How Smart Liposuction Works

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Two Chinese doctors perform liposuction on a woman in Shanghai. Plastic surgery is growing in popularity in China, but if it's too invasive for you, smart liposuction is one alternative.

Imagine if there were a magic pill that would instantly melt away fat, leaving you with the perfect Hollywood body. Unfortunately, no such thing exists just yet, but science is making great strides toward finding ways to slim us down. In lieu of diet and exercise, a comparatively quick -- but not so painless --way to shed the weight is through and moves back and forth through the fat cells, breaking them up. When this process is complete, the surgeon uses a vacuum tube to suction out the fat into a flask. The procedure works well, but because it is relatively invasive, it can have some unpleasant side effects. For a more in-depth explanation of the procedure, read our article on How Liposuction Works.

If surgery isn't for you, there are a few new liposuction treatments on the market to choose from. The latest technology involves ultrasound-based techniques for recontouring the body. These cosmetic procedures can be performed in a doctor's office with a small dose of anesthetic -- no surgery required.

In Vaser LipoSelection, the patient is placed under general, local or intravenous sedation. The doctor creates a tiny incision in the area to be treated and fills it with a solution containing epinephrine, which shrinks blood vessels to reduce bleeding, and an anesthetic, which numbs the area. The doctor then inserts an ultrasonic probe that releases sound waves. The sound waves break up fatty tissue in areas such as the abdomen, arms, back, knees and hips -- or "love handles" -- while leaving nearby tissue intact. The doctor finishes the procedure by using suction to remove the emulsified fat.

UltraShape and LipoSonix are procedures that use an ultrasound to break up fat cells from outside the body. With UltraShape and LipoSonix, there is no need for an incision. While the patient lies on a bed, the technician uses a handheld device to deliver ultrasound energy to the area that's being treated. The energy disrupts the fat cell membranes and ruptures the cells. The body then transports the fat to the liver, where it is removed.

The Smart Liposuction Procedure

Liu Jin/AFP/Getty Images
In smart liposuction procedures, the patient's body excretes fatty oil through the liver. Here, in a conventional liposuction procedure, fluids are vacuumed out of the body.

Laser-assisted liposuction works on small, localized areas of fat on the face and body. Areas that can be treated with laser-assisted liposuction include the face, neck, jowls, arms, back, gynecomastia (or male breasts) and loose skin.

Just as with any surgical procedure, laser-assisted liposuction isn't for everyone. The ideal candidate is someone who is in generally good health and close to a normal body weight, but who has areas of fat that just won't budge, even with diet and exercise.

The smart liposuction procedure begins with a consultation. During the consultation, the doctor asks about the patient's medical history to determine if he or she is a candidate for the procedure. The doctor will also evaluate the areas to be treated.

Before the actual procedure begins, the doctor uses a local anesthetic to numb the treatment area. Then the doctor makes a 1- to 2- millimeter incision in the skin and inserts a cannula, or a very thin tube with a laser fiber through it, just under the skin's surface. The doctor moves the cannula back and forth in a fanning motion through the areas of fat underneath the skin. A small red light on the laser is visible through the skin to help the doctor see what he or she is doing.

Lunch Hour Lipo?

Laser-assisted liposuction has been referred to as "lunch hour liposuction" because of the speed at which it can be performed. Depending on how much of the body is treated, sessions last only from 45 minutes to one hour. The name "lunch hour lipo" is a little misleading -- you can't exactly head straight back to work after liposuction. Most doctors recommend that their patients stay home and recuperate for a day or two to let the treated area heal.

As the laser fiber comes into contact with the fat cells, the heat it gives off causes the cell membranes to swell -- similar to blowing up a bubble. When the cells swell big enough, they burst into fatty oil. This oily byproduct is why ads for smart liposuction often say that laser-assisted liposuction "melts away fat." If the treatment area is relatively large, the doctor will remove the fat remnants with a suction device. For smaller areas, the body will just absorb the liquefied fat and excrete it via the liver, just as it would any other waste product.

Another appeal of the smart liposuction procedure is that the energy from the laser doesn't just destroy fat cells -- it also triggers the production of collagen. Collagen is a protein that gives skin its strength and keeps it looking firm. This extra collagen tightens the treated area, which is why laser-assisted liposuction works better than conventional liposuction for people who have loose skin.

After Smart Liposuction

Recovering from laser-assisted liposuction has proven to be easier than recovering from traditional liposuction procedures. For one thing, there are no stitches to deal with. Because the doctor's incision is so small, no stitches are needed to close the skin. Many people will feel a bit sore after their procedure, but so far studies have found no risk of any serious side effects. Because the laser closes off small blood vessels as it moves under the skin, there is less chance of bleeding, swelling and bruising than with conventional liposuction.

There was some concern that the extra fat circulating in the blood after the procedure might eventually increase patients' risk for developing high cholesterol and potentially lead to heart attacks or strokes, but researchers have not found this to be the case.

Within a day after surgery, most patients can slowly resume their normal activities, although doctors advise that they avoid strenuous exercise or hot tubs for about two weeks. Wearing special compression garments for a week or two after the procedure can speed healing. These close-fitting elastic garments can also reduce swelling.

Most people start seeing results within a week after the procedure, but it can take up to a full six months to achieve the final look. In the majority of cases, people need only one laser-assisted liposuction treatment to see results. However, some go back for minor touch-ups. It is possible to retreat the same areas, but patients need to wait at least four months between procedures. Laser-assisted liposuction also can be done before or after regular liposuction to hit hard-to-reach areas.

Why re-treat these areas -- isn't laser-assisted liposuction permanent? That largely depends on the patient. The body makes only a limited number of fat cells, so once they're gone, they're gone for good. But because this procedure removes only small pockets of fat cells, patients who don't eat healthy diets or regularly exercise can risk losing their streamlined figures. The fat cells that remain will enlarge, and patients will gain weight in parts of the body where they didn't have the liposuction.

Laser-Assisted Lipo vs. Conventional LipoConventional liposuction can remove more fat from larger areas than laser-assisted liposuction, but it does have a greater number of potential complications. This table shows how the two techniques stack up:

	Laser-Assisted	Conventional Liposuction
What it's used to treat	Small areas of fat that don't respond to diet and exercise, and loose skin	Larger areas of fat (but it won't fix the bagginess of loose skin)
Areas treated	Face, jowls, neck, arms, loose skin, male breasts	Thighs, abdomen, buttocks, hips, male breasts
Anesthesia	Local anesthesia	Local, epidural or general anesthesia
Complications	Soreness, minor bruising	Bleeding, bruising, infection, dimpling or rippling under the skin if too much or too little fat is removed, blood clots, fluid accumulation, swelling, nerve damage, rarely death (1 in 5,000).
After surgery	Minor discomfort. Patients can go back to work within one or two days, but need to avoid strenuous exercise for about two weeks.	Pain, soreness, or burning for a few days to a couple of weeks after surgery. Swelling continues for four to six weeks. The doctor will remove stitches or they will dissolve after about 10 days. Patients need to avoid exercise and strenuous activity for about a month.
Cost	$4,000 - $8,000	$2,000 - $7,000 per body part

For more information about liposuction and other body beautification alternatives, follow the links on the next page.

Smart Liposuction Overview

The Smart Liposuction Procedure

After Smart Liposuction

Lots More Information