Almost every day we hear news about some new procedure or advance in plastic surgery.     Unfortunately, most of these claims are more hype than substance, and can often be more damaging then helpful.    As a plastic surgeon with a busy practice in Las Vegas and as director of the Las Vegas Institute of Plastic Surgery,   I make an effort to carefully evaluate the risks and benefits of every new claim or procedure made about cosmetic surgery prior to introducing it into my practice

 

Lately there has been a large amount of press about the benefits of laser liposuction.     The initial laser liposuction machines did not have a great deal to offer in terms of advantages over traditional liposuction.    In addition to this, there were increased risks to the patient including possible burns to the skin.    At that time, I personally chose not to offer laser liposuction.   However, in the past two years since the introduction of laser liposuction, there have been significant advances that now make laser liposuction a beneficial tool that we can safely add to the many procedures that we offer at the Institute of Plastic Surgery.  

 

Initially, the laser liposuction was a single laser that was not very powerful or specific for fat cells.  Most lasers still operate with only one laser, but the newest and most advanced form of laser liposuction, Smart  Lipo, now combines two lasers in one for better destruction of the fat cells.     Initially there was hope that the laser could heat the skin and thereby tighten the skin.   However, the early liposuction lasers had no real good way to heat the skin and even more concerning, no good way to measure how hot the skin became.   This meant that the skin could be heated to such a small amount it was useless, or heated so much that the skin could be burned. Most laser liposuction machines still cannot measure the heat of the skin.   Fortunately, the Smart lipo machine has a special hand piece that carefully measures the temperature of the heated skin.   I think this is a major advantage over other types of laser liposuction and increases the safety of laser liposuction greatly.  It allows surgeons to know exactly how hot the skin becomes so that we can heat the skin to get maximal effect without burning the skin.

 

The ability to safely heat the skin combined with the ability to destroy fat cells makes the laser a much more useful tool.    Laser liposuction cauterizes the vessels and decreases the swelling and bruising, making the recovery quicker and less painful.   A patient can typically return to work as quickly as 3 to 5 days without bruising when small areas, such as the inner thighs or submental (under the chin) area,    have been treated.

 

Another major of advantage of laser liposuction is the possible ability to tighten the skin.  While there is always a small amount of skin tightening with traditional liposuction, it is usually fairly minimal.   This has limited the effectiveness of liposuction in some areas or in some patients who have loose skin or poor skin elasticity due to aging, weight loss or pregnancy.     The Smart Lipo can safely heat the skin thereby contracting the collagen and elastin fibers present in the skin.     This leads to greater skin tightening which allows us to perform liposuction on areas where we previously could not.   The additional skin tightening helps us to get better results on every area we liposuction.

 

Finally laser liposuction may allow us to treat some cellulite.   Traditional liposuction has been ineffective in reducing cellulite.    Because Laser liposuction uses heat and very tiny fibers, it may help in the treatment of cellulite.   

 

Laser Liposuction is not a panacea for all things.   It still does not have the ability to tighten extremely loose skin, such as some women have after pregnancy or massive weight loss.   These patients will still need other procedures such as a tummy tuck (abdominoplasty,) or body lift etc.   Laser liposuction is not useful for large areas or when large amounts of fat need to be removed.    In these situations, laser liposuction must be combined with traditional liposuction to be maximally effective. Therefore it is important your surgeon be familiar with all types of liposuction.

 

Finally the biggest drawback to laser liposuction is due to the companies that make and market the machines.      Laser liposuction machines are very expensive, with many of the machines costing well over a $100,000.    In order to sell as many machines as possible, the companies have been marketing them to any physician they can.   This means they have been selling them to family practice physicians, obstetricians, internists and even dentists.   They give them weekend courses and marketing help, including before and after photographs, and tell them they can begin performing liposuction and make large amounts of money.    There are definite ethical questions regarding this practice that need to be addressed.   Patients are fooled into thinking the liposuction pictures they shown are those of the physician who is trying to sell them liposuction surgery.   While liposuction can be very safe when performed by an experienced well-trained surgeon, it can be extremely dangerous when performed by those that have not had adequate surgical background and training.    It is important for the potential consumer-patient to research his or her physician prior to undergoing liposuction.      Much more important than the type of liposuction being performed, laser or traditional liposuction, is the surgeon who performs it.   A well-skilled surgeon using traditional liposuction will have significantly better results more safely, than any laser liposuction performed by an average or poorly trained physician.    Prior to any type of liposuction, make sure your physician is a Board eligible, or Board certified by the American Board of Plastic Surgery or has trained in an accredited plastic surgery program in the United States.   Also be sure they have several years of experience with liposuction.    Ask them specifically if the before and after photos they are showing you are those of their own patients.   If a physician cannot meet these basic requirements, it is best the potential patient seek another surgeon. 

 

Like many things in plastic surgery, there is a great deal of hype currently surrounding laser liposuction.  It is important for the consumer to beware of false claims made regarding laser liposuction as well as any new or established cosmetic surgery procedure.     It is important for the patient to choose his or her surgeon wisely.    Laser liposuction can give wonderful results with quick recovery time when properly performed by a well-trained plastic surgeon.