These two groups represent the standards of care for liposuction that can still be found in practice today.  General plastic surgeons distinguished their technique from the dermatologists by favoring low-volume wetting solution and general anesthesia.  This approach is associated with significant blood loss; hospitalization; extended recovery periods; and a death rate as high as one in 5,000 cases.  Alternatively dermatologists prefer local anesthesia.  In 1985, Jeff Klein, a dermatologist, developed the method of tumescent liposuction, which uses relatively large volumes of dilute local anesthesia to numb the fat being removed.  This method had significant advantages over other methods and patients undergoing this form of liposuction did not require blood transfusions, hospitalization, and a very low death rate estimated to be one death in every 300,000 cases.

What began as a failed experiment has since evolved into a relatively safe procedure called tumescent liposuction.  Tumescent liposuction is performed under local anesthesia and has very little down-time during recovery.  For this technique, the doctor inserts a small cannula into a small incision that heals quickly.  Laser liposuction, a recently-introduced technique, is a variation on tumescent liposuction in that it also uses a cannula and is invasive.  The significant difference between traditional tumescent liposuction and laser liposuction is that the cannula used in laser liposuction has a small laser attached to the end.

Laser Liposuction vs. No Laser

Laser-based liposuction systems are touted in marketing as the newest and most effective form of fat removal and body sculpting.  Although lasers sound sexy and precise, like something out of a science fiction movie, they have not always lived up to the marketing hype.  Carbon dioxide laser resurfacing, for example, has left thousands of women with scarred or depigmented skin.  In contrast, Zerona® laser treatment, which has never been independently peer-reviewed or scientifically proven to be effective, is unlikely to cause any harm.  So why do doctors continue to push laser-based procedures?  The answer is based on money; once doctors sign a 6-year lease or buy these very expensive machines, they feel obligated to earn their money’s worth by pushing their patients into the service whether it is right for them or not.

The hype surrounding laser-based liposuction machines with unrealistic before and after pictures are equally misleading.  Typically these before and after pictures show a flabby stomach next to a rock-hard etched stomach.  These pictures could show the same person, but it is unlikely the differences were the result of laser liposuction.  The chiseled stomach is most likely the result of laser liposuction in combination with a carbohydrate free diet, hundreds of hours in the gym, and photoshop.  There is no evidence that the device is better than tumescent liposuction or any other form of liposuction.  The incisions required to insert these devices under the skin are larger than those needed for the microcannulas.

Invasive vs non-invasive procedures

Smartlipo™, or laser liposuction, is more effective than non-invasive body-sculpting methods such as Zerona Laser Treatment.  Although the web is awash with testimonials from allegedly satisfied customers of Zerona, there are no valid peer-reviewed studies showing that this method of shining a low-intensity laser on the skin has an effect on the fat cells targeted by this type of treatment.  Changes in body fat associated with this treatment may have more to do with the recommended diet and exercise advised when having this treatment.

Tumescent Liposuction under local anesthesia with mild oral sedation is the safest technique to eliminate those stubborn fat cells. Tumescent liposuction causes minimal tissue trauma, nearly no blood loss, and a fast recovery.  Dr. Steinsapir uses a dilute local anesthetic, which is infiltrated gradually into the fatty areas, and removes the fat with a microcannulas, or very small cannulas.  A microcannula takes out smaller amounts of fat with each pass offering a highly refined method to control how fat is sculpted.  Using microcannulas reduces the size of the incisions required and the amount of trauma to the surrounding tissue.

About Dr. Steinsapir

Dr. Steinsapir is an expert cosmetic plastic surgeon who has skillfully handled liposuction procedures in Los Angeles and Beverly Hills for over 20 years.  He only performs tumescent liposuction under local anesthesia because of its superior results and fast, comfortable recovery time.  He is a board certified surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of liposuction.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

Safe, Non-invasive, Effectiveness Questionable

Despite the testimonials of allegedly satisfied patients who have had Zerona Laser Treatment, there is no independent, peer reviewed studies showing that this treatment is effective.   Individuals reporting on RealSelf.com have raised significant questions regarding the effectiveness of this treatment.  Interestingly, the Zerona Laser Treatment protocols also call for altering your diet.  Any calorie restriction that is severe enough is likely to cause weight loss.  This does not mean that also shining a laser at your body further enhances the body contouring simply caused by a calorie restriction.  It is unclear if the Zerona Laser is more effective than shining a laser pointer at your body.  What does appear accurate is that this treatment is probably completely safe.  However, if you spent thousands of dollars for a treatment that is supposed to contour your body and are disappointed, this may be of little solace.

