David B. Reath, MD
Knoxville, TN (865) 450-9253

Smart Lipo: not so smart, afterall.

smart lipoUnless you just woke up from a three or four year nap, you have probably heard about laser assisted liposuction (LAL), or what one laser company calls their machine, “Smart Lipo.” And there has been a ton of  hype about this technology.  The public has been bombarded with companies marketing this as the greatest thing since sliced-bread.  The real question we need to answer is: is this really better than what we have now?  Furthermore, is it as good, or as safe as what we are currently using?

Recently, I attended the annual meeting of the American Society of Aesthetic Plastic Surgeons, and there was a lot of talk about this technology, and how it stacks up to other forms of liposuction.  The best discussion was in a point/counterpoint session.  And the key question that everyone is trying to answer is:does LAL cause skin contraction? The physician who was promoting LAL and was saying that there was skin contraction was really trying to prove his point from a scientific standpoint.  And, perhaps there is a little bit of skin contraction that can be measured scientifically.  However, from the results shown, this didn’t appear to amount to much, and wasn’t clinically significant.  That is to say, if you have loose skin, can you really tighten it with LAL?  No.  Not in my mind, and not in the minds of the surgeons listening to this presentation.  (There was a straw poll of about 200 surgeons, and only 2 thought LAL made a difference.)

What was kind of interesting  was that the surgeon who presented his view that LAL wasn’t any better than what we already have, really wanted LAL to work. We would all like to have a way to tighten skin without removing it and creating scars.  But, as of yet, we don’t have it. And if you are seeking out someone to do LAL on you because you have loose skin, you will be very disappointed.

But there were some other things I learned about this.  First, the cases being done with this are very  low volume liposuctions.  They were removing about half or less of the volume of fat I usually remove in a liposuction operation.  Also, this is a difficult technology to use.  It takes a lot of experience, even for a plastic surgeon who is very adept at liposuction, to get a good and smooth result.  Further, there is a risk of burns to the skin due to the heat generated from the laser.

Now, I’m not planning on getting this machine on the basis of what we currently know about it.  But who will?  Well, this –as of yet — unproven technology is being heavily marketed to the public and physicians alike. And many of the people buying this are non-plastic surgeons, or even non-surgeons, with little experience with liposuction.  And they will then heavily market LAL to the public as the greatest and sexiest form of liposuction ever. After all, it is a laser.

So, people with little or no experience with liposuction will buy a technology — Smart Lipo — which is difficult to learn and difficult to get a good result with.  How smart is that?

What will they think of next — freezing fat?

Stay tuned.

David B.

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