SmartLipo: Much ado about nothing?

SmartLipo, the laser assisted liposuction device sold by Cynosure Inc. was released in January 2007. It had been under development for a number of years and an early article was published in the Brazilian literature in 2002. The device uses an Nd:YAG laser to melt fat, prior to its being suctioned out. This laser type has been around for a long time and variants are  used for hair removal and tattoo removal, among other things. The key question, which was the subject of a recent article in the Wall Street Journal and is discussed in their blog.

There is no question that liposuction, which has been widely performed since the 1980s, is an effective procedure. The question is whether the SmartLipo device adds anything to the procedure. There is very little evidence that this is the case. There is no doubt that melting the fat rather than breaking it up with a cannula  is physically easier on the surgeon. It also is a slower procedure than traditional liposuction, resulting in a longer procedure in some cases. However, to justify the cost of the device, greater than $100,000, hopefully it should have significant benefits for the patient. The claims made for SmartLipo are that it produces tightening of the skin beyond that  seen in traditional liposuction. So far, there is no published evidence that this is the case.  It is quite common to see skin tightening after traditional liposuction.  Frequently we see people who have a roll of skin on their lower abdomens, and they ask whether the skin should be cut out along with the liposuction. We tell them that the skin will tighten and that if there is not enough tightening, we can remove the excess skin in a subsequent procedure. We have never had anyone request that this be done, and we have been doing liposuction since the mid 1980s.
In the Wall Street Journal Blog  Dr. William Coleman III, the editor of the journal of the American Society of Dermatologic Surgery says "Smartlipo is a marketing gimmick to get people through the door.” He adds that there’s no scientific evidence in human tests that Smartlipo improves outcomes, tightens skin or speeds recovery, compared to tumescent liposuction, according to the WSJ.
It is not uncommon for new technology to be released with great hype and little patient data to back it up. This, in my view, is an unfortunate situation because it makes the early patients into involuntary participants in a study to see how well the device works and what types of complications will be seen after large numbers of people are treated. I have previously noted that Reliant Technologies is relatively unique in this regard, having treated over 500 people with the Fraxel re:pair laser before releasing it. This approach should be more widespread.

Gerald N. Bock MD
California Skin & Laser Center
Stockton and Lodi, CA

Comments

[novasuresystem]

Great information.Very informative article.Thanks.!Liposuction is normally performed under general anaesthetic and usually requires only an overnight stay at the hospital.