Zerona vs. Laser Liposuction

Zerona Laser is not surgery or liposuction.  It is simply a fancy low energy laser shined on the skin.  The treatment is a bit of a light show so one might have the impression that it is actually doing more than it is.  However, it is not a surgery or invasive procedure.  In contrast, Smartlipo™, or laser liposuction uses a small cannula assisted with a laser.  The aspect of the surgery that seems to please most patients is that their liposuction is performed under local anesthesia with a mild oral sedative.  Like tumescent liposuction, the down time for laser liposuction is minimal under local anesthesia.  The results are comparable to what can be accomplished with other methods of performing liposuction under local anesthesia.

Unlike Zerona Laser Treatment, laser liposuction is similar to tumescent liposuction in that local or general anesthesia is administered and the procedure is invasive.  Laser liposuction yields visible and proven results only because it is essentially tumescent liposuction ― the laser has no scientifically-proven impact on the procedure.

Why all the hype?

Marketing people understand that the public is fascinated by lasers and is under the impression that any treatment with laser must be better.  However, due to a loophole in how the FDA approved devices, manufactures only need to show that these devices are safe.  This is a much less rigorous standard that drugs are held to.  Drugs must be proven both safe and effective.  So when a company reports that their device is FDA approved, the public may think that devices also must meet the safe and effective standard; is not the case.  Consequently, device manufactures have more leeway in marketing their devices compared to drug manufactures.  Care is therefore needed in assessing device claims.

About Dr. Steinsapir

Dr. Steinsapir is an expert cosmetic surgeon who has skillfully handled liposuction procedures in Los Angeles and Beverly Hills for over 20 years.  He only performs tumescent liposuction under local anesthesia because of its superior results and fast, comfortable recovery time.  He is a board certified opthalmologist and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in cosmetic surgery with an emphasis on minimally invasive techniques and surgery, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of liposuction.

The areas that commonly concern women include the inner and outer thighs, inner knees, stomach, and flanks. In men the common areas of concern are the love handles, stomach, and flanks. Less common areas include the tail of the breast in women and the breast area in men. Liposuction is one of the most popular cosmetic procedures. However, it is essential to understand what liposuction can and can’t accomplish. How liposuction is performed, and what factors contribute to make liposuction unsafe.

Even though liposuction is one of the most widely performed cosmetic methods, there remains a lot of confusion about the best way to perform liposuction and when it should be performed. Dr. Steinsapir, a renowned Eye Plastic and Cosmetic Surgeon in Los Angeles and Beverley Hills, provides his input on liposuction by presenting the following valuable facts…

Liposuction: Not a Quick Fix for Your Weight Problem
Liposuction is a body sculpting technique and not a weight reduction procedure. Liposuction improves your silhouette by getting rid of the fat that is localized to only certain areas of the body. As such, the surgery is best for individuals with stable weight. If you regularly yo-yo in weight more than 15 pounds, then liposuction is probably not right for you.
It is a misconception to think that you will lose weight from liposuction. You will not. While fat is removed from the body surgically, the swelling that follows usually more than compensates for the fat removed. The reality is that only two things determine our weight: How much we eat and how much we metabolize.

It is completely normal to regain the fat that has been removed, but due to the sculpting of the body with liposuction the fat that returns is more evenly distributed over the entire body, rather than getting disproportionately re-deposited in the problem areas. Your body weight primarily depends on two factors, the quantity and quality of the food that you consume and your metabolic rate. The only way to lose weight is to increase your metabolism by regular exercise and follow a healthy diet. No form of liposuction will cause you to weigh less.

Tumescent Liposuction: The Safest Liposuction Technique
Pure Tumescent Liposuction under local anesthesia is the safest technique to eliminate those stubborn fat cells. Widely acclaimed for his minimally invasive treatments, Dr. Steinsapir practices tumescent liposuction in Los Angeles because it causes minimal tissue trauma, nearly no blood loss, and a fast recovery. To execute this procedure, Dr. Steinsapir uses a dilute local anesthetic, which is infiltrated gradually into the fatty areas, and the fat is removed by micro-cannulas or very small cannulas. A microcannula takes out smaller amounts of fat with each pass offering a highly refined method to control how fat is sculpted.

