Liposuction: The Good, The Bad and The Skinny
During consultations for body contouring, patients will often ask me about the newest techniques such as Smart Lipo. During all of my consultations I feel that it’s necessary to educate patients regarding the different methods of liposuction and their unique uses.
Standard or traditional liposuction involves infiltrating the fatty tissue with an epinephrine containing solution call tumescent. In most areas of the body there are two fatty layers separated by a thin layer of tissue.
After the tumescent has had time to work, the fat is removed mostly from the deeper layer with small 2.0-4.0mm cannulas. Removing the fat via different directions and keeping deep to the skin reduces the amount of contour irregularity that can occur after the procedure.
Recently we have seen the introduction of laser-assisted liposuction such as Smart Lipo, Cool Lipo and LipoLite. These systems use laser energy delivered through a 1.0-2.0mm cannula to heat the fat cells causing their rupture. The fat must then be removed via standard liposuction cannulas. The claim of companies that make these products is that the procedure can be done in the office under local anesthesia and there is skin tightening due to the interaction of the laser with the underside of the skin.
To date there are no published scientific studies that have demonstrated the effectiveness of these devices to both remove fat and tighten skin. I have seen patients in consultation that have undergone this procedure and are quite unhappy. Patients complain that there wasn’t any skin tightening and there is considerably more contour irregularity. This is likely because the fat is removed more from the superficial layer than the deeper layer.
In these tough economic times patients are looking to improve their appearance at the best cost/benefit ratio and with the least down time. Unfortunately, products that are marketed in response to this may not be the most appropriate in all situations. While I do think that these technologies will find a use, such as removal of small amounts of fat under the chin, I don’t think they are necessarily appropriate for larger areas.
It has always been my philosophy that it’s good for patients to see several surgeons and get different opinions before proceeding with any procedure. Ask lots of questions and be sure that the procedure you have decided on is right for you. I feel very strongly that new technologies are necessary to advance our medical field. However, only after thorough scientific evaluation can we determine the usefulness of each.