Why Are Many Plastic Surgeons Against Smart Lipo?

I have been calling a few board certified plastic surgeons to enquire about laser lipo (smart lipo) here in South Africa and to my surprise, a few replied saying that they do not perform or recommend it. They prefer classic lipo. I'm stunned! Why is that?

Doctor Answers 5

Smart Lipo Expensive

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Smart Lipo uses a laser to melt fat so that the surgeon can just vacuum away the melted fat which is less traumatic to the underlying skin. The machine is expensive ( >$ 80,000 initial investment0 and .> $8000 per year to maintain it). These costs are added to the normal Liposuction and can add up to $2000 to the cost of the surgery. I have  used the Vaser ultrasonic machine to melt fat for > 5years. The added cost for my patients is $200. I used smart Lipo on 6 patients and did not feel it worked as well as the Vaser. The Vaser cannot burn through the skin or abdominal muscle wall because it uses lower energy. There are many documented cases where lasers have done this.

San Ramon Dermatologist
4.2 out of 5 stars 5 reviews

Smart Lipo- Smart marketing

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I perform both Smart Lipo and traditional liposuction and can address the current issues with laser assisted liposuction. Smart Lipo has been a marketing success for Cynosure, the manufacturer of the machine, as the Smart Lipo platform is the most expensive available and therefore it costs the most in overhead for the surgeon. There is no data suggesting that  Smart Lipo is better than any of the other laser assisted lipo platforms. Many Plastic Surgeons are against Smart Lipo because this machine has been aggressively sold to non-Plastic surgeons without providing adequate training. Make no mistake, Smart Lipo is technically more difficult to perform especially in the hands of inexperienced operators causing a wide variety of problems that Plastic Surgeons are asked to reconstruct.  There are few if any reasons to perform Smart Lipo rather than traditional lipo. Besides cost, one cannot harvest fat for fat grafting as the laser "melts" the fat before suctioning and the manufacturer has oversold the skin tightening obtained with the laser and it is not recommended  as an answer to skin laxity.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon

Why are many surgeons against Smart Lipo?

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The main reason that some surgeons are against Smart Lipo is that the equipment is quite costly.  They may feel that they are perfectly happy with traditional liposuction and that there is no reason to change.

Many claims have been made about how easy and fast Smart Lipo is and those claims just aren't true.  It is a useful tool and it may help with skin tightening but it doesn't always.  It does make the procedure longer.  It doesn't make it any easier but it seems to decrease post op discomfort.

Smart Lipo is a powerful tool and needs to be performed with a great deal of caution.

Kenneth L. Stein, MD
Chicago Plastic Surgeon

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If a plastic surgeon doesn't recommend SmartLipo it is because they don't HAVE a SmartLipo.

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If a plastic surgeon doesn't recommend SmartLipo it is because they don't HAVE a SmartLipo.

Not everyone wants to invest that much money in technology, but for those of us that do a large amount of body shaping or high definition liposculpture the investment is well worth it.  Also that technology enables the surgeon to do great things, but it does not make a  bad liposuction surgeon into a great liposuction surgeon.

Many plastic surgeons also tend to denounce SmartLipo because it is also performed by Non-board certified plastic surgeons.  For example there are family practice doctors, and cardiologists (and others) that have purchased a laser and are now promoting themselves as body contouring surgeons.  They usually claim membership to the American Society of Cosmetic Surgeons (or something similar) which makes them sound legitimate, when in reality their training, and board certification, is in something completely different.

Buyer beware

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 299 reviews

Smart Lipo not recommended by some South African Plastic Surgeons??

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You would have to ask the individual surgeons why they would not recommend it.  It is an advance in technology and allows liposuction and improved results in many areas where standard liposuction doesn't work.  The laser is costly and requires some training to use.  Perhaps the surgeons that are advising against it do not want to invest the time and money in Smart Lipo yet do not want to lose patients to competitors that are offering it in area practices.

Christopher J. Schaffer, MD
Birmingham Plastic Surgeon

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.