Smartlipo

By David E. Berman, MD

Smartlipo is best thought of as a niche for regular liposuction. It shares certain similarities to regular liposuction but also has certain advantages over regular liposuction.

The most important factors for getting great results from Smartlipo are proper patient selection and excellent technique. The ideal patient has a relatively small area of fat in 1-3 locations. These “fat pads” can be located anywhere. The most common areas are the abdominal area, flanks (sides), saddle bags and inner thighs, upper arms and neck area.

However one area that is not commonly thought of is the bulge that many women get when they wear a bra. This creates a fat bulge from the front and lateral to their bra cup. Smartlipo can also be very useful in select cases of gynecomastia (when men get too full in the breast area).

One of the best advantages of Smartlipo is that it can be done in the office with either no sedation or just oral sedation. Most patients return to work the second day after the procedure and return to full exercise 7-10 days later.

There is rarely any significant bruising and most patients have minimal pain. The incisions are so small that they only require one dissolving suture to close the wound. The patients shower the day after the surgery.

All patients should be seen by a board certified plastic surgeon to determine if they are best served by Smartlipo or if it would be better for them to undergo either ultrasonic liposuction or another procedure such as a tummy tuck or arm lift.

When the patient returns for the procedure in the office, they are carefully marked and photographed. After that, a small amount of local anesthesia is placed where the tiny incisions will be located. After this, a very small cannula is inserted and the area is infiltrated with saline mixed with a local anesthetic (so there is no pain) and epinephrine (so there is no, or little, bruising).

A fiber-optic cable, which is very tiny, is then passed back and forth through the area where the fat is located. This cable is connected to the very technically advanced laser box, which sends two different wavelengths of laser light down the cable. This melts the fat, coagulates blood vessels (another reason why there is rarely bruising) and intentionally causes heating of the skin, which leads to skin tightening.

The latest upgrade to the newest Smartlipo machine actually has a temperature probe right on the fiber-optic cable so that the surgeon has maximum control over how much he or she heats up the skin.

After the fat is liquefied, another cannula is inserted, which removes this liquefied fat. Follow-up is usually a week or so later. The improvement will continue for 4-6 months.