Why is there a drastic change in some people with smart lipo but not others?

Radical changes in appearance are usually achieved when there is a large amount of fat sitting on relatively normal frame and the fat is removed artfully. Sometimes the effect is magnified by using using liposculpture techniques to enhance muscle definition and by injecting the extracted fat into the buttocks and hips. Of course all of this takes skill, experience and talent. It doesn't happen by accident.

Body contouring/liposuction has evolved over the past years and is not just about fat reduction but more so about sculpting and defining. In patients who have smaller problem areas, you want an energy based device to help melt fat and tighten skin. as well, it helps to define and shape the musculature. I have found much better improvement with ultrasound, to be able to get more sculpting and etching like effects if i want them.  This type of liposuction requires a specialized body contouring specialist who is trained in 4D hi definition procedures and can do fat removal with both deep and superficial liposculpture.  Most doctors do just "fat reduction" and improve the area but do not shape it.  The results are depedent on who is doing the procedure.  Please see an expert for sculpting and defining procedures, whos practice is dedicated to these types of surgeries. Best, Dr. Emer.

This is a common question.  I always say that it is not the machine but the hands using it.  You can see a wide spectrum of results from amazing to disappointing based upon the doctor's experience, skill and goals.  Some doctors unfortunately do not care about getting significant results.  Others do not spend enough time removing the fat.  Others just do not have the experience with the machine.  This situation applies across all fields of medicine, not just lipo surgery.  And of course, every patient is different in terms of amount of body fat, genetics and healing abilities.  Hope this helps and good luck!Dr Chang