Today we have multiple options for reducing unwanted fat areas. Liposuction, and its recent technological advances such as Smartlipo or laser liposuction, is the surgical or invasive approach. Minimally invasive techniques, such as Lipodissolve, offer a non-invasive approach. Both methods have been heavily advertised and promoted…often leaving most potential patients confused. Having performed a lot of Lipodissolve injections over the past few years in my Indianapolis plastic surgery practice and most recently doing Smartlipo, I can offer the following opinion.
Lipodissolve injection therapy is best used for small fat areas that otherwise might not be worth undergoing a traditional liposuction procedure. Usually the size of the fat area should be about the size of a large hand. While I have seen some moderate to good results with Lipodissolve therapy, it is a slow and multi-treatment process. It usually requires at least 3 or 4 injection sessions to see some results. While the slowness of the process was never a concern (because it was avoiding an operation), there was always a fair amount of swelling and discomfort for about a week after. Quite frankly, the postinjection course was about the same as if the area had been liposuctioned and usually had even more swelling. That became a real issue for the neck area due to repeated swelling episodes.
Smartlipo uses a laser probe and essentially brings a lot of heat to the fat area. My impression is that it is more effective than traditional liposuction due to the heat which causes collateral damage to fat that goes beyond a mechanical injury. Much of the marketing about Smartlipo focuses on its use as being capable of being done under local anesthesia. While this is certainly true for smaller areas, larger or multiple areas cannot really be done unless one is under a deeper anesthesia. For smaller areas, the use of improved tumescent infiltration techniques and the thinness of the laser probe do make for reasonable comfort in necks, chest, back of arms, abdominal, flank, back rolls, outer thigh and knee areas. But no more than two or three such areas at a time.
In the face of Smartlipo, I feel the role of Lipodissolve has largely now been supplanted. Even though Smartlipo is a more invasive procedure (even when done under local), it removes a lot more fat and does it in a single procedure. Given that the swelling and bruising is about the same as Lipodissolve, it is better to undergo the process once and be done. Smartlipo may cost more than any injection series but because it is more effective it is a better value.
Dr. Barry Eppley
Indianapolis, Indiana