Vaser vs Smart Lipo

Is the Vaser lipo better than the Smart lipo system?  Can someone tell me what's the difference and what type usually works best for getting rid of fat around the belly and chest?

Doctor Answers 34

Better is in the eye of the beholder

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I'm not sure if it is possible to say one technology is "better" than another. However, here are some useful points to consider (and bear in mind that I have tried them both in my practice):

The VASER uses ultrasound energy, which when properly applied to the tissues, is highly specific for fatty tissue emulsification. This means that nerves, blood vessels, and skin are at low risk of injury—a great benefit. The blood supply to the skin and other tissues is minimally disturbed—and this is evident in the material removed during the procedure; the amount of blood seen in a VASER case is remarkably less than in liposuction cases where other technologies are used. VASER probes are blunt and at least 2.9mm in diameter, so the risk of penetration of the abdominal wall is quite low in the hands of a well-trained and experienced plastic surgeon.

The laser-assisted technologies uses laser frequencies that are not as specific for fat as the ultrasound energy of the VASER is, meaning that the energy emitted from the device can be nearly equally damaging to fat, nerves, blood vessels, and skin. The company says this is a benefit, as the device will coagulate blood vessels so there is less bruising; but as a plastic surgeon, I think that preservation of the nerves and blood vessels is in my patient's long term best interests considering that there is very little bruising with the VASER in any case. Finally, the laser filaments are narrow, pointy, and the tip gets quite hot—I am concerned that this creates a significant risk of penetration of the abdominal wall, leading to bowel injury upon skin penetration.

The final remaining point to make is that the companies that produce laser assisted liposuction devices claim that these devices are a patient's best option because of the promise of "skin tightening." This improved skin tightening over other techniques (including the VASER) has simply not been seen by any responsible and unbiased practitioner or in any well done and honest study.

So, in my opinion, the laser assisted devices offer no advantage over the VASER, and expose the patient to significant added risk. That's why I now have only a VASER and have gotten rid of my laser assisted device.

I hope that helps.


Vaser Lipo, otherwise known as Liposelection, uses low...

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Vaser Lipo, otherwise known as Liposelection, uses low frequency ultrasound waves to emulsify fat and tighten skin. The procedure may be performed in the office under a local anesthetic and involves three steps:

Tumescent anesthesia is applied witth a gentle pump that slowly infiltrates Lidocaine with Epinephrine and saline to freeze the area involved.
A small ultrasound probe is then inserted into the area to emulsify the fat.
All of the fat is aspirated and permanently removed from the body.
Smart Lipo is a laser system that uses a needle the size of an IV. catheter with a fiberoptic wire that transmits a 1064 wavelength ND-Yag signal to melt fat and tighten skin. In some regions, such as Europe, the fat is not even removed from the body. This system alone can not remove the fat, therefore it must be combined with some sort of liposuction system.

The best combination is to perform vaser lipo and smart lipo together. The two systems are complementary together, providing even more fat melting and exceptional skin tightening.

One system is not better than the other but the two partnered together offer amazing results. When searching for the best liposuction results find a board certified plastic surgeon who performs both smart lipo and liposelection by vaser.

One liposuction device does not always fit all

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Vaser is a type of ultrasound assisted liposuction while Smartlipo is laser assisted liposuction. Both systems are ways of getting rid of unwanted fat deposits. They work very differently.

With Vaser, soundwaves are used to break up fat. With Smartlipo, laser light is used to destroy the fat. Just like both a helicopter or a plane can be used to travel to different places, either of these technologies can get you to the same endpoint.

Ultrasound is usually utilized for removal of larger areas while Smartlipo is typically utilized for smaller areas. Thus, I would not say that one of these technologies is "better" than the other as they are both used for body sculpting and each has advantages and disadvantages.

I would find a surgeon who offers both, as there are many plastic surgeons who will tell you that one is far superior to another just because it is all they offer. Most true plastic surgeons are going to understand the fundamentals of liposuction and be able to explain to patients which subtype of liposuction will work best for them.

These days there are so many non-core "cosmetic" surgeons offering Smartlipo or Vaser after literally taking weekend courses and buying a machine. The patient needs to be careful to find a physician who has performed thousands of procedures and can offer all types. I hope that this information helps.

