Laser Liposuction-Does it really work?

Over the last one to two years, I am sure you have noted the massive explosion in the number of magazine ads promoting laser liposuction.  Many patients have asked if I perform this procedure and how well does it work?  As I am always interested in providing my patients with the latest and greatest in technological advances, I set out to find as much information as possible on the subject and to seek the opinions of nationally respected plastic surgeons as to the validity of this new treatment method.

Laser liposuction involves the introduction of a fiber optic probe below the skin. Through this probe, laser light is introduced for the simple purpose of heating the tissue in the area to be treated.  Although different manufacturers have devices that produce slightly different wavelengths of light, the goal is the same; to dissolve fat without damaging the surrounding tissues.  Unfortunately, the optimum light wavelengths that deliver the “most energy” to an area to dissolve the fat may also unavoidably pose the most danger to the surrounding skin.

Laser liposuction manufacturers also advertise the machines ability to tighten loose skin.  This desirable effect is supposedly accomplished by imparting energy (heat) to the collagen contained in the skin.  This concept is not new, as it was the working principle for the previously popular use of the CO2 laser on the skin surface to attempt to tighten facial skin.  The basic concept appears to be an attempt to impart enough energy or heat to the skin, this time from the inside-out, to be able to cook and tighten it, but not burn it.

So what do I think from reviewing all of the technical information and literature available? I was not very impressed.  As I have not personally performed this procedure I wanted to seek out the opinion of well recognized plastic surgeons that have had experience with this technology.  Their conclusions were as follows:

1. The new found popularity of laser liposuction appears to be primarily attributable to the manufacturers of these $100,000(+) machines who provide the individual physicians who purchase these devices a sizable advertising budget to attract patients.
2. There appears to be very little in the way of well controlled scientific studies to validate the effectiveness and safety of these machines.
3. Laser liposuction does not appear to be a more effective or superior method to remove fat as compared to conventional liposuction.
4. The claim that laser liposuction significantly tightens skin appears to be very questionable.
5. The amount of energy or heat that would be required to possibly affect or tighten the skin appears to be dangerously close to the heat level that would damage or burn the skin.
6. Laser liposuction machines are being provided by their manufacturers to a large number of physicians in a wide variety of specialties such as dermatologist, Ob-Gyns, family practitioners, etc., who have never performed liposuction and have minimal or no experience with aesthetic surgery.

In summary, laser liposuction is an interesting and potentially promising addition to our armamentarium to fight unwanted fat.  But I feel it capabilities and utility are being grossly oversold and promoted.  Most patients with significant Lipodystrophy issues will be more effectively treated with conventional techniques that allow the surgeon to aggressively treat problem areas with the danger of heat damage to the overlying skin.

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