Debate on Laser Liposuction to Remove Fat

Study Shows Technique Removes Fat and Helps Skin Tightening; Critics Worry About Burns

Reviewed by Laura J. Martin, MD on April 26, 2010
From the WebMD Archives

April 26, 2010 (Washington) -- You've probably seen the billboards, not to mention the glossy magazine ads, touting the benefits of laser-assisted liposuction. But is it really that "smart or that "cool?"

The answer depends on whom you ask. Advocates say laser liposuction involves less bruising and a quicker recovery time. And new research presented at the annual meeting of the American society for Aesthetic Plastic Surgery in Washington, D.C., suggests laser liposuction also results in the much-coveted skin-tightening effect.

But others say laser liposuction merely adds to the cost of traditional liposuction, not the results, and increases the risk of side effects, namely burns.

Laser liposuction uses lasers to liquefy the fat before it is removed, making it easier to vacuum out via liposuction. Lasers may also stimulate the production of collagen and elastin, which results in firmer, tighter, and smoother skin. Lasers may also coagulate small blood vessels in the area, which translates to less bruising.

In one study, patients had laser liposuction on one side of their abdomen and traditional liposuction on the other side. They had more elasticity on the laser side at three months then on the side with traditional liposuction.

"Skin loses elasticity and gains laxity, so for areas with loose skin, laser lipo may be the way to go," study researcher Barry DiBernardo, MD, tells WebMD. DiBernardo is a plastic surgeon in Montclair, N.J. and a consultant for Cynosure, maker of Smartlipo Triplex, a laser energy device used for laser liposuction. "It's not magic. It's just another tool that can add skin tightening to improve the overall result."

Laser Lipo: Risk of Burns

It's not for everyone, DiBernardo says. "Lasers bring increased collagen and elastin to the party. If you are too old, cells don't have the capacity to make collagen and elastin."

But there is a risk of burns. "You need to monitor the temperature," DiBernardo says.

Peter B. Fodor, MD, a plastic surgeon in Los Angeles, is not convinced about the benefits of laser lipo, and has seen his fair share of burns from laser liposuction procedures gone wrong. "It is tremendous hype and a lot of hype is from the companies," he tells WebMD. "Don't place commerce ahead of science."

The results -- and risks -- are dependent on the doctor performing the procedure, he says.

When you injure the skin with the laser, it contracts, Fodor says. "There is no question that if you hit it exactly right, you will cause the skin to contract. A little injury is good, but too much and you get burned."

Put another way: "There is a very small margin of error."

Jeffrey M. Kenkel, MD, a professor and vice chairman of plastic surgery at the University of Texas Southwestern Medical Center at Dallas and the director of the Clinical Center for Cosmetic Laser Treatment in Dallas, has reservations about the procedure.

"It liquefies fat and there is no data that I am aware of that shows it consistently tightens skin," he tells WebMD. "There is a fine line between skin tightening and injury. I am not convinced that we are at a point where we can safely and predictably offer laser lipo as an option."

Show Sources


American Society for Aesthetic Plastic Surgery annual meeting, Washington, D.C., April 23-27, 2010.

Jeffrey M. Kenkel, MD,  professor and vice chairman, plastic surgery, University of Texas Southwestern Medical Center; director, Clinical Center for Cosmetic Laser Treatment, Dallas.

Peter B. Fodor, MD, plastic surgeon, Los Angeles.

Barry DiBernardo, MD, plastic surgeon, Montclair, N.J.; consultant, Cynosure.

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