Debate on Laser Liposuction to Remove Fat

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April 26, 2010 (Washington) — You’ve probably seen the billboards, not tomention the glossy magazine ads, touting the benefits of laser-assistedliposuction. But is it really that “smart or that “cool?”

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

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

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

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

“Skin loses elasticity and gains laxity, so for areas with loose skin, laserlipo 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 forCynosure, maker of Smartlipo Triplex, a laser energy device used for laserliposuction. “It’s not magic. It’s just another tool that can add skintightening to improve the overall result.”

Laser Lipo: Risk of Burns

It’s not for everyone, DiBernardo says. “Lasers bring increased collagen andelastin to the party. If you are too old, cells don’t have the capacity to makecollagen 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 aboutthe benefits of laser lipo, and has seen his fair share of burns from laserliposuction procedures gone wrong. “It is tremendous hype and a lot of hype isfrom the companies,” he tells WebMD. “Don’t place commerce ahead ofscience.”

The results — and risks — are dependent on the doctor performing theprocedure, he says.

When you injure the skin with the laser, it contracts, Fodor says. “There isno question that if you hit it exactly right, you will cause the skin tocontract. 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 atthe University of Texas Southwestern Medical Center at Dallas and the directorof the Clinical Center for Cosmetic Laser Treatment in Dallas, has reservationsabout the procedure.

“It liquefies fat and there is no data that I am aware of that shows itconsistently tightens skin,” he tells WebMD. “There is a fine line between skintightening and injury. I am not convinced that we are at a point where we cansafely and predictably offer laser lipo as an option.”

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