What’s the difference between liposuction and Smartlipo?

There are many techniques of contouring used in aesthetic plastic surgery, and the most recognized one is liposuction.  As most people know, liposuction involves suctioning fat from under the skin using small tubes called canulas inserted into the fat layer.  Areas commonly treated with liposuction include the thighs, abdomen, waist, upper arms, and neck.  

Various technologies can modify the basic idea of sucking fat through a tube.  These include using a power device to oscillate the tube back and forth, a jet of saline (Body Jet) to help break up the fat, or applying ultrasonic or laser energy to the fat to help break it up or melt it.  SmartLipo is a technology that melts the fat using laser energy.  At Pacific Plastic Surgery in Santa Barbara, Dr. Mackenzie has several liposuction technologies available including conventional and power assisted liposuction, water-assisted (Body Jet) liposuction, and SmartLipo Triplex.

The current version of SmartLipo is actually the SmartLipo Triplex platform, which incorporates significant advancements over previous versions of SmartLipo.  Three different laser wavelengths, each with a specific purpose contribute to the overall effectiveness of the laser. These include fat melting, hemostasis (less bleeding and bruising), and tightening.  Also, the SmartLipo Triplex is capable of keeping the tissue temperature within a narrow range of safety and effectiveness.  This is a great advance over previous SmartLipo versions that were criticized for their poorly controlled temperatures that could cause poor effectiveness when too low and risk contour problems when too high.  (The company that makes the SmartLipo Triplex, Cynosure, is now only selling the device to plastic surgeons and some select dermatologists.  Previous criticisms of SmartLipo outcomes had a lot to do with the fact that it was sold to non-plastic surgeons.)

Because the SmartLipo fiber is narrower than a typical liposuction canula, the holes made in the skin are even smaller than the small holes of conventional liposuction.  No stitches are necessary.  Passing the fiber through the fat tissue requires less force, not only because of the narrower diameter but also because of the laser which “melts” its way through the fat rather than plowing its way through.  This makes the SmartLipo much easier to do under local anesthesia than conventional liposuction or even Body Jet liposuction.  

Like conventional liposuction, a saline tumescent fluid mixture is instilled into the fat layer, and this helps reduce pain and bruising and provides a smoother result.  The SmartLipo laser is then applied with energy and temperature settings designed for the specific area treated.  A small conventional liposuction canula is then used to remove some of the residual fluid and liquified fat.  Dressings and absorbent pads are applied to  soak up the significant drainage that happens over the first 24 hours.  

The SmartLipo offers advantages over conventional liposuction in certain cases.  SmartLipo is easier than liposuction for fibrous fat such as on the back.  Because of its thin flexible fiber, it can get around curves better than conventional liposuction.  It can provide collagen stimulation and contraction resulting in skin tightening.  For many cases however, such as younger patients with good elastic skin and typical abdominal and waist fat distribution, the advantages of SmartLipo are probably minimal and any liposuction technique should yield good results.  

Costs for SmartLipo are comparable to conventional liposuction techniques, and often less as SmartLipo is more amenable to being done under local anesthesia which can save hundreds of dollars.  For more information on minimally invasive body contouring procedures, click on these links: SmartLipo Triplex, Body Jet liposuction, LiposuctionCellulaze.

Dr. Douglas Mackenzie, Santa Barbara, California

Author
Douglas J. Mackenzie, MD

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