Plastic surgeon Haideh Hirmand surveys the field’s latest innovations: devices that not only vacuum fat, but also claim to tighten and tone the skin
We want a lot out of liposuction. Patients used to come to me just wanting to look thinner. Now they want to leave the operating room looking not just svelte, but with the body they had in their 20s. I’m no magician, but I can tell you that this procedure has entered a new stage.
When liposuction first came along, it was revolutionary. Doctors made small incisions, connected a cannula tube to a suction machine, and manually vacuumed excess fat under the skin. The procedure evolved a bit when surgeons added a magic liquid called tumescent fluid, which not only sucked out the fat more easily but also decreased patients’ pain, bleeding and bruising. The new frontier? Ultrasound-assisted liposuction technology, which is said (though not scientifically proven) to create smoother results. Welcome to a new era in liposuction!
1. Laser-Assisted liposuction (examples include Slim Lipo, Smart Lipo, Cool Lipo, Pro Lipo): There are half a dozen devices, based on laser energy, that claim to remove fat while improving the tone, tightness and firmness of the skin. How is this achieved? Laser light energy, applied using a thin fiber through small incisions, melts the fat before sucking it out with a cannula. Then — and here’s the revolutionary part — the laser energy is applied to the skin’s underlayers through the same incisions. Heating the skin promotes collagen synthesis and remodeling. Over several months, manufacturers claim, the skin will become tighter. The process, done correctly, takes longer than regular liposuction.
Warning: Most of these laser machines are FDA-approved, but the procedure is still controversial. Scientific data suggests that while the technology really does tighten the skin, the results may not be amazing. Laser lipo may tighten the skin better than regular liposuction in some patients, but do your research first. Go to a qualified plastic surgeon, experienced in performing liposuction, who can advise you about the true benefit to you as well as the risks. Also, all laser-lipo machines are not created equal. Doctors are gaining more experience with this technology to see which machines and which wavelengths are most efficient.
The Ideal Patient: Someone who could benefit from a mild to moderate level of skin tightening. If you have super-loose skin, it won’t make the hanging skin or all those ripples disappear.
2. Radio-Frequency Assisted Liposuction: (Example: BodyTite technology) Radio-frequency energy (high-frequency electrical current) has been used in surgeries for decades. It’s also been used for external skin tightening (like Thermage). Doctors zap radio-frequency energy through the cannula to generate heat and melt the fat. Similar to laser liposuction, the energy is using precise settings to heat the skin in the area, so over several months, collagen will process and the skin will tone. It additionally heats all the fibrous tissues that connect the fat and the skin so the tightening is not just at the skin level. This procedure still takes more time than regular liposuction, and its safety and efficacy is under clinical investigation.
Warning: Again! This is NOT FDA-approved at present and only available under the study protocol.
The Ideal Patient: Someone with moderate loss of skin tone. Someone a bit older who has tried working out at the gym and can’t get rid of that annoying excess flub, muffin-top or roll. A younger person with good skin would do fine with regular liposuction.
The Cost: Both procedures start at $2,000 and go up from there, depending on the extent and areas. Expect three days to one week for initial recovery and then three to six months for final results. Surgery is best done in an accredited operating room — either a surgical suite in a doctor’s office, ambulatory facility or hospital. It’s not advisable to have this done in an office examination room or small procedure room. A patient will often need sedation or some kind of mild anesthesia. If you’re having a very small area worked on, local tumescent with a valium may be enough for you. An overnight stay is not required unless large volumes of fat are taken out.
The Bottom Line: For the best results, know that it is not what liposuction machine is used, but who is behind the machine performing the liposuction. Don’t fall for marketing schemes. Seek the advice of a reputable board-certified plastic surgeon and discuss the benefits for your individual situation as well as the risks, which for these latest technologies include skin burns or blisters, in addition to the usual side effects of liposuction. These new energy-based liposuctions need more expertise. To receive the principal benefit of skin contraction, each step in the process must be done properly and safely – and even then, the benefit may be moderate. Realistic expectations are key and best defined when speaking to your surgeon.
Editor’s Note: Dr. Haideh Hirmand is a plastic surgeon, academic and thought leader in the aesthetic and beauty arenas. She completed her Doctorate in Medicine at Harvard and is Clinical Assistant Professor of surgery at the The New York Hospital/Cornell-Weill Medical Center. She specializes in eyelid and facial rejuvenation, secondary breast surgery, and body contouring, and is recognized nationally as a pioneer in injection techniques.