Liposuction: Laser Assisted Lipo Reconsidered

Since the original release of laser assisted liposuction machines, I have been a skeptic. I have regarded the claims as unverified and the procedure as one that added risk without providing a proven benefit. In fact, there have been burns associated with this procedure. The original device, the SmartLipo was initially underpowered and it used wavelength appears not to have been optimal. There were claims of skin tightening, but no documentation of this was produced. In fact the manufacturer discouraged studies that would have evaluated whether this occurred

The Skinny About Liposuction

Ever since the onset of tumescent liposuction, there have been a number of modifications of the procedure, attempting to produce better results or to speed up the procedure. These approaches include mechanically assisted liposuction, ultrasonic  assisted liposuction and, most recently, laser assisted liposuction.

We have had experience with mechanically assisted liposuction, and have been unimpressed. Although it makes the procedure easier on the physicians, it does not make the procedure any quicker.  Ultrasonic assisted liposuction has never become very popular, due to the relatively high incidence of reported complications. This approach uses ultrasound vibrations to break up the fat cells. Then this is followed by traditional liposuction to withdraw the fluid. one of the associated complications has been the formation of seromas, accumulations of fluid that have a tendency to recur.

Cryolipolysis: Fat Removal Without Surgery?

As cosmetic surgery has become more more sophisticated, there has been a movement toward less invasive procedures. Many of the initial attempts were marginally effective, but with time the effectiveness and specificity of these procedures has improved. Fat removal has so far not been affected by this trend. The supposed, but still unproven, advances of laser assisted liposuction still required surgery. The use of mesotherapy, which involved the injections of solutions of varying composition, proved to be problematical for treating fatty areas of significant volume, and had problems that resulted in a number of lawsuits and the bankruptcy of a chain of facilities that were formed to capitalize on the treatment. Now, an article in the most recent "Dermatologic Surgery" journal reports on the use of external cooling to reduce fat.

Laser Assisted Liposuction: Cholesterol Reduction?

There are a number of laser assisted liposuction machines on the market. None of them have demonstrated any clear advantage over traditional liposuction, although the claim is that they produce more skin tightening than traditional liposuction. When one researcher proposed looking at this scientifically, the laser company he was working with refused to let him proceed.
Now a company studying another low level laser liposuction device has seen reduction in serum cholesterol and triglyceride levels two weeks after treatment with their device (LipoLaser). In a group of 19 patients the mean cholesterol level fell by 19 mg/dL, with the mean LDL (bad) cholesterol reduction of 14 mg/dL.

Lipotourism

Every so often we see a patient who has traveled to another country for the purpose of having a cosmetic procedure preformed. They are usually quite proud of getting a bargain compared to US prices, and at times are willing to overlook what would be considered by most people to be unacceptable results. Apparently the number of people going this route is increasing.

Liposuction: Permanent fat removal

Liposuction was successfully performed in1974 by Dr. Georgio Fischer, an Italian gynecologist in 1974 and it was further refined by several French surgeons. The next major advance was made by a US dermatologist, Dr. Jeff Klein, who developed tumescent liposuction in 1985. Dr. Klein's advances allowed liposuction to be performed under local anesthesia. This resulted in a major advance in the safety of the procedure, and moved it out from the hospital operating room to an outpatient or office facility. Dr. Klein also pioneered the use of microcannulas  which allow for  more precise fat removal.