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Dear Dr. Seckel, I am considering laser liposuction. I have a small amount of belly fat and loose skin on my tummy after having 3 children. I also would like a little fat removed from my hips and thighs. I have read a lot about laser liposuction and it sound like it is a better treatment than the older liposuction. I have read that skin tightening is better with laser liposuction and the skin is left smoother. I have read about SmartLipo, Cool lipo, SlimLipo and Lipotherme. I am not sure which ones are available in the Boston area. They all sound great on the internet. Is there a big difference between one laser liposuction machine and another? How does one make the right choice? Thank you, Michelle, Boston, Massachusetts.

Dear Michelle,

Thank you for your question about laser liposuction. There is a great deal of enthusiasm for laser liposuction today. There are some potential advantages to the laser liposuction technique, but the most important thing for you is to find an experienced, expert, board certified plastic surgeon that you are comfortable with and trust.

The doctor who does your liposuction is much more important than the particular technique that is used. I always recommend consulting two board certified plastic surgeons and choose the one who you feel most comfortable with and feel you can trust. Ask this doctor about laser liposuction and the techniques that he or she use.

Having said that, I do use laser liposuction and feel that there are advantages of laser liposuction over the older techniques in my hands. My results so far in my Boston area patients have been very good, see before and after laser liposuction pictures below:

Before and after SlimLipo laser liposuction body sculpting of the upper and lower abdomen and mini tummy tuck

Before and after SlimLipo laser liposuction body sculpting of the upper and lower abdomen and mini tummy tuck

The main advantage that I see so far is smoother skin after laser liposuction, tighter skin, and fewer contour deformities, in my experience. The laser liposuction fiber melts the fat into a liquid, which makes fat removal easier, using smaller cannulas.

There are several laser liposuction machines available and they all work. I use the SlimLipo laser liposuction machine which I believe has the advantage of using a very specific laser wavelength that is uniquely absorbed by fat. The other laser liposuction technologies primary target is water, not fat, so the actual fat melting process is less efficient, in my opinion.

To more specifically answer your question, I am reprinting below an article that I recently wrote which compares some of the various laser liposuction machines that are available.

There are very significant differences between the major laser liposuction machines in use today. Because of patent restrictions, many companies have had to use wavelengths that are not the most effective for fat removal. In the article below I will first try to explain the procedure and then describe the technologies used in the most widely used machines.

How Does Laser Liposuction Work?

Older standard suction assisted lipectomy techniques removed fat by inserting a metal tube called a cannula beneath the skin to remove fat by aspiration with high powered suction. The fat cells are actually ruptured and sucked out from beneath the skin. Other supporting tissues beneath the skin are also removed. This procedure is quite traumatic and can produce bruising and swelling and post operative pain which can lead to a prolonged recovery. Results for fat removal are excellent, however lack of uniformity of skin appearance and loose skin after the procedure have been reported in as many as 20 % of patients.

The new laser liposuction technique first involves the placement of a tiny laser fiber beneath the skin to melt or liquefy the fat before removal. This allows for a much less traumatic fat removal because much smaller aspiration cannulas can be used and there is less tissue trauma and injury to the non fatty tissues.

After the laser fat melting process a small cannula about half the size of the older cannulas is used to remove the liquefied fat. In addition, the heat generated by the laser causes the skin to tighten, and results in my Boston area patients have shown improved skin tightening following laser liposuction.

In addition to liquefaction or melting of fat, many more fat cells are injured by the laser and are reabsorbed by the tissues, so that fat volumes are typically less using this new technology.

SlimLipo Machine

SlimLipo laser liposuction uses a patented 924nm laser wavelength to melt fat. The 924nm laser is the most specifically and highly absorbed laser wavelength by fat tissue. The 924nm laser melts 3-5 times as much volume of fat as the other wavelengths in use today. The SlimLipo uses a 924nm/975nm blended wavelength for skin tightening effect.

SmartLipo MPX Machine

SmartLipo was the first laser liposuction machine on the market. The original SmartLipo used a 1064nm wavelength to melt fat. The target of the 1064nm is water, thus the SmartLipo melted fat by heating the water in the fat and the fat is melted secondarily.

Recently, SmartLipo MPX laser liposuction has been introduced, which uses a combination 1064nm and a 1320nm laser to improve fat melting. Below you can link to a video which shows a comparison of the fat melting power of the SlimLipo vs. the SmartLipo MPX technology:

Video comparing SlimLipo to SmartLipo and Lipotherme.

Cool Lipo Machine

Cool Lipo laser liposuction uses a 1320nm laser wavelength to dissolve fat. Although the 1320nm wavelength has better fat absorption than the 1064nm wavelength, water is still the primary target of the 1320nm. Thus the fat melting mechanism is the same for the 1320nm as with the 1064nm used in SmartLipo.

Lipotherme Machine

Lipotherme is a new entry in the laser liposuction field and uses a 980nm wavelength for fat melting. Again the primary target of the 980nm wavelength is water, so again this new technology melts fat by first heating water rather than by fat absorption of the wavelength.

Why is Laser Wavelength Important in Laser Liposuction?

The importance of using the appropriate wavelength to melt fat is that the greater the absorption by the fat of the laser energy, the easier and more complete the fat melting process. This is graphically demonstrated in the video link above.

Not only is the 924nm wavelength used in SlimLipo capable of liquefying 3-5 times as much fat per unit of energy as the other technologies, but the fat melting mechanism is entirely different. The 924nm is completely absorbed by fat and a much larger area of fat is dissolved. The other lasers which use water targeted wavelengths have to heat water to boiling and the water the heats ad destroys the fat. This water heating process is slower, less efficient and as can be seen in video is essentially chipping away at fat.

The heat generated by the water absorbed lasers is also a concern as the higher temperatures generated by the water heating lasers may be more prone to cause heat injury or burning, in my opinion.

I have had excellent skin tightening using the SlimLipo machine and have been able to actually do laser body sculpting in even thinner patients with small areas of fat to be removed.

I have also been able to remove lumps and smooth the skin of patients who had had a previous old time non-laser liposuction which left skin irregularities after recovery. See before and after pictures below:

Before and after pictures of SlimLipo laser liposuction to smooth skin irregularities caused by previous non-laser liposuction

Before and after pictures of SlimLipo laser liposuction to smooth skin irregularities caused by previous non-laser liposuction

Who Should Do Your Laser Liposuction Procedure?

Laser liposuction is a surgical procedure no matter what the internet marketing campaigns imply. My opinion is that I personally would only want a Board Certified Plastic Surgeon performing this procedure on me or one of my loved ones.

Be very careful and study the credentials of your doctor. There are many doctors today who advertise themselves as Cosmetic Surgeons who have never had one day of surgical training. Check the credentials of your doctor by visiting the website of the American Board of Plastic Surgery.

There are many Board Certified Dermatologists who do this procedure and I am sure some are very good. However when you have surgery of any kind, It is essential that your doctor has had the appropriate surgical training to take care of you if something goes wrong.

Do your homework and protect yourself.

Dr. Seckel

Concord, Massachusetts
Boston, Massachusetts