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Can you explain the difference between SmartLipo and traditional Liposuction?


I'm a healthy 48 year old male with "love handles" and belly fat.  I have never been overweight and stay in the range of 175 to 180 pounds.  I exercise and watch my diet.  Would liposuction be the procedure necessary to get rid of the love handles and belly fat?  What is the difference between SmartLipo and traditional liposuction?  Thank you.


Yes, since you have tried diet and exercise without resolution of these love handles, liposuction should help.  We have found patients that lose some weight before a liposuction procedure tend to do much better long term than those who do not.  I believe it is a motivational issue to keep their weight stable.

Laser assisted liposuction is an adjuvant to liposuction.  There are many such assistants, including water assisted, ultrasound assisted, radio frequency assisted, etc., to name but a few. They all make claims to improve the liposuction experience/technique. Consult with a member of ASAPS to see which method would be best in your case and for your concerns.


Gary R. Culbertson, MD, FACS


The explosion in medical aesthetic technology has resulted in a market that is literally flooded with new products, devices and procedures, like Smart Lipo, all claiming to be the "latest and greatest" or the "next big thing."  A great deal of dedication (and caution!) is required to sort through all of the new (and often not-so-new) technology which is marketed simultaneously to aesthetic professionals and to the public.

I have not seen a single study that shows any advantage of Smart Lipo to traditional (tumescent) liposuction. But, there may be increased risk of complications, particularly since it seems this device is used by many physicians with absolutely no formal surgical training who are just entering the world of aesthetic medicine.

In my practice I use Power assisted liposuction.  These procedures are performed with tumescent liposuction.  The training of the physician is far more important that the procedure being used with these modalities and others.

Liposuction is the most commonly performed surgical procedure each year in the United States.  Surprisingly, the majority of physicians performing liposuction in the United States are not plastic surgeons; in fact, many do not have any formal surgical training whatsoever.  It seems hard to believe, but many physicians performing liposuction or Smart Lipo have had no more training in liposuction than a "weekend course."

I fear that some practitioners, and now consumers view liposuction as a "simple" surgery, since it does not involve making large incisions, and it requires little, if any, suturing.  Nothing could be further from the truth.

Liposuction, in my mind, is a very challenging operation that requires careful planning and preparation, and a great deal of care and finesse when it is actually performed.  It requires a three-dimensional understanding of the layers of human anatomy, an understanding that is second nature to a surgeon alone.

I think that it is often an inadequate understanding of anatomy (and perhaps, of the body's response to surgery) which leads to the poor results in liposuction and body contouring that unfortunately are so often seen.

Although many aesthetic cosmetic surgery procedures are not performed in hospital operating rooms, the fact that a hospital has granted a surgeon privileges for a given procedure ensures that the surgeon has met an accepted standard of competence.  It also means that your surgeon will be able to take care of you at a hospital, should any complications from cosmetic surgery arise.

If you are planning to have any type of cosmetic surgery performed, you should do your due diligence to determine if your surgeon has the appropriate credentials and experience.



To answer your first question, it sounds like you might well be a good candidate for liposuction. The ideal liposuction patient has localized fat deposits (bulges often) that don't go away with diligent diet and exercise and is someone who is at or close to their "ideal" weight.

There are a number of different "tools" available to perform liposuction procedures, and SmartLipo is one of them.  Good results can be obtained with most of them; what is critical is the skill and experience of the operator, not the machine being used!

Bruce K. Barach, M.D. - View Other Answers by this Doctor
Schenectady, NY


The short answer for the difference between SmartLipo and traditional lipo:  millions of dollars of marketing by the manufacturers of the SmartLipo device!

Speaking seriously:  laser-assisted liposuction (like SmartLipo), power-assisted liposuction, standard liposuction and VASER ultrasonic liposuction can all be used successfully to treat your love handles, as long as your skin elasticity is acceptable.  Studies show little significant difference between these methods.

What is really the most important factor is the choice of the surgeon, not the gadget.  It's the carpenter, not the hammer, that makes the difference.

Thomas G. S. Fiala, M.D.M.D., F.R.C.S., F.A.C.S. - View Other Answers by this Doctor
Altamonte Springs, FL


From your description, Liposuction would solve your problem.  Instead of worrying about the type of liposuction (they all do essentially the same thing), pick a surgeon with significant experience in Liposuction.  Experience is more important, much more important than the specific type of Liposuction.


Traditional liposuction is tumescent liposuction which is still the most common technique of body contouring. Since the introduction of liposuction in this country over 30 years ago, there were a lot of changes in technique. This involved using smaller canulae for the fat extraction and introducing the superwet and tumescent techniques. With these improvements, the procedure became practically bloodless, more fat could be removed and better contours could be achieved. Later on, internal and external ultrasounds were introduced to help melt or extract difficult, fibrous fat (usually in men, people who had scarring from previous liposuction). The PAL or power assist system was introduced, and lately lasers were introduced as adjuncts to the "traditional" liposuction. Smart lipo is a laser which helps tighten the skin right after the liposuction. It is very inefficient in removing large fat volumes. Remember, these are tools used by plastic surgeons to improve or deliver the best results. Unfortunately, the Smartlipo laser was acquired by many unqualified surgeons or non surgeons as well, capitalizing on the tremendous marketing success of Cynosure who makes the laser. I had a patient last year who was treated with Smartlipo by a neurologist friend of hers and completely destroyed her lower abdominal wall. I see one Smartlipo complication per month (by the way, I use the VASER, Smartlipo and Ticklle lipo in my practice). Remember, the best tool is between the surgeon's ears. Seek a board certified plastic surgeon who has good judgement and experience in body contouring.

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