Liposuction is a surgical procedure used to remove fat deposits and reshape areas of the body. Liposuction may be performed alone or in conjunction with other cosmetic or plastic surgery procedures, such as lifts or reductive surgery. It is not recommended for weight loss, but a viable technique for areas where fat deposits won't disappear.

Procedure

Regardless of the specific area being treated, the technique is generally the same. A small incision is made in a natural crease of the skin or some other inconspicuous place. A hollow, pen-like device, called a canula, is inserted into the skin. The canula is used to suck out the fat. In some cases, an ultrasonic probe is used to break up the fat into small pieces before it is sucked out with the canula. A newer technique, called the tumescent technique, forces extreme amounts of water into the fat prior to vacuuming it out, making hard fatty deposits easier to remove. Depending on the extensiveness of the surgery, liposuction may be an outpatient or inpatient procedure.

Risks

Complications from liposuction are more serious than for most other cosmetic procedures. They include:

Infections - which can occur after nearly any surgery but can be life threatening if left untreated.

Embolism - a piece of fat can get trapped in a blood vessel and can clog pathways to the lungs and brain, which is life threatening.

Visceral Perforations - Because physicians cannot see under the skin to where they insert the canula, organs can be punctured requiring additional surgery to repair.

Fluid Imbalance - A lot of liquid is used in liposuction for fat removal. This can cause an imbalance, which may lead to heart, lung or kidney problems.

Skin Problems - In some cases, swelling on the skin above the area where the liposuction occurs remains for months. Additionally, the skin may "die," change color and slough off.

Fatalities related to liposuction have been reported in as few as 3 in 100,000 cases and as high as 100 in 100,000 cases. However, many patients enjoy positive experiences with liposuction when conducted by a certified, experienced and trusted surgeon.

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LaserBodySculpting, Laserlipolysis

The Smartlipo is the first laser system designed for LaserBodySculpting and for the disruption of fat cells. It is ideal for treating localized deposits of unwanted fat, fat tissue irregularities and for coagulating tissue leading to a tightening effect. Smartlipo is ideal for treating small areas of the face, neck, arms, male breasts (gynecomastia), and other areas of loose or lax skin (flabby skin).

How does the Smartlipo work?

Smartlipo laserlipolysis is a minimally invasive surgical procedure. The procedure disrupts the fat cells through a thermal and photodisruptive action ñ heating and shattering the fat cell membrane. The laser coagulates the underlying vessels due to the hemostatic properties of the laser, resulting in less bleeding, bruising, trauma as well as less down time. As an added benefit, the system has also been reported to promote tissue tightening through bulk thermal heating and tissue coagulation.

The procedure is commonly performed under local and tumescent anesthesia. A laser fiber is introduced through a handpiece and detachable cannula. The cannula is then inserted through a 1 to 2 mm incision in the skin and into fat pockets. The cannula, with the tip of the fiber exposed approximately 2 mm, is then moved in a "back and forth" fanning motion. The laser's aiming beam can be visualized through the skin, allowing the physician to identify the treatment area. As the fiber tip comes in contact with the fat cells it ruptures the cell membranes and releases the fatty oil from the fat cells. This end product may then be aspirated from the site.

What are the benefits of Smartlipo?

• Treats unwanted fat and fat tissue irregularities
• Promotes tissue coagulation resulting in skin tissue tightening
• Treats flabby or lax skin and areas of high vascularity
• Minimal edema and bleeding due to the laser's hemostatic properties
• Minimal bruising
• Causes less trauma and faster healing time than traditional liposuction

What type of system is used?

The Smartlipo is an Nd:YAG laser with high peak power and a high rep rate of 40 Hz. The laser energy is delivered using a 300 micron fiber which is threaded through the handpiece and cannula.

Are there disposable costs associated with the procedure?

Laserlipolysis with the Smartlipo system has very few disposable costs associated with the procedure. The handpiece and cannulas are re-usable and would only be replaced due to normal wear and tear. The fiber is warranted by the manufacturer for one use. However, the fiber is a "cut and cleave" design, meaning you could simply continue to trim down the end of the fiber after each case.

Does this procedure have FDA Clearance?

The Smartlipo has been cleared by the FDA for laser-assisted lipolysis. It is also cleared for incision, vaporization, ablation and coagulation of soft tissue.

Who can use the Smartlipo?

Currently, only physicians who have previous liposuction experience are able to purchase the Smartlipo laser. Prior liposuction experience will shorten the learning curve significantly. Those without prior liposuction training and experience should be trained based on the guidelines of the American Academy of Cosmetic Surgery.

