COVID-19 UPDATE: As of May 11, 2020, we have re-opened our office to regular in-person appointments. We are operating at a lower-than-normal capacity in order to respect social distancing advisories and best protect the health of our patients. We are still offering telemedicine as an option. For more information please call us at (314) 996-8800.

Is SMART- or laser-assisted liposuction an improvement over standard tumescent liposuction?

Tumescent liposuction is a method to reduce pain and bruising as well as blood loss. Tumescent fluid consists of salt water with added numbing medication and a medication to reduce the size of blood vessels.

Standard liposuction involves two steps:

  1. placement of tumescence solution to reduce pain and minimize bleeding
  2. sucking out the fatty tissue.

Laser-assisted liposuction involves three steps:

  1. placement of tumescence solution to reduce pain and minimize bleeding
  2. using a laser to internally heat the treatment area
  3. sucking out the fatty tissue

SMARTâ„¢ liposuction is the name of a device made by the laser company Cynosure. It has been updated several times with more power and additional lasers to improve treatment speeds in addition to other benefits. Laser wavelengths that are used alone or in combination in various laser-assisted liposuction devices include 924 nm, 975 nm, 1064 nm, 1320 nm and 1440 nm and target blood vessels, water or the collagen in the skin. Reported benefits of laser-assisted liposuction include tightening of the skin by heating collagen and denaturing proteins, reduced bleeding by searing blood vessels, and possibly less swelling.

Dr. Terry Myckatyn, MD and Dr. Marissa Tenenbaum, MD

Dr. Terry Myckatyn and
Dr. Marissa Tenenbaum:

Trusted. Experienced. Committed.

Some scientific studies are coming out to evaluate the effectiveness of laser-assisted liposuction. At this point, the results are inconclusive. Two studies with 10 (DiBernardo et al. 2010) and 3 patients (Sasaki et al. 2010) respectively showed significantly more skin tightening of the abdomen at 3 months compared with standard liposuction. But a larger study performed in Chile showed no significant additional benefit when the laser was used in 25 patients (Prado et al. 2006). Several pilot studies have been completed looking at the effectiveness of laser-assisted liposuction. We hope that these will give rise to larger studies with better evaluation criteria looking at patients longer term to provide a clearer answer on the effectiveness of this technique.

In our experience, we prefer to use SMART liposuction for treatment of the neck and in small areas of the trunk and extremities. In these select areas, there may be some skin tightening and more rapid recovery. Still patients should understand that this is still liposuction, and therefore, still surgery.

Both types of liposuction can be performed in the office with the patient awake or in the operating room with sedation. This decision is made with the patient taking into consideration patient preference and the size of the area treated.


If you have questions or would like to book a consultation with one of the surgeons at West County Plastic Surgery, please call (314) 996-8800.

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