The best treatment for excess fat is of course diet and exercise. When a patient needs a little help they often turn towards liposuction. Liposuction has a certain amount of risk, tenderness, and recovery that does not make it the “ideal” procedure for fat removal. The “ideal” procedure for fat removal would; be effective every time, have no surgical risk, be painless, result in tightening of the overlying skin and have instant results with no down time. Oh yeah, and reduce cholesterol and risk of cardiovascular disease.
There is no such procedure at this time. Hopefully someday. However, there is promising new technology and will likely continue to be more in the future as our understanding of technology evolves.
I’ll be completely honest, I am not sure which of the current treatment options for fat reduction is best. No one does. The technology is moving faster than the research. There are basically no unbiased studies comparing treatment options head to head. Most of the research is being sponsored by the companies who own the devices.
I have been, and continue to be quite happy and impressed with traditional liposuction. For me this is the gold standard that all other treatment options should be compared. I’m not stubborn. If and when some other form of liposuction or fat reduction procedure is shown to be superior and safe, I will embrace it. I believe in progress, I just think it should be done responsibly.
The alternative liposuction treatment options fall into two categories. 1) Technology that is used in addition to liposuction or 2) Non-invasive procedures that cause fat damage resulting in fat resorption. I will discuss the non-invasive procedures in part 2 of this blog post.
Techniques that cause fat damage or loosening before liposuction
- Ultrasound assisted liposuction – Ultrasound energy at the tip of the cannula helps to burst the fat cells prior to removal. There is an increased risk of seroma and skin burns. The superficial fat cannot be treated because of this risk of skin burns. Good for dense tissue such as breast tissue.
- Vaser™ liposuction – A newer version of ultrasound assisted liposuction that loosens the fat cells without bursting prior to removal
- Laser liposuction. The laser is used to liquefy fat prior to liposuction. The initial goal was fat resorption without suction. This proved to be inconsistent and liposuction is now a standard part of the procedure. The question is whether burning the fat and heating the tissue before removal is valuable. The claims are skin tightening. The studies are underwhelming. Be cautious, most doctors currently using laser liposuction are not plastic surgeons. The current leaders in laser liposuction are Smartlipo®, SmoothLipo®, SlimLipo®,LipoLite®, CoolLipo™ and LipoTherme™
- Power assisted liposuction – The cannula tip vibrates rapidly to loosen the fat cells making fat removal more efficient. This is what I have used for 8 years and have found little reason to change….yet.
- Body Jet® – water assisted liposuction. A spray of saline solution with lidocaine at the tip of the cannula is used to anesthetize and loosen the fat cells immediately before they are removed. Benefits are potentially larger treatment areas with less risk of lidocaine toxicity. The claims are more precise treatment as less fluid needs to be infiltrated and quicker recovery. Too early to know but there is some promise here.
Remember, the skill of the surgeon is MUCH more important than the technology in his hand. A skilled liposuction surgeon would likely get a fabulous result with any of these technologies. Likewise, a poorly trained surgeon would likely get an equally poor result with any of them as well.