What is recommended for a woman who is 5’3", 200 lbs and bottom heavy? Laser lipo or standard liposuction? (Photo)

Thank you for your question!You need a formal evaluation by an expert in body shaping and contouring to determine what is best. You will likely need to lose weight first before undergoing any cosmetic procedure to get the best outcome. For best results, it is recommended to be at your ideal or stable weight before getting a sculpting liposuction procedure. Liposuction is not a weight loss procedure; rather, it is for sculpting, defining and removing problem areas that cannot be removed with weight loss, diet and exercise alone. If skin is very loose before surgery, then it will need to be removed: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin. In the meantime, I recommend getting a formal evaluation with a bariatric doctor or dietitian. Best, Dr. Emer

I have performed lipo for many patients with a bmi greater than 33, with the understanding that the inches lost from their waistline will be more noticeable than the improvement in their contour. Patients who share the same or similar height and weight should note: Lipo is NOT a weight loss procedure (but you do lose weight as a side effect of fat removal), due to limitations of the amount of numbing fluid used, it is important to choose the areas which bother you the most and then complete lipo on other untreated areas in two or three stages, and individual results depend on the individual. If you are unable to eliminate carbs from your diet, you are not willing to walk (exercise) daily, and or unwilling to seek care from a lymphatic massage specialist after lipo, then you should postpone. Also, consider speaking with your family doctor regarding , not just you physical health, but also your emotional well-being. More than a few patients with untreated depression over eat to "treat' themselves. Hope this finds you well.

While not for weight loss, liposuction will remove stubborn areas of fat. Personally, I use Vaser ultrasound (over Smart Lipo laser) liposuction as it allows for gentler liposuction with skin tightening. Multiple areas can be treated with proper patient selection.An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations. 

Thanks for your question and photos you provided! This is a common question we get in the office. I would go on consultations with board certified plastic surgeons so you can work together to formulate the best surgical plan for your body.Laser Lipo is best used for tightening skin, meanwhile Standard/power-assisted liposuction is the work horse that actually sucks the fat. Based on your photos, standard liposuction would allow for the most subcutaneous fat removal and optimal results! Good luck! 

You may not want to hear this, but I'm going to be very honest with you here: Liposuction won't give you a model's body if you're starting from 200 lbs.If you're willing to accept that, and you want improvement over perfection, then liposuction may work for you. I would recommend starting with 1-2 areas that bother you the most, doing the procedure under local anesthesia, and then committing to a lifestyle change following the procedure. If you still have areas of stubborn fat after about 6 months, then you can always treat those during a second procedure. This will hopefully make these changes more affordable, more likely to stick, and better overall (as large-scale rapid fat removal can result in loose skin).Doing the procedure under local anesthesia will offer you a few advantages:Quick, much easier recovery with less swelling and bruising since you will be making a lifestyle change after surgery, including being more active, the last thing you want is to be laid up in bed for a month or more following surgery, and gaining the weight backLess risks of the most serious complications during the procedureMore affordable pricing you may want to use some of the cost-savings to invest in a trainer to help you make that lifestyle change post-procedureI have had several patients do this successfully. You need to really commit that this surgery will be a catalyst for a life change in order to be successful, but it is do-able, you just need to make a plan prior to the procedure for how you're going to ensure it happens.Here are some questions to take with you on your consultations as you interview doctors:Have you treated patients my size before? Can you show me photos so that I can have a better idea of what results you think are reasonable for me?Can you show me in the mirror how much of my areas of concern are visceral fat (and untreatable by lipo) vs. subcutaneous fat (able to be removed with lipo)?Is my concern more of a skin issue, or a fat issue? Do you think lipo is the right choice for me?How much of a loose skin problem do you see me having after this procedure? Best of Luck!

Liposuction helps improve fatty areas that produce a contour issue. It’s success rate is higher for patients who are close to their recommended weight . However, it can be successful for overweight patients that have defined contour issues.  You should see your plastic surgeon and get more information. 

NO type of liposuction is a weight loss technique. You should lose at least 40-50 lbs before getting Smartlipo (or any type of liposuction). I would strongly recommend that you consider the ketone supplements (see my web site) with a ketone diet w intermittent fasting. It would be very helpful if you exercised 5-6 times per week for an hour too. You want to make serious life style changes and not just rely on technology.david berman md

Hi and welcome to our forum!
The type of liposuction is not as important as the skill of the surgeon who uses the type of instrument with which he / she feels comfortable. 
Find a reputable board certified plastic surgeon with considerable liposuction experience.
Best wishes...