Advancements in methods of fat removal by liposuction continue to change and be ‘improved’. One of the most noteworthy methods that is currently marketed and touted is laser liposuction, or more accurately, laser-assisted liposuction. As opposed to the traditional technique of cannula insertion, eating up the fat tissue, and then sucking it out, the mechanical beat-up is replaced by laser energy. A laser fiber is inside the liposuction cannula which delivers heat to the fat cells, thus breaking them down inito a more liquid state making it easier to be sucked up the cannula. In theory, the heat from the laser also causes the overlying skin to tighten.
As of this date, there are three such laser-assisted liposuction systems available in the U.S. They are under the marketed tradenames of SMARTLIPO (Cynosure), COOLIPO (CoolTouch), and PROLIPO (Sciton). All of them tout more effective fat removal, less bruising and swelling, a faster recovery, and skin tightening.
The real question is….are they really better than traditional liposuction…and are there increased costs over traditional liposuction worth it? (someone has to pay for the equipment purchase…and that is you the patient!) To date, they remain tremendously appealing, particularly to the general public. Historically, any treatment associated with the word, laser, always causes mass patient allure. No clinical trials have yet been reported, that I have seen, that have ever directly compared any laser-assisted vs traditional liposuction procedure. Nor has any large clinical trial been done that even compares two differently-treated patient groups, no matter how impossible it really is to ‘match’ patients from different groups.
Much like ultrasonic-assisted liposuction when it was introduced 10 years ago, laser-assisted liposuction may be a popular trend that, in the end, will fare no better. It will undoubtably have its place in liposuction options and armamentarium but I doubt if it is magic and offers a quantum leap in patient outcomes and recovery times. It may offer some improvement in fat removal efficiency, but it remains to be proven if overall better outcomes, a faster recovery, and significant skin tightening will occur.
I am all for any form of advancement in liposuction, which is a fairly traumatic procedure on the tissues. While effective, liposuction is still one of the most ‘brutal’ procedures that we as plastic surgeons do. Is laser-assisted liposuction, such as Smartlipo, a real improvement? It sounds very promising but time will provide those answers ins a few years of further clinical use.
Dr Barry Eppley
Indianapolis, Indiana