Traditional Liposuction is suffering and so are the patients who are going under the knife for this procedure! Many of us desire leaner, more sculpted, figures and have found that liposuction may be the answer to our prayers. Finally, a way to get rid of unwanted fat that doesn’t respond to diet and exercise! But with so many different choices of “liposuction” procedures out there, Smartlipo, Body Jet Lipo, VASER/ultrasound Lipo, or traditional power-assisted or mechanical liposuction…..how do you choose which is the right one for you?

Well, let me explain - Traditional Liposuction, whether power-assisted or hand-driven, employs larger cannulas to mechanically disrupt (think - cheese grater) the fatty, subcutaneous, layer followed by use of a suction device to remove the chunks of fat. Due to the brutal nature of this procedure, most surgeons opt to treat patients under general anesthesia, but some do perform the operation under tumescent (local) anesthesia with sedation. The mechanical technique does not give the physician the ability to avoid nerve endings or blood vessels and, therefore, results in a great deal of bruising, swelling, and superficial nerve damage. In addition, when patients are treated under general anesthesia, not only do this increase the risk of the procedure due to the use of the anesthetic medications, but also takes away the verbal feedback from the patient as to their level of discomfort - a vital tool when trying to avoid complications, like perforating bowel or other internal structures. Compression garments must be worn for 4-6 weeks in effort to decrease swelling and help with skin retraction post-operatively. The cost for these procedures is typically higher due to the need for general anesthesia and use of an operating room.

So, you still want to get rid of that fat?! OK, there ARE other options. Laser-assisted liposuction came on the scene about 10 years ago. These devices use small, laser cannulas (usually about 1 mm in diameter), inserted under the skin after infusion of local anesthesia, to gradually “melt” away the fat in the area before the fat is then suctioned. This tool has also been shown to produce approximately 50% more skin tightening due to the effect of the laser energy on the overlying skin. I have found this to be a wonderful tool to address small body areas or localized fat deposits. Results are seen quickly because the laser spares the surrounding vasculature and nerve endings from damage, so we see less bruising and swelling. Compression garments are only required for 1-2 weeks after the procedure which is typically done on an out-patient basis in the office. This is a great option for treatment of superficial fat in relatively small, thin, individuals. At our office, we use the SmartLipo laser which was the first FDA approved devise for this purpose and has stood the test of time compared to it’s competitors on the market. Price for treatment? Approximately $1500 per body area.

Have more than just a “little” to lose? Newer technologies include ultrasound-assisted liposuction, such as the VASER device and water-assisted devices such as the Body-Jet. We use the VASER here in our office and I love it. This tool allows me to treat larger patinets, patients who may have had previous liposuction procedures (who may have some scarring or fibrosis in the area), and men, who, typically, have more fibrous fat. These patinents need a more aggressive approach. The powerful ultrasound energy targets the deeper fatty layers and easily disrupts tougher fat, such as male breast tissue or fat that has been previously liposuctioned. Patients get more dramatic results and seem to be happier with their overall treatment. Post-procedure bruising and swellling is expected for up to two weeks after the procedure but much better tolerated than what is typically seen after traditional liposuction cases. Body Jet Lipo is new to the market and employs high-pressured water to disrupt the fat cells before suction is applied. The makers of this device tout less downtime and discomfort for their patients with this method. Having seen the procedure performed first-hand, I am not convinced that it offers any real benefits over the ultrasound device, except that it may play a better role in fat harvesting for reinjection into other areas such as the breasts or the face, since it does leave the fat cells intact rather than melting them before suction. Both of these techniques are good at targeting deeper fat and may be used in larger individuals. That being said, I would still recommend use of a laser device to help aid in skin tightening as an adjunct to either therapy. In my practice, I routinely use the VASER device to get at the deeper fat layer followed by the SmartLipo to target the superficial layer and give the finishing touches. Price? Approximately $2000 per body area. Results? Perfection!