Liposuction: Under General Anesthesia or Local Anesthesia?
The major difference between liposuction under general anesthesia and local anesthesia is safety. Liposuction under general anesthesia is much more profitable for the surgeon than doing liposuction under tumescent local anesthesia. The same liposuction that can be done in 45 minutes under general anesthesia may take about 3 hours to perform under local anesthesia. This means that surgeons who do liposuction under general anesthesia can do 3 times the number of cases in the same time frame. This is why liposuction is still performed this way.

However, you pay a huge price for your doctor’s convenience. The death rate due to liposuction under a general anesthesia has been estimated as 1 in 5000 cases, which is alarmingly high. Compare with the death rate associated liposuction under a local anesthesia, which is estimated as 1 in 500,000. This proves that liposuction performed under local anesthesia is much safer than performed under general anesthesia.

There are additional benefits for doing liposuction under local anesthesia. For one, with much few drugs in your system, you recover much faster. Instead of being hung over for days with a general anesthesia, you feel very much yourself the next day. There is far less trauma with liposuction under local anesthesia. The reasons for this are straightforward. When you are under general anesthesia, surgeons tend to do very aggressive liposuction with larger cannulas. This means that you are severely beaten up during surgery. It can take 6 to 8 weeks before the body recovers from this type of trauma. Blood loss can be so severe that a blood transfusion and hospitalization are needed. Not so with tumescent liposuction under local anesthesia. Liposuction is done with very small micro-cannulas and a pace that is comfortable for you. This means much less trauma, much more rapid recovery, and minimal blood loss. Hospitalization and blood transfusions are not reported in large studies of this technique. Most people return to their work out in two days with some soreness.

Laser Liposuction vs. No Laser
Laser based liposuction systems are being touted in marketing as the greatest thing since sliced toast. The marketing proposition is very compelling: lasers are sexy. It is practically a sure fired sales pitch. It works equally well on doctors and the public. However, think about another laser service: CO2 laser resurfacing. This has been and continues to be a huge disaster for the public. There are literally thousands of women out there with scarred or depigmented faces out there. Even after these complications were recognized and there was a public backlash, docs were out their performing these awful procedures. The reason was simple. Once you sign a 6 year lease or buy these very expensive machines, every one coming into your office has to be pushed into the service whether it is right for them or not. I know one doc who tells his patients that their faces will be depigmented by the service and there will be a line between where the face was treated and the neck skin where treatment stopped. At least he is honest about what this treatment does.

We are seeing a similar type of hype with the laser based liposuction machines with unrealistic before and after pictures. Typically these show a flabby stomach in the before and a rock hard etched 6-pack stomach in the after picture. Sure, this could be the same person but it is impossible that the only difference was laser liposuction. Try laser liposuction plus a carbohydrate free diet, hundreds of hours in the gym, and a little photoshop. Again, these machines cost over a hundred thousand dollars. Once a doc buys the machine, everyone is going to be pushed into this procedure. There is no evidence that the device is better than tumescent liposuction or any other form of liposuction. The incisions needed to insert these devices under the skin are larger than those needed for the microcannulas. The bottom line here is that you will be bearing the expensive of this pricy machine with no evidence that it is any better that pure tumescent liposuction under the safety of local anesthesia.

Liposuction: The After-Effects
It is common to experience a lumpy firmness after liposuction due to the inflammation caused by the surgery in the fatty areas. This inflammation gradually subsides in 4-6 weeks, as the body begins to heal from the surgery. Due to long term remodeling of the fat, the body continues to improve over a period of 4 to 6 months. It is common to experience soreness and bruising after the procedure. Generally most people take two or three days off from work and return to their work out in two days. Compression garments are provide with the procedures and are used for 5 to 6 days. Compare this with other liposuction techniqueswere compression garments need to be worn for 6 to 8 weeks.

Contact Dr. Steinsapir today for a Liposuction consultation and discussion that is perfectly tailored to your needs, concerns and desires.