Lipo Treatments: Which Treatment Yields the BEST Result (All Things Being Considered)?

Vaser Liposuction, Tumescent Liposuction, Smart Liposuction, or Traditional Liposuction and what are the differences between them? (or is there another fat removal tx that is better than the above?)

Doctor Answers 16

Best liposuction technique

Thank you for your question about the best liposuction technique.

  • Vaser uses ultrasound plus traditional liposuction + tumescent and costs more
  • Smart lipo uses laser plus traditional liposuction + tumescent and costs more
  • Tumescent or Superwet injection of fluid into the fat is used in all liposuction.
  • Traditional lipo uses a cannula (fat removal tube) powered by the surgeon only
  • PAL (pulsatile) uses a cannula that vibrates, requiring less surgeon energy.
  • The best for small liposuctions is traditional or PAL + tumesecent or superwet
  • The best for larger areas is PAL + tumescent or superwet
  • Smart lipo may help is a rare patient with very loose skin.
  • Hope this helps. Best wishes.

Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

The Best Liposuction Option

When you are considering liposuction, it is most important to go to a doctor with a lot of training and experience. There is little proof that any of the devices (laser etc) significantly improve the results over traditional tumescent liposuction. Also, with the laser devices, you will still need liposuction to achieve results. So be careful if someone is promising better results because they are using a laser. Look for a physician that has many years of experience, good before and after photos, patients that you can call, a good surgical team of nurses, an accredited surgery center, and a good name. Thats great that you have visited more than one surgeon. I always recommend that.

Jennifer Reichel, MD
Seattle Dermatologist
4.5 out of 5 stars 42 reviews

Traditional Liposuction give as good or better results that all the new modalities

While traditional liposuction has been modified over the years since its inception in the early 80's, It still gives as good or better results than all the new modalities. The canulas have been made smaller to prevent gouges, Super wet or tumescent techniques in which the tissue is expanded by ringers lactate with local anesthetic and epinephrine have made the removal of tissue safer, easier and with better control of the contours and much less blood loss. Micro air is a modification of the Traditional liposuction technique which makes it easier on the physician but does really add any benefits to the patient's results.

Ultrasonic (Vaser) melts the fat before the essentially Traditional liposuction is done. It costs more, requires larger incisions and increase the length of surgery and doesn't give any better results. When the same surgeon did traditional liposuction on one side and ultrasonic liposuction on the other, no difference in the results were noted. 

Laser liposuction is said to shrink the skin but a study out of University of Texas Southwestern could only document  a 3% tightening at the most. Many surgeons have tried this technique and abandoned it because of problems that it caused that the Traditional technique of Liposuction did not have. 


Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 reviews

Best results with liposuction

Which modality gives the best results with liposuction is a matter of opinion.  Obviously, if you ask ten plastic surgeon (as you are doing) you will get ten different answers based on their training and experience.  There is no right or wrong answer here.  With that in mind, I will instead give you a brief history of liposuction.  With traditional liposuction, we mark the area to be treated, infiltrate the tissues with local anesthesia (which numbs the tissue and helps shrink the blood vessels and decrease bleeding/bruising), and then use various sized "cannulas" (long thin metal tubes attached to the liposuction machine by tubing) to remove the fat.  I imagine that EVERYONE now uses tumescent solution for their local anesthesia.  This is simply a very dilute solution of local anesthetic.  Because it is diluted in saline, it can spread out more and we can use more of it.  With Vaser liposuction, we still mark the patient and infuse the tumescent solution but, before sucking out the fat, we treat the fat with ultrasound (the Vaser machine) which helps loosen the fat for removal.  The Vaser uses ultrasound directly on the fat.  There are ultrasound machines that supposedly work through the skin without removing fat but I am skeptical about these.  The next innovation was Smartlipo/Slimlipo.  Both are lasers - Smartlipo is a pulsed laser, Slimlipo is a continuous laser.  If that doesn't mean much to you, it doesn't mean much to me either.  Basically, the idea is that, like Vaser, it liquifies the fat, turns it into fat soup if you will, for easier removal.  The added benefit of the laser is that it heats up the undersurface of the skin and helps tighten the elastic fibers in the skin more than with traditional liposuction.  This is great if you have some looseness in your skin, but totally unnecessary if you have good elasticity in your skin to begin with.  There are various creams and other external devices developed over the years that have been designed to improve cellulite or smooth fatty bulges.  In my mind, if you don't remove the fat, you aren't accomplishing anything and the cellulite/bulges will return if you stop these treatments.  Just my opinion.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 24 reviews

Which type of liposuction.

Are there different types of liposuction?

I have been performing liposuction for 25 years. Over the years I have seen different types of liposuction come and go. The most widely used type used is the Tumescent method. The Tumescent method has also been around the longest. It is considered the 'Gold Standard' to which all other forms of liposuction are compared. None of the newer forms have proven as effective. Some of these so called new and improved forms of liposuction have even ended up being dangerous. They have lead to severe complications for the patients. I use the Tumescent procedure in my practice. I have found no form of liposuction that is superior.


Francis X. Fleming, MD
Kennewick Plastic Surgeon
4.5 out of 5 stars 17 reviews

Best liposuction

Traditional areas of liposuction like the anterior abdomen, hips and thighs can be treated with suction assisted liposuction effectively with minimal risk.  Energy-added systems like laser or ultrasound are useful in more fibrous areas like the upper and lower back, or chest in gynecomastia.  However these may pose risks in the thermal energy they create possibly resulting in burns or contour deformities if not used carefully.  Discuss all these modalities with your surgeon. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Liposuction Methods

All the methods you mentioned work well. The only area where laser liposuction is advantageous is on the back or where the surrounding tissues are very fibrous. The difference in outcome is in the surgeon who performs the procedure. Many people doing liposuction are not even surgeons and do not understand the physiologic changes that occur in your body following the procedure. This can be dangerous. They also have not had the experience to assure a true smooth cosmetic result. Make sure the surgeon you pick is a plastic surgeon and has many years of experience with liposuction and that the facility where the procedure is to be done is certified. Whatever method he/she uses will provide excellent, safe results. 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Lipo Treatments: Which Treatment Yields the BEST Result

All the techniques can give good results. Only the manufacturers of various devices make claims of better outcomes. There are no definitive studies demonstrating superiority of one technology over another. 

The surgeons experience and judgement are important. Not the instrument. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Liposuction and best results

There are many devices out there to perform liposuction. In general, I prefer the non-heat generating systems like traditional and power-assisted.  However, all can give good results. I always say it is not the wand but the magician that makes all the magic!

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Which #Lipo Treatments are the Best

There is no technology that is significantly superior to another, it is your choice of surgeon who is wielding that technology  Do your research and find a surgeon who is board certified in plastic surgery and has good liposuction results. Don't worry about the type of liposuction performed unless they are promising a different result because of the device!

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 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.