Smart Lipo Vs Liposuction for Knees and Thighs?

I am about to have Liposuction on my knees and thighs. Although I have lost weight and toned up my legs they are still considerably 'flabby' and this is a problem I have always had. However, I would prefer the 'Smart Lipo' (due to the advantages I have read about) BUT I was wondering if they can take out as much fat and achieve the same results as traditional Lipo? If I am going to have this proceedure I would rather go with the option that will give me the best results regardless of the pain involved.

Doctor Answers 5

Liposuction Techniques: SAL vs. PAL vs. Vaser vs. SmartLipo

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There are several different techniques for liposuction. The traditional method is called suction assisted lipectomy (SAL). Adding an ultrasound device allows sound waves to break apart the fat and is called ultrasound assisted lipectomy (UAL). Both VASER and VASER Hi-Def are variants of UAL. When you have a motor or other device that oscillates the liposuction cannula back and forth automatically, it is called power assisted lipectomy (PAL). Finally the addition of a Laser device to break down the fat cells in conjunction with liposuction is known as laser assisted lipectomy (LAL), of which SmartLipo, CoolLipo, and ProLipo are the best known products.

No major study has shown superiority of one technique over another with regards to cosmetic results. The benefit of one technique over another may be seen in time/effort to remove fat, bruising, pain, or bleeding. These issues are more critical in larger volume liposuction. Given the small area to be treated, any technique used will be successful as long as it is performed by someone who is experienced in lower extremity liposuction.

Paramus Plastic Surgeon

Smart Lipo and Slim Lipo for knees and thighs vs Liposuction

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Traditional liposuction is a great way to reduce volume in areas where you have good skin tone.  If you have moderate to severe skin laxity, then liposuction alone many not get you the desired skin tone that you want.  Consider these four scenarios:

1)  Excess volume - great skin tone:  Traditional liposuction is a great option

2)  Excess volume - mild laxity in skin tone:  Traditional liposuction is a great option, but you can enhance the results with the skin tightening effects of Slim Lipo and Smart Lipo.  The volume you remove can be the same whether you use traditional liposuction or not.  However, because the lasers also melt the fat, the cells that have been destroyed and not suctioned out will also be removed from the system.

3)  Excess volume - moderate skin laxity but don't like the idea of larger incisions:  Slim Lipo or Smart Lipo may help you reduce some of the laxity, but they may not give you as strong a result as a formal thigh lift procedure

4) Excess volume -  moderate to severe laxity - what is the best option?:  A formal lift with the possible addition of liposuction or laser liposuction would give you best result but also comes with the most downtime.  It allows for surgical excision of the loose skin and fat and you can fine tune the shape with your liposuction options.

For best results:  Remember the greatest predictor for your surgical options is the credentials and experience of your surgeon.

Liposuction Candidate?

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Thank you for the question.

Most well trained experienced board-certified plastic surgeons will agree that it is not the tool that makes a difference but the “fool behind the tool”. On the other hand, surgeons looking for a “gimmick” will make claims that there “miracle technology” has better success rates.

Choose your surgeon, not a specific technology, carefully.

Best wishes.

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DumbLipo, Not SmartLipo, is Still the Gold Standard

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Thank you for your question. I appreciate your approach to learning from a variety of sources to inform your decision to undergo body contouring surgery. is a great website precisely because it brings together specialists from different backgrounds and of differing opinions and viewpoints. You mentioned that you wanted SmartLipo "due to the advantages I have heard about." Well, certainly we are all looking to see what those advantages are, but things are never as simple as the marketing pitch may make them sound.

My view is that plain-old DumbLipo is likely what I'd use to treat these areas, even if I were given a SmartLipo machine for free and I was treating my own family members.

I am following the SmartLipo craze with interest, particularly having had three of my colleagues tell me the same thing, that "Well it may be slow and I have seen burns, but boy does it make the phone ring." These surgeons went on to say that often they will only perform part of the surgery with SmartLipo and that many times they will actually perform the bulk of the surgery with a traditional device.

Hope this helps,

Nick Slenkovich MD, FACS

VASER vs smartlipo vs slimlipo vs lipo - what is the difference?

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I have spent a lot of time trying out lipo, VASER, Smartlipo, and Slimlipo. My experience has been that liposuction will absolutely let the skin hang a bit more. If the surgeon uses small cannulae and multiple entry sites, that is better, but it is still a major risk for exces skin areas. The VASER, which uses ultrasound, doesn't seem to tighten skin that much, but it will not let the skin hang. Basically, the skin will look the same before as after the procedure. Hi-def VASER, which uses lower energies and longer treatments, seems to be better at skin tightening and superficial fat, but mostly because the plastic surgeon is treating more superficially with Hi-Def. I tried Smartlipo and thought it was inferior to the VASER. The laser wavelength is not specific for fat and most surgeons just slimlipo for a few minutes and end up just doing regualr lipo after. It's heavily marketed and performed by dermatologists, too, which is suspicious for the gimmick angle and plastic surgeons don't like! I just got the Slimlipo, which is really producing some skin tightening - i did a flabby neck, hanging arms, a big back wrinkle, and a hanging tummy - and all of them improved dramatically. So I bought the machine, I was so impressed. It's basically replacing the VASER, and I consider the smartlipo to be a gimmick. Remember, small cannulae, multiple access incisions around the knee, and wearing your compression garments are key to a good result.

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 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.