SmartLipo vs traditional lipo for stubborn back and abdominal fat?

Question

From researching here and the rest of the internet, i thoughts I had learned that smartlipo was the better option for me to get rid of some stubborn back and abdominal fat. I thought I understood that it's less intense and the recovery is much easier. I had a consult however with a PS that does both, and she told me the opposite- that smart lipo is actually more intense and would be "way overkill" for what I am wanting to correct and instead suggested regular traditional lipo. Which is true??

Ryan Rebowe, MD · Answer

In terms of pain and downtime, my experience that SMARTLipo do not have extended recovery periods from the procedure compared to the traditional liposuction procedures. However, it does increase the cost and time under anesthesia, and therefore if it is not absolutely necessary it is usually recommended to perform a more traditional, or non-energy assisted procedure. The extra laser and energy it utilized to tighten the skin more than traditional liposuction, so if this is not an issue then I would not recommend pursuing SMARTLipo in lieu of traditional liposuction.

Daniel Barrett, MD · Answer

Dear kcarpenter83,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gregory Chambon, MD · Answer

Smart Lipo has the advantage of not requiring general anesthesia, less trauma on the body if adequate lasering is done, and quicker recovery (most are back to work in 2-3 days). I would see another provider for a second opinion.

Louis D. Cole, MD · Answer

Thank you for your question. Smart Lipo can be helpful in the removal of stubborn back fat and abdominal fat. It can be used to break up some of the fibrous tissue in the fat and then micro cannular liposuction can be done after that more easily. Upper back fat is a difficult area and requires experienced physicians to get good results. The same goes for stubborn abdominal fat that is fibrous. There isn’t one approach that’s better than the all others, but just pick an experience surgeon and you should do fine.

Darryl J. Blinski, MD · Answer

Any type of lipo should help but is it worth using the Smart Lipo over superficial lipo sculpture? For me, a past Smart Lipo trainer, I recommend only traditional option. It is the artistic expertise of the surgeon more than special technologies.

