How Smart Is Smartlipo?

When a product or manufacturer calls itself ‘smart’, there should be a good reason. Such is the case with the plastic surgery method known as Smartlipo. Highly touted as a better and more efficient method of liposuction, its name clearly suggests that it is better than traditional or ‘dumb’ liposuction. Grandiose claims are made all over the internet, most of which by doctors who use this liposuction technique. The manufacturer of the liposuction device, Cynosure, focuses on the established science behind it.

Smartlipo is a laser technique for melting fat to make it easier to extract. By first heating up the fat to a specific temperature, like oil in a cooking pan, it is turned from a solid into a liquid. This is done by using a laser probe that is passed through the fat area until the right temperature is reached. Then a liposuction cannula is used to remove by vacuum the oily liquid and any other fatty chunks in the area.

But what makes this liposuction so smart and why is it better? First, what it isn’t. Because a laser is involved, many potential patients think it is not invasive surgery. It is just as invasive as traditional liposuction which means there will be a recovery. This is not some magical approach that works from outside the body. Just because it is a laser, it doesn’t really zap the fat like a video game. It is about raising the temperature of the fatty zone until the fat begins to melt. The laser is just a way to heat the fat like the burner on the stove.

What makes Smartlipo better is that it creates a global melting effect which removes more fat than suction alone. Because of the heat damage, more fat is lost later than just what comes out at the time of surgery. Fat continues to die days to weeks later, thus the full effect of the fat removed is not really seen for months even though the early results are apparent within weeks after the procedure. This heating effect also accounts for its skin tightening capability. Such an effect, however, is almost always overstated and over expected. Do not expect Smartlipo to replace what a tummy tuck or armlift can do.

While many doctors tout Smartlipo as being done under local anesthesia with little recovery, this is often not so. Because there is considerable heat generated during the procedure, it is not hard to see that local anesthesia is often not enough for a comfortable operative experience. One can only remove enough fat if the patient is comfortable and will allow it. It is not a test to see who is the toughest. This is why I recommend a general anesthetic. The best result in the shortest period of time can be done when the maximal amount of fat can be comfortably removed.

Recovery from Smartlipo is not much different than traditional liposuction. While the amount of fat removed can be better, this does not mean there is less recovery. The laser does result in less pain and bruising but the amount of swelling is about the same, requiring months to eventually see the final body contouring effect.

Dr. Barry Eppley

Indianapolis, Indiana