At the Whole Beauty® Institute in Chicago and Winnetka our patients have the choice of the two leading technologies for laser liposuction, smartlipo® and slimlipo®. There are few practices in the Chicago area that offer both technologies. In our experience with these technologies over the last few years we have come to the conclusion that there are several laser liposuction advantages over other liposuction techniques, such as classical liposuction and ultrasonic liposuction.

What are the different types of liposuction?

Liposuction has undergone a series of evolutions since it was introduced in the 1980’s. With classical liposuction the plastic surgeon makes a tiny incision and passes a metal tube with openings near the tip into the area of excess fat. The tube is connected to a suction pump, so that as the surgeon passes it back and forth, fat is removed.

Classical liposuction was improved when several surgeons discovered the advantage of introducing salt water solution with local anesthetic and a medication that shrinks blood vessels into the area to be suctioned. This makes the liposuction more efficient and less traumatic. This introduction of fluid is known as the tumescent technique and is the starting point for all types of modern liposuction.

The next major advance came when an Italian plastic surgeon discovered that certain frequencies of ultrasound were very effective in breaking up fat. To this day ultrasonic liposuction is very popular and works well. One of the most common ultrasonic technologies is known as Vaser® liposuction.

Laser liposuction is the most recent innovation in liposuction techniques. Like all other forms of liposuction, the first step is for the surgeon to fill the zone with tumescent solution. Next the surgeon passes a thin fiberoptic wand into the treatment zone and applies laser energy. This laser energy has two effects: it melts fat and tightens the area that is treated. The final step is for the surgeon to remove the melted fat from the treatment zone with a metal tube that is passed through the area of treatment while being connected to a suction pump.

Laser liposuction Is Ideally Suited to Local Anesthesia

When I began to utilize laser liposuction in my patients I was surprised how easily the treatment could be carried out under a local anesthetic in the office. Although I cannot offer scientific proof I have common sense opinions as to why laser liposuction seems to be more tolerable than either Vaser® ultrasonic liposuction or classical liposuction under a local anesthetic.

With laser liposuction only the tip of the fiber optic delivery system is hot, as this is where the laser energy is delivered. You could hold the side of the device all day and not feel any warmth. With ultrasonic liposuction the energy travels down the side of the metal tube that serves as the delivery system and then the energy is concentrated at the tip. As anyone who has worked with ultrasonic liposuction can tell you, if you touch the side of the tube when the energy is activated, it is very uncomfortable. If the patient is under general or IV sedation anesthesia, he or she will not feel this discomfort, but under local anesthetic ultrasonic liposuction can be uncomfortable.

Why is classical liposuction not the most comfortable technique under local anesthesia? There is no heat factor, since there is no energy delivered to the tip of a classical liposuction cannula, so it would seem that this should make for a more comfortable procedure. Here are my thoughts as to why laser liposuction has been more comfortable that classical liposuction in my experience. First of all the fat that is treated with laser liposuction is almost a liquid consistency. As a consequence it can be extracted in a gentler way than would be the case with a classical liposuction technique. Second, the extraction cannula that we use for removal of fat that has been melted with laser liposuction is a gentler design than a classical liposuction cannula, so there is less damage with cannula motion.

There Are Advantages to Plastic Surgery Under Local Anesthesia

Over 90% of the laser liposuction surgeries that we carry out at the Whole Beauty® Institute in Chicago and Winnetka are done under local anesthesia. A local anesthetic technique offers a number of advantages to our patients.

Patients who undergo surgery with a general anesthetic or IV sedation need to fast after midnight of the evening before surgery. As a consequence patients may arrive hungry, thirsty, dehydrated, and light-headed. All of this can be avoided with a local anesthetic technique. Our patients eat a light breakfast before surgery.

Many people have a headache if they don’t have their morning cup of coffee or tea. Our local anesthesia patients avoid this, since they can have their usual morning beverages in reasonable quantity.

The drugs given during general or IV sedation anesthesia can cause a fluctuation in blood pressure, which in some cases can be physiologically stressful. These fluctuations are avoided with a local anesthetic technique.

There is less risk of a patient developing blood clots in the legs under local anesthesia.

No IV is necessary, which makes the surgical experience less stressful for the patient.

The patient finishes a local anesthetic procedure much less groggy than she would be after general or IV sedation anesthesia.

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