Mats Hagstrom, MD (license on probation) · Answer

In reality there is no source for neutral information regarding cosmetic surgical procedures available for the general public.
All information available to you is biased.
Not only is the information biased but it is made biased on purpose to promote commerce in one way or another. This makes it extremely confusing to people trying to learn about procedures.
The degree to which procedures and equipment is the started in the name of marketing is more far reaching than you could probably imagine.
Don’t let the fact that this comes under the umbrella of medical care for you into believing that people have your best interest at hand when they’re telling you what’s good and what works.
To put things in perspective I will briefly introduce you to my background. I’ve been a board-certified plastic surgeon for close to 25 years. For the first 15 years of practice I did general plastic surgery including Liposuction, fat transfer, reconstructive and cosmetic surgery. 10 years ago I began focusing my career exclusively on liposuction and fat transfer procedures only.
I currently only perform liposuction and fat transfer and have done over 8000 liposuction procedures to date.
The following are the most important pieces of information patients need to know about this procedure.
Equipment makes no difference when it comes to Liposuction results. All Liposuction equipment are based on a small stainless steel tube connected to a vacuum source and this is not changed for 40 years.
There’s been numerous attempts for individuals and people making equipment to try to differentiate themselves to put them at the top of the curve for patients looking for technically advanced equipment.
All of the various forms of technologically advanced Liposuction still rely on traditional liposuction but simply add a secondary pre-treatment and then spin this is some thing revolutionary or remarkable or being completely different than what it really is.
Let’s take smart Liposuction since that’s what you are inquiring about.
The term is trademarked and owned by the cynosure laser company.
Many years ago they developed lasers to be used in conjunction with Liposuction with a great marketing program claiming all kinds of advantages like skin tightening, lower blood loss, less bruising, faster recovery, increased safety etc. etc.
Theoretically those are not untrue but in reality the actual impact is so small that it’s not noticeable. The fact that something works theoretically doesn’t mean it actually has any specific purpose or advantage.
For example the idea that adding a laser treatment reduces bleeding is based on the idea that if the laser fiber randomly happens to touch a small blood vessel that’s bleeding it could cauterize it as it goes through.
It is true that laser energy can cauterize a small bleeding vessel.
The chance of that actually happening is extremely remote and so in reality there is no advantage.
It turns out that the same is true for every single one of the justifications for using this equipment.
The provider who claimed that smart Lipo was overly aggressive probably doesn’t have first-hand experience using it because the equipment really doesn’t do much.
I’ve done literally thousands of laser assisted Liposuction cases and from first-hand experience can tell you that the laser has no impact on the outcome of the procedure.
It’s not more aggressive or less aggressive it simply doesn’t add anything to the procedure.
The fat during treatment is soaking wet with numbing solution and this causes the laser fiber to be completely ineffective as it’s passed through the tissues.
I could go on and on about technical aspect but another way to demonstrate the loss of interest in smart Liposuction is to look at the price of the equipment on the secondhand market.
Most of these devices new cost around $100,000. that’s pretty accurate for all of the various Liposuction technology devices that use some form of energy. This includes VASER, JPlasma(A.k.a. Renuvion), bodytite, Smart Lipo etc. etc.
You can currently buy the latest model of smart Lipo laser equipment on eBay for around $3000 and I’ve seen them sell for much less than that.
If you compare that to the second hand cost of VAS ER which is another form of energy-based Liposuction those devices typically hold their value much better and typically sell for around $30,000.
There’s no interest in smart Lipo equipment because surgeons know they don’t deliver anything.
The devices have literally lost 97% of their value.
Now for the important stuff
Equipment is not relevant to results when it comes to Liposuction.
Who does your procedure is the only variable that matters and is the only variable you should be concerned with.
Delivering consistent quality liposuction results is much more difficult than most people including plastic surgeons believe.
The number of providers who can truly deliver consistent quality results is relatively few in each community.
Simply being a board-certified plastic surgeon with a good reputation with years of experience is completely insufficient to confirm or know that they’ve mastered Liposuction to an acceptable standard.
Mastering this procedure is far more difficult than people believe.
Liposuction results are permanent and irreversible.
If done poorly people are left disfigured and this cannot be corrected.
Anybody interested in this procedure needs to do two things.
The first is to get an honest and accurate assessment in regards to their own candidacy. you need to understand if you’re a good candidate for the procedure in the first place. I typically consult with about 10 patients each day I work and out of those 10 patients typically three patients will be non-candidates, four patients will be average candidates and three patients will be good candidates.
One and 20 consultations has what I would call an excellent candidate.
I sometimes describe perfect candidacy for Liposuction as a patient who is young, tight and pudgy.
Loose skin is the enemy of Liposuction and patients who have skin laxity or are older should lower their expectations significantly or consider a different procedure.
Understanding if you have the potential to get good results or not is extremely important because it should influence your decision of having the procedure or not.
Since different doctors very greatly in their skill, experience, approach an ethical standards you’ll get very different responses by different providers since there are so many variables.
The second important task is to find the most talented and experience provider in your community.
Tempting as it may seem the Internet is not the way to do that.
Everybody uses their computer and tries to maximize quality information but like I told you earlier there is no unbiased information available to the consumer using the Internet.
Wikipedia it’s probably your best source of neutral information and it does actually have a pretty good explanation of Liposuction.
To find the best provider patients need to schedule lots of in person consultations.
Virtual consultations may seem appealing and be encouraged by providers but he will not be able to properly vet the provider nor will the provider be able to give you a proper assessment without meeting in person.
For that reason I recommend exclusively having in person consultations.
During each consultation ask each provider to show you their entire collection of before and after pictures of Liposuction results of the area you’re looking to treat.
Personally I treat the torso as a single anatomic unit in order to leave people with a natural even thin fat distribution without unnatural transition zones from treated to and treated areas. I do not spot treat the torso or treat certain areas only.
A full torso includes upper abdomen, lower abdomen, love handles, waist, full back and under arm area.
On a man it would also include the chest.
Being shown a certain number of preselected sample images which most likely represent the best results of the providers career is completely insufficient to get a clear understanding of what average results look like in the hands of each provider.
This is why patients need to be advocates for themselves and properly vetted the provider by asking them to open up their portfolio and show as many before and after pictures as possible.
It’s fair game to ask a provider how many of these procedures they’ve performed and based on that number there should be some fraction of before and after pictures available. for example, I told you I’ve done over 8000 liposuction procedures. some of those were done at clinics where I was employed somewhere done in my private practice and other institutions. on my phone the folder labeled abdomens under Liposuction before and after pictures has 1405 pictures
An experience surgeon should be able to show you a minimum of 50 sets a before and after pictures of a commonly performed procedure like abdominal liposuction.
Ask the provider to show you as many pictures as possible of patients who have similar body characteristics to your own.
Look carefully and take your time on reviewing their pictures. On the after pictures when you’re looking at results look carefully for any evidence of contour regularities of the skin on any treated area.
There should be none!
Ask the provider to explain on each picture what areas were treated and what areas were not treated. Look carefully at the transition zone between treated and entry to areas.
There should be a very clear understanding with good explanation of exactly what areas will be included with the treatment and exactly where the treatment will stop and where you expect to see results.
Make sure you see results from all angles and make sure that the body position is identical in the before and after pictures. this means the arms should be in the exact same position in the before and after pictures.
If the arms are cropped in the picture it may be because the patient is lifting their arms straight over their head in the after pictures which by itself can give enough improvement to look like a quality liposuction results. before and after pictures should be highly consistent and show the entire torso and preferably most of the lower extremities from the neck to the knees.
Try to make a point system for each provider writing down what you liked and what you didn’t like and this is especially true in regards to reviewing before and after pictures.
I suggest patients read all reviews on 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 than having an abundance of positive reviews.
Do not make a deposit or commit to having surgery on the day of the consultation.
Always give yourself time to think about your decision and always make sure that you finished all schedule consultations before committing to having surgery.
People sometimes have a tendency of thinking of this as a simplistic procedure and it’s “just getting a little liposuction”. The truth is the reality of the procedure is completely opposite. it’s a permanent procedure they can leave patients with striking body transformations in par with some of the best procedures ever performed and can also leave people disfigured for life.
I mentioned this earlier and I will mention it again. The number of providers of mastered liposuction and deliver consistent quality results is relatively small.
Every one of them will tell you that they’re good at it and that they have lots of experience.
That may be true in their view but the results speak otherwise.
You don’t have to spend much time on real self to recognize the discrepancy and outcomes nor the number of people who did not go through a proper vetting process and choosing their provider.
Patients post on the website daily asking how bad outcomes can be corrected and unfortunately dancer for almost all of them is that it can’t.
Continue having consultations until you feel quite certain you have the right provider.
All plastic surgeons have the equipment they need to do their job.
The question is not the equipment but rather who is doing the work.
Find the right plastic surgeon and everything falls into place.
Best,
Mats Hagstrom MD

