Smartlipo represents a paradigm shift in liposuction technology. Using a laser probe and the emitting of pulsed energy from its tip, it is used to directly and indirectly destroy fat cells. Whether it is by direct contact with the laser probe through multiple passes or the build-up of sufficient heat energy by working continuously in one area, fat is more effectively removed by the combined direct and field effect.
From the outside and to the patient or novice user, one would believe that the benefits of Smartlipo are primarily the result of the probe’s direct contact on fat. In reality, raising the temperature in the subcutaneous fat area is very important also. It is currently acknowledged that the death or rupture of fat cells will occur at temperatures around 42 to 45 degrees centigrade. But how does one know when that temperature is reached as the laser probe is under the skin?
In the past few years since the introduction of higher powered laser machines, which are now capable of delivering much more heat quicker, one could only estimate the fat temperatures by how the skin feels by touch. While this is a rough guide, it is not as accurate as one would like and it is possible to actually create too much heat which can be destructive and cause substantial fat necrosis and indentations.
The more recent introduction of the thermaguide to the Smartlipo machine really brings a much greater precision to the procedure. The thermaguide is a special cannula, through which the laser probe is inserted, that reads the temperature of the area you are in and puts it in real time on the computer screen. In addition, the thermaguide requires the use of a 1mm (1000 micron) probe as opposed to the smaller 600 micron probe. This not only makes it more stiff for easier tissue passage but also delivers more heat energy due to its larger cross-sectional surface area. This helps heat each fat area faster.
The thermaguide represents a real advance for laser liposuction. While initially ridiculed when it first came out due to its low powers and slow and ineffective treatment times, a 30 or 46 watt machine with the thermaguide now makes laser liposuction a really effective procedure. I now believe that Smartlipo rivals traditional or ultrasonic liposuction in operative speed but with more effective fat reduction. Heating up the subcutaneous fat layer before suctioning provides good fat removal, less pain, and the potential for some small amount of skin retraction.
Dr. Barry Eppley
Indianapolis, Indiana