How is training for the Smartlipo system handled?

Once a customer purchases the unit, they will receive training on the procedure at a designated Cynosure training site.

Due to the nature of the product and procedure there will be no demonstration of the Smartlipo sytem.

Does laser-assisted lipolysis produce lasting results?

Yes! The Smartlipo procedure permanently destroys the treated fat cells. Adults do not create new fat cells. When a person gains weight, that person' s fat cells simply expand. Should you gain weight, that fat will most likely be deposited in areas where the procedure was not performed.

Who is a good candidate for the procedure?

Ideal candidates are in good health, close to normal body weight and have realistic expectations for the results. If the person has areas of fat that will not respond to diet and exercise, then that person is a candidate for laser-assisted lipolysis.

How many treatments are required?

For most patients, typically only one treatment is required. The session may last from 45 minutes to one hour for each area treated. Laserlipolysis is also an ideal choice for "touch ups" and revisions.

How can facilities become training sites?

Cynosure is very interested in establishing training sites for the Smartlipo through out the country. The qualified training centers should perform 10-20 liposuction cases per month and be willing to follow Cynosure training guidelines.

How does the Smartlipo compare to the Vaser?

Smartlipo is a laser system with the energy transmitted through the fiber (which is threaded through the cannula) and deposited directly to the tissue, disrupting the fat cells. The laser's aiming beam allows visualization of the treatment area.

The Vaser is an ultrasonic device that transmits energy throughout the entire probe and not just the tip. The energy is more difficult to control and has been known to cause burns near the incision. The probe is much larger than the laser fiber and requires a larger skin incision.

The company provides the system and all accessories to the customer and charges $500 per procedure with a minimum of 4 procedures per month.

How does the Smartlipo compare to the new ultrasound systems such as Ultrashape or Liposonix?

These systems are non-invasive and deposit focused ultrasound energy that does not differentiate between fat and other structure within the body. Extreme care must be taken to guide the system through out the treatment area. The scanner remembers where the system had fired. For example, the Ultrashape device has a 5 mm spot size used via a scanning mode. A 10x10 cm area can take over one hour to treat.

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In Ultrasonic-Assisted Liposuction, a specialized cannula is used which transmits ultrasound vibrations within the body. This vibration bursts the walls of the fat cells emulsifying or liquefying the fat, making it easier to suction out. Because fat cells alone are selected, blood and tissue loss is minimal. UAL may be a good option in places where the tissue is firm or fibrous, or when large amounts of fat are to be removed.

To learn more about UAL, click here.

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Power assisted liposuction is performed using a special cannula which rapidly vibrates to break up and loosen the fat cells so that they may be suctioned away gently with less trauma to the surrounding tissues. PAL is performed using the tumescent liposuction technique, which involves infusing large volumes of saline, local anesthesia and adrenaline into the treatment area for smooth fat transfer through the cannula.

To learn more about PAL, click here.

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Before the tumescent technique, traditional liposuction involved making large incisions in the fatty areas to allow insertion of long cannulas, which are long hollow needles with holes at the end. With tumescent liposuction, one or more small incisions are made allowing less invasive micro-cannulas to be used. These micro-cannulas provide more targeted and controlled removal of fat. As a result, surgeons are able to contour the treated area more effectively.

To learn more about the Tumescent technique, click here..

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The super wet technique is similar to tumescent liposuction, except that it uses a solution containing less lidocaine and epinephrine which are anesthetics. Instead, intravenous sedation or general anesthetic is used since the area being treated does not become fully anesthetized by the solution alone. By not using an injected local anesthetic the doctor doesn't have to wait for swelling to go down, resulting in a quicker procedure. The surgery usually takes no longer than two hours, and can be combined with other procedures.

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Abdominal etching is an advanced liposuction procedure available to those who already have form fit bodies and want a flatter, tighter stomach area, with a much stronger muscle definition. Abdominal etching differs from an abdominoplasty in that it only removes excess fat and skin, and not abdomen muscles like an abdominoplasty could.

If you think you may be a candidate for Abdominal Etching and would like to read more, click here.

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To be ABPS board-certified, a physician must meet these tough requirements:

• The plastic surgeon must graduate from an accredited school.
• Complete a combination of at least five years of general surgery and plastic surgery residency training.
• They then must pass a comprehensive oral examination given by ABPS plastic surgeons.
• They then have to wait a year, if they pass, and then take the written exams.
• It does not stop there. After receiving there Board Certification, they have to regularly attend medical education courses, and have to adhere to a strict code of ethics.
• All surgeries performed must be done in an accredited surgical facility

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