Can you do fat grafting with smartlipo?

Question

I read in an article from a few years back that smartlipo was not a good option for fat harvesting. It said the the laser part of smart lipo destroyed the fat cells so the fat being harvested with smartlipo was not good at all compared to fat harvested with Vaser lipo. Recently, most surgeons seem to be recommending smartlipo for fat grafting so I am confused. Have things changed in the past few years and now you can graft good fat with smart lipo to transfer somewhere else?

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Smartlipo is a two-stage procedure: the first stage is usually the passing of a the laser fiber through the fat near the surface of the skin to promote skin tightening. Fat the has been burned by the laser is dead and can't be injected anywhere. Anyone who tells you otherwise is not being truthful. The second part is standard liposuction without a laser in the deeper fat. This fat is not burned so it is not dead and it will be fine to inject anywhere. If the fat deposit is thin, the fat is removed with standard liposuction first and the laser is used afterwards.

Ryan Rebowe, MD · Answer

In general, traditional liposuction (performed without ultrasound, laser, or other assistance) provides the largest percentage of non-traumatized fat cells in the lipoaspirate. This fact is why the majority of surgeons feel as if it is the best method of fat harvest for grafting. Other surgeons feel as if they can harvest more fat utilizing ultrasound assisted or laser assisted liposuction, so that even though a lower percentage of the fat cells are viable, there are more total fat cells to graft because they have harvested more. It is important that your surgeon is board certified in plastic surgery and regularly utilizes the method that they choose to perform your procedure. This will ensure the best chance at an excellent result.

Leonard Grossman, MD · Answer

Your first statement is absolutely correct. The laser energy is so high that it will destroy any and all of the fat cells it comes in contact with, melting them into pure oil and non-viable for transfer material. Laser liposuction should not be used for fat harvesting. I hope the selves and good luck from New York City Plastic Surgery

Darryl J. Blinski, MD · Answer

It is strange both Smart lipo and Vaser/ Ultrasonic lipo when first introduced to the surgery markets stated the fat was either “melted” or destroyed. NOW, because of the fat transfer interests the technologies are acceptable for viable fats. THIS NOT TRUE ! For any energy based liposuction. Best fat fir transfer is mechanically retrieved fats. 
My opinion as doing all types of lipo since 1983

Mats Hagstrom, MD (license on probation) · Answer

If you focus on the names of the equipment you’ll probably miss the boat. 
The name of the equipment or whether a laser or ultrasound probe is used is unimportant.
If a laser is used it’s always done as a second procedure either right before or right after the liposuction. If the fattest being harvested for fat transfer then the surgeon would do the laser treatment after the fat has been removed.
Lasers do not add any advantage to Liposuction other than as a sales tool to gullible people.
There are only two variables that determine liposuction results and this is also true for fat transfer. It’s the scale of the surgeon compared with the candidacy of the patient.
You may or may not be a good candidate for a Liposuction or fat transfer but there isn’t all that much you can do about it other than potentially lose some weight if that was to make you a better candidate.
What are you do I have control over is who does the procedure.
When great doctors get great results it is not because they use some specific brand name device.
It is because they have experience and skill.
Liposuction especially but fat grafting injustice much has an enormous variety of outcomes based purely on different skill sets of providers performing these procedures.
Finding the right surgeon based on skill an experience is the only variable you should be concerned with and the only one that really matters. in the end all forms of liposuction use the same tiny little stainless steel tube connected to a vacuum source sucking out the fat just like it has for the last 50 years.
The difference between quality outcomes is candidacy and skill.
I’m not sure what areas you’re interested in getting treated but the following is a pre-written response with recommendations for someone interested in a BBL regarding provider selection and things to look out for.
Delivering consistent high-quality liposuction and fat transfer results is more difficult than most people believe in this is true for both patients and plastic surgeons. Most plastic surgeons think they are better at liposuction than they actually are. Liposuction and fat transfer has more variance or difference in outcome purely based on who does the procedure than any other surgical procedure I’ve ever seen. Being board-certified in plastic surgery with an overall good reputation is not sufficient to guarantee that somebody has mastered body contouring with liposuction and fat transfer. Personally I view the torso as a single anatomic unit and either treated the entire torso or don’t do Liposuction. There are of course exceptions but for the most part I believe in treating the entire torso. A full torso includes upper abdomen, lower abdomen, love handles all the way down to the hip dips, waist, the entire back and under arm area all the way to the side of the breast. this leaves people with a natural thin fat distribution without transition zones between treated and entrteded areas. I’ve viewed the BBL as an enhancement to body contouring creating an ideal feminine S-curve that goes from the armpit to the knee. I did not emphasize a large buttocks with liposuction of the outer thigh creating a big round butt on the small leg which I sometimes called the “lollipop look”. Instead I emphasize long smooth harmonious curves creating a slightly hyper feminized balanced figure. To find the most talented and experienced provider in your community I suggest having multiple in person consultations. I do not recommend patients travel for elective surgical procedures and I recommend patients whenever possible avoid virtual consultations. During in person consultations ask each provider to show their entire collection of before and after pictures of BBL results. Always confirm that after pictures were taken at least three months from the time of surgery. anybody who shows early postoperative pictures such as pictures with patients still showing surgical drawings on them, being in the operating room or any evidence of recently having had surgery should be immediately discounted as showing “.fake news”. Early fat transfer results can look very impressive but do not at all represent final results. Ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. Specifically ask each provider to show as many pictures as possible‘s of patients who have similar body characteristics to your own. An experienced provider should have no difficulty showing you a minimum of 50+ sets of before and after pictures. Simply seeing a handful of pre-selected sample pictures which in reality most likely represent the best results of that providers career is insufficient to get a clear understanding of what average results look like for that provider. Highly experienced providers will have hundreds or even thousands of before and after pictures and should be willing to give you access during the consultation to see as many pictures as possible. If somebody claims to of done a lot of surgery but doesn’t have a lot of before and after pictures then you should ask yourself why? Do not commit to surgery or pay a down payment during the time of consultation until you’ve finished all your consultations and have given yourself plenty of time to think about your decision. The results from these procedures are permanent and irreversible. When in doubt slow down and schedule more consultations. Finally I recommend patients read all reviews on all various physician review websites avoiding providers for any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling and having an abundance of positive reviews. Plastic surgeons with the biggest social media profiles are not necessarily any more talented than those who have no websites at all. Famous or likable does not equal talented. Find the right plastic surgeon and everything falls into place. 
Good luck, 
Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
While low power Vaser liposuction can be combined with fat grafting, SMART liposuction destroys the cells and cannot be used for fat transfer. Both procedures fall into the category of augmented liposuction. Vaser utilizes ultrasound energy while SMART lipo utilizes a laser.
Best wishes...

David E. Berman, MD (retired) · Answer

smartlipo is a great way to both kill and remove fat cells and get some skin tightening. you can return to work the very next day. Most patients have only mild discomfort after smartlipo since there is some residual numbness that will last several days after Smartlipo. Because the fat cells are killed by the laser, they cannot be transferred to other areas.

david berman md, frcsc

david berman md, frcsc

Can you do fat grafting with smartlipo?

Answers (7)

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