction (Smartlipo or not) replaces the need for a tummy tuck. What you need is a smart surgeon. If you already have sagging skin in those areas, liposuction alone does not sound like the best option for you. Combining a tummy tuck and liposuction is a great way to get rid of both excess skin and fat. (If you only had excess fat and good skin quality than you could expect good results with liposuction alone.)  Somehow the name Smartlipo makes it sound far advanced over liposuction, and this has not been shown to be the case. Definitely consult with a board certified plastic surgeon on this one.

Anita Patel, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

Tummy Tuck and Liposucition

In most cases, a Tummy Tuck is the best option for removing skin. Liposuction is best for removing small pockets of fat. Consult with  Board Certified Plastic Surgeon. Upon evaluation and examination, your surgeon will be able to recommend the procedures that would best address your individual concerns. Best wishes!

Christine Sullivan, MD
Columbus Plastic Surgeon
4.6 out of 5 stars 33 reviews

In this case, SmartLipo not so smart

Thanks for your question!

SmartLipo alone will not be able to effectively treat all of these areas and give you the results that you are probably looking for.

SmartLipo works best for small areas. Areas such as the saddle bags can be very effectively treated with liposuction or U/S lipo.

All of the tummy tucks that I perform include liposuction because liposuction lets me treat areas that I would not be able to with a tummy tuck alone.


Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

Tummy Tuck or Smart Lipo- which is best for me?

Hi there-

Without a careful discussion of your goals and an examination, it would be nearly impossible to advise you properly and responsibly, but the following does generally apply...

If you have loose, excess skin, there is NO form of liposuction that will improve this, no matter what you are being told. Claims of skin shrinkage by the manufacturer of the Smartlipo device and by those physicians who have purchased it have largely been debunked at this point.

Your best bet is to find a surgeon certified by The American Board of Plastic Surgery that you like and can trust and discuss your goals with them.

For further information and help sorting out the liposuction options out there, please read this:

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Tummy tuck vs Smart Lipo

It's difficult to answer that question without examining you or at least seeing photos, but based on your description, it sounds like you need a tummy tuck with liposuction of the saddlebags. You mentioned that your mini-tummy "sags down" ... saggy skin is usually best treated with a tummy tuck or mini tummy tuck, and not liposuction. I recommend you discuss your goals with a board certified plastic surgeon so the two of you can make your plan together. Best of luck!

James Knoetgen, III, MD
Fresno Plastic Surgeon
4.8 out of 5 stars 59 reviews

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.