Evan Sorokin, MD
Cherry Hill Plastic Surgeon
4.8 out of 5 stars 77 reviews

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VASER liposelection for most applications; Laser Lipo for necks, arms and small fat deposits

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Like traditional liposuction (SAL - suction assisted lipectomy), both procedures begin with placement of a TUMESCENT filling solution of Adrenaline and a local anesthetic (to reduce bleeding and pain) into the fat. The fat is then treated with either ultrasound waves (VASER) or Certain wavelengths of laser and then the treated areas are suction vacuumed, removing the loose fatty fluid.

VASER Liposuction / Liposelection (UAL) - high frequency sound waves shake and selectively break up the walls of fat cells but not of nerves or blood vessels.

Laser Liposuction (LAL) - various systems use different wavelengths (ProLipo (Sciton) and SmartLipo (Cynosure) - 1024/1320 nm and SlimLipo (Palomar) - 924/975 nm) to damage fat cells. There is an argument between the 1024/1320 users and the Palomar users which system is superior. There is scientific evidence that fat cells break up with much less heat with the 924/975 nm frequencies and as such the SlimLipo MAY be superior. The ProLipo and Smart Lipo counter that their 1024/1320 nm wavelengths are AS effective and their heat shrinks the overlying skin better. The jury is still out on these claims.

What is clear is that unlike VASER - LAL is too slow and inefficient for large area liposuction and is best used on 1-3 SMALL areas of fat deposits. It does seem to work great on fatty necks and arms.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Liposuction by any other name...

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Vaser lipo and Smartlipo are two different twists on traditional liposuction. Vaser uses ultrasound to emulsify fat, while Smartlipo uses a tiny laser cannula (hollow tube) to break up fat and (supposedly) tighten overlying skin. I am not aware of any study showing that either of these methods is MORE effective at fat reduction than traditional liposuction.

No form of liposuction does significant skin tightening, so if your problem is loose skin, liposuction in any form is probably not your best answer. Even the "laser lipo" hasn't been shown to tighten skin significantly in any study of which I'm aware (and I've looked).

Oh, if you have a large amount of fat to remove, you still have to do traditional liposuction to remove the fat that has been emulsified by Vaser or by laser.

There are a great number of marketing tactics out there--talk to your plastic surgeon about the ones you've read about or heard about; your surgeon should be willing to discuss different methods and explain why she uses the ones she does. She should be able to help you make an educated and informed decision about what will work best for you.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 46 reviews

VASER v. Smart Lipo

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VASER liposuction uses ultrasound to emulsify the fat. Smart Lipo uses a laser through a fiberoptic cable to melt the fat.

These are clearly very different technologies and therefore have very different uses.

I don't think the question is which technology is better, but rather which is better for you?

  • What areas would you like to treat?
  • How much volume would you like to have removed?
  • What kind of tissue do you have and how is the quality of the overlying skin?

These are the important questions that your plastic surgeon must go over with you so that the RIGHT procedure can be done to meet your needs.

Remember that there is no "best" technology - just the one that's best for you.

Dr Pazmino

Which is the better choice? Vaser vs. Smart-Lipo?

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There are a number of invasive and non-invasive techniques and techologies for treating unwanted fat.

It is initally important that the surgeon and the patient first agree on the aesthetic goal, and then discuss the benefits, realiastic outcomes, and complications of each technique. While some surgeons accomplish wonderful and consistent results with one technique, another surgeon may reach the same endpoint with a different approach.

It is in the patient's best interest to suggest, and not demand, a particular technique. It is important that your physician feel comfortable and confident in the technique used.

Specifically, the differences between the two techniques are as follows:

  • Smart-Lipo: Laser technology that utilizes a 1064 ndYag laser with associated laser fiber and cannula to emulsify (swell and cause bursting of) fat cells. The theoretical advantages of the FDA approved technology are reduced downtime, pain, its use under a local anesthetic (and not a general anesthetic), and is less traumatic to the patient's tissues. However, an evacuation system needs to be in place to allow removal of the emulsified fat. The downside is that it is a relatively new treatment option and the learning curve for "predicting" fat removal has yet to be determined by most surgeons. Others propose that such emulsification makes subseuquent traditional liposuction or VASER liposuction at the same setting an easier technique for fat aspiration.
  • Vaser Technique: Liposuction technique that uses ultrasound waves to emulsify the fat as well. It is associated with heating and thus can produce skin contraction and tightening. Its use is proceeded with a tumescent (local anesthetic) solution to the treated areas to reduce brusing, swelling, and discomfort. The fat is then subsequently aspirated out. It is very similar to the "true and tried" various forms of liposuction.