David E. Berman, MD (retired) · Answer

Smartlipo is done under local in the office with oral sedation. you can return to work the next day and full exercising in just 5 days,. you will continue to improve for 6 months after the procedure (so you need to be patient). It is less painful than regular liposuction because the areas that are treated with smartlipo will be somewhat numb for several days. 
most people having traditional liposuction, need 3-5 days before they return to work. it is usually done in the operating room under general anesthesia.

for both procedures you want your bmi to be 30 or under. No type of liposuction is a weight loss technique.

i have done over 1,400 smartlipo cases in my office and it is my always go to procedure for someone wanting or needing just liposuction (no skin resection as with a tummy tuck)

david berman md, frcsc.

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
Liposuction involves removal of fat through small pipes (cannulas) placed under the skin under extreme vacuum after pretreatment with an infusion of solution containing a blood vessel constrictor (to prevent bleeding) and an anesthetic (if performed awake). Augmented liposuction utilizes laser energy or ultrasonic energy to semiliquify the fat, making it easier to remove and adds a subtle skin tightening effect.
Liposuction is a safe procedure. It is a reshaping procedure and not a weight loss procedure. 
In general, the experience of the surgeon is more important than the type of instrument utilized.
I recommend you visit a plastic surgeon with considerable liposuction experience and allow him / her to use the instrument with which he / she feels most comfortable.
Best wishes...

SmartLipo vs traditional lipo for stubborn back and abdominal fat?

Answers (8)

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