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The Skinny on Liposuction

Updated on February 11, 2009

As one of the region’s leading board-certified plastic surgeons specializing in cosmetic surgery, I frequently see patients interested in body contouring procedures. At the Maryland Plastic Surgery Center, I perform hundreds of fat reduction procedures every year. Clearly, patients are interested in looking their best by winning the “battle of the bulge”.

So, what is the best way to obtain optimal body contouring? It seems that I hear or see a commercial for some type of fat reduction medication, supplement, or procedure every day. With obesity hitting “epidemic” proportions in the United States, it is no surprise that commercial ventures abound proclaiming to help us reduce unwanted fat.

Of course, the mainstay of fat reduction is to engage in a healthy lifestyle, including appropriate eating habits and adequate levels of daily exercise. Despite this basic understanding, many individuals continue to gain significant weight. In some cases, this is precipitated by a reduction in physical activity due to injury or due to hormonal fluctuations. In other cases, caloric intake exceeds caloric output. For these individuals, basic behavioral modifications are frequently needed to achieve a goal weight.

But what about those of us who eat well and regularly exercise but continue to have localized areas of excess fat? You know what I’m talking about…the proverbial double chin, outer thigh "saddle bags", "love handles" above the hips, or the "jelly roll" around the belly button – areas that appear out of proportion with the rest of your otherwise healthy physique. A procedure that removes fat from discrete areas is the answer.

Non-surgical procedures (such as “lipodissolve”, mesotherapy, or “medsculpt”) purport to simply dissolve unwanted fat using a cocktail of unregulated chemicals. Some patients do obtain improvements from these injections. However, typically hundreds of injections during multiple office visits over several months are required, with many patients ultimately finding that their expectations have not been met.

For a more reliable, predictable and faster result, localized areas of fat that are resistant to weight loss and exercise are very effectively treated with liposuction. Liposuction is a surgical procedure that removes unwanted fat and is frequently performed under local anesthesia on an outpatient basis. In this case, many patients are able to return to normal, light activities within a day or two. When multiple areas are treated, twilight sedation or general anesthesia may be preferred.

Over the past decade, a number of technologies have been adopted to help improve the results of traditional liposuction. Power-assisted liposuction (“PAL”) reduces the amount of manual effort needed, thus lessening surgeon fatigue while improving on the contouring process. Ultrasonic assisted liposuction (including “liposelection”) literally melts large areas of fat and disrupts fibrous tissue – this is especially useful in patients who require a secondary procedure.

The latest trend is laser assisted liposuction (such as “SmartLipo” and “SlimLipo”) which also melts the fat and heats surrounding tissues, resulting in the potential for some additional tissue tightening. Patients should be aware that laser assisted liposuction is a new technology that is still being refined and is NOT an appropriate solution for all patients.

It appears that the laser is useful in treating small areas of excess fat, but larger areas respond better to the other liposuction treatment methods, especially ultrasonic assisted liposuction. The term “laser” connotes an almost mystical quality where patients expect substantial improvements with no problems regardless of who performs the procedure. However, with the laser, there is an increased risk of burns and contour irregularities, depending on how the procedure is performed.

Additional technologies are currently being investigated and I expect that other options will be available in the future. Because there are so many different liposuction technologies available, it is very important to be evaluated and have your procedure performed by an experienced board certified plastic surgeon who can help you determine which body contouring procedure is best for your particular needs.

Dr. Adam Summers is a clinical assistant professor of plastic surgery and he is certified by The American Board of Plastic Surgery, Inc. Dr. Summers created Maryland’s first medical spa, The Medical Spa & Cosmetic Surgery Center, and his artwork has been featured in the National Library of Medicine. Dr. Summers has pioneered many innovative procedures, such as the One-Hour Facelift and the Laser-Chemical Peel. For more information, visit his website at or call the Maryland Plastic Surgery Center at 410-553-9444.


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