When consulting your physician consider the following points:

  • Which technique does your physician perform on a regular basis?
  • Can he demonstrate consistently good post-operative results with either techinque?
  • And importantly, what are qualifications of the surgeon, the facilities, and the anesthesiologist?

Jeffrey D. Hoefflin, MD
Los Angeles Plastic Surgeon

Smart lipo is smart as a marketing tool

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I have used both Smart Lipo and VASER. Both accomplish the same end i.e. emulsifying fat cells to make them easier to remove. I routinely use VASER because I've had good results with this process. Smart Lipo uses laser light which converts the heat to melt the fat and VASER uses ultrasonic sound waves which converts to heat to melt the fat. Both procedures are useful in areas where fat is more difficult to remove because it tends to be more fibrous. These include the back, and saddlebag area as well as the chest on men being treated for gynecomastia. They are also useful when performing large volume liposuction. Both theoretically reduce bleeding which means that there will be less bruising, swelling, and pain, and faster healing. I believe that the VASER causes less damage to the sensory nerves in the area being treated which is the main reason why I use it.

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 27 reviews

Vaser vs. Smart Lipo in Raleigh NC

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The explosion in medical aesthetic technology has resulted in a market that is literally flooded with new products, devices and procedures, like Smart Lipo, all claiming to be the ‘latest and greatest’ or the ‘next big thing’. A great deal of dedication (and caution!) is required to sort through all of the new (and often not-so-new) technology which is marketed simultaneously to aesthetic professionals and to the public.
I have not seen a single study that shows any advantage of Smart Lipo to traditional liposuction. But, there may be increased risk of complications, particularly since it seems this device is used by many physicians with absolutely no formal surgical training who and are just entering the world of aethetic medicine.
Vaser is an ultrasonic liposuction technology. Vaser is useful for treatment of areas that are densly fibrous such as the back and male breasts. For treatment of areas that have some asscociated skin laxity, Vaser can be helpful in providing skin retraction.
Liposuction is the most commonly performed surgical procedure each year in the United States. Surprisingly, the majority of physicians performing liposuction in the United States are not plastic surgeons; in fact, many do not have any formal surgical training whatsoever. It seems hard to believe, but many physicians performing liposuction or Smart Lipo have had no more training in liposuction than a 'weekend course'.
I fear that some practitioners, and now consumers view liposuction as a 'simple' surgery, since it does not involve making large incisions, and it requires little, if any, suturing. Nothing could be further from the truth. Liposuction, in my mind, is a very challenging operation that requires careful planning and preparation, and a great deal of care and finesse when it is actually performed. It requires a three-dimensional understanding of the layers of human anatomy, an understanding that is second nature to a surgeon alone. I think that it is often an inadequate understanding of anatomy (and, perhaps, of the body's response to surgery) which leads to the poor results in liposuction and body contouring that unfortunately are so often seen.
Although many aesthetic cosmetic surgery procedures are not performed in hospital operating rooms, the fact that a hospital has granted a surgeon privileges for a given procedure ensures that the surgeon has met an accepted standard of competence. It also means that your surgeon will be able to take care of you at a hospital should any complications from cosmetic surgery arise.
If you are planning to have any type of cosmetic surgery performed, you should do your due diligence to determine if your surgeon has the appropriate credentials and experience.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Smart Lipo not actually so smart!

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Smart Lipo is just a marketing term for laser assisted liposuction. I don't use Smart Lipo because there are no convincing studies that show its advantages. I think it has potential disadvantages because the laser introduces a new source of energy with a potential for complications.

Vaser Lipo is indeed one of the useful forms of liposuction which can be used. The important thing is to individualize and use the technique that will benefit the particular patient.

The other point to make is that how well the liposuction is done by the particular surgeon is much more important than which specific kind of liposuction is used.


George J. Beraka, MD (retired)
Manhattan 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.