Laser Assisted Liposuction (LAL)

Despite receiving FDA approval over two years ago, there is still relatively little information available about the benefits of performing liposuction with laser assistance. The first device introduced was the SmartLipo, by Cynosure, but now there are multiple devices on the market, some using the 1064nm wavelength (SmartLipo, ProLipo) & some using the 1320nm wavelength (CoolLipo, SmartLipo MPX). The ThinLipo operates at 924nm and 975nm. In many laser devices the laser light is preferentially absorbed by the target cells. This is not the case with fat cells, which are destroyed by photoacoustic and photomechanical effects.

The down sides of this approach are more evident than the benefits. Because of the narrowness of the fiber and the amount of energy that must be delivered, the procedure time is prolonged. Skin burns and loss of hair in the male neck have been reported. Because the fiber is delicate, there is a risk that it could break off inside the patient during the procedure.
There have been very few studies comparing the results of LAL with traditional liposuction, partially because at least some of the manufacturers have refused to let their investigators look at this.  A series of 82 patients who had 1064nm LAL for the chin area did have some benefits, but some of the patients had traditional liposuction as well.  A randomized study comparing LAL followed by traditional liposuction on one side with traditional liposuction only on the other side found no differences between the two sides. The side treated with LAL had longer treatment times but patients reported less pain on that side. A study comparing the 1064nm laser with the 980nm laser found similar tissue responses.
LAL is supposed to produce greater tissue tightening than traditional liposuction. This is still unproven. It is also supposed to cause less blood loss, but the amount of blood lost during traditional liposuction is minimal. It is also said to be less painful, and one study suggests this could be true.

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