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Sarah Plumridge and Kirsten Tellam/Medill News Service

Medill Reports meets William Evans, a laser liposuction specialist, for a consultation. 


Laser liposuction melts fat away--literally

by Sarah Plumridge and Kirsten Tellam
Dec 07, 2010


LASER_womengraph

Sarah Plumridge and Kirsten Tellam/Medill News Service.

The top five cosmetic surgeries in 2009 for women. Information from the American Society of Plastic Surgeons

LASER_mengraph

Sarah Plumridge and Kirsten Tellam/Medill News Service.

The top five cosmetic surgeries in 2009 for men. Information from the American Society of Plastic Surgeons.

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Sarah Plumridge and Kirsten Tellam/Medill News Service.

Enfuse Laser Center and Medical Spa in Wicker Park.

Bonnie Bredt had always loved her body.

An active tennis player and workout enthusiast, Bredt, 58, was in perfect shape—except for one problem area.

“My middle looked like I had a spare tire,” said Bredt, who lives in Philadelphia. “I couldn’t stand it. I sell clothing for a living and when I put my clothes on I would cry. I wanted to go back to high heels and bikinis.”

Bredt looked into liposuction as a way to remove some mass from her stomach, but said the prospect of going under a general anesthetic and the long recovery process were unappealing. So she turned to the newest technology available to whittle her middle: laser liposuction, in which fat is melted with a laser before being removed from the body.

Ryan Tsujimura, a Phoenix-based plastic surgeon, said laser liposuction has been Food and Drug Administration approved in the U.S. for three years and in practice in Europe, South America and Asia for about 10. While he refers to the procedure as “laser assisted liposuction,” many patients refer to the procedure by popular brand names, including SmartLipo and SlimLipo, he added.

“People come in saying, ‘I want laser lipo,’” Tsujimura said. “They usually use that term SmartLipo since that was the first one out and they did a lot of marketing for it. It’s a real popular procedure. People hear about it, read about it and they actually come in asking for it.”

Laser liposuction can be done in two ways. The first is what Tsujimura referred to as a “lunchtime” procedure, in which the doctor uses a local anesthetic on the area to be treated. He said doctors use a tumescent formula, which contains lidocaine, epinephrine, and saline and is standard in all liposuction procedures, underneath the fatty area. It helps minimize the pain and constricts small blood vessels, which reduces bleeding.  Tsujimura said the doctor then lasers the area, melting the fat.

“It’s not a lot, it’s not a huge difference after you do it that way,” Tsujimura said. “You’ll see some improvement, you’ll see some treatment of the area.” He added these patients usually have to come back five weeks later to have the procedure repeated.

As a plastic surgeon, Tsujimura prefers the second form of laser liposuction, which involves both a laser and the suction typical of standard liposuction. Patients go under general anesthesia and can have more fat removed with a cannula, which is a long, thin tube that sucks out fat cells during liposuction.

“I’ll laser the area, melt the fat so it turns the fat into this emulsified, oily liquid,” Tsujimura said. “But then I go back in with a small suction cannula and do suction and removal of that. And I know what it’s going to look like at the end of surgery, so I don’t expect them to have to come back five weeks later and do another procedure.”

Mir Jafer Joffrey, medical director of the Liposuction Institute of Lift Laser and Body in Chicago, agreed that laser liposuction isn’t as effective at fat removal as standard liposuction.

“It is not really a magic wand in any sort of way, it is a great skin tightening technique is what it comes down to,” Joffrey said. He added the laser energy tightens the patient’s skin for up to three months after the initial procedure.

Joffrey said laser liposuction doesn’t save a patient any recovery time, contrary to popular belief.

“If you look at advertisements for Smartlipo, Prolipo, whatever all these laser liposuctions they make it seem like you have less down time,” Joffrey said.  But he noted it is only because patients have smaller amounts of fat removed with laser liposuction than with standard liposuction that they have a faster recovery time.

Tsujimura said most of the risks associated with laser liposuction are the same as in standard liposuction. These can include contour irregularities or volume shifts from removing too much fat or anesthetic-related problems. Joffrey said there was a risk of burning the skin or the fat during a laser liposuction procedure.

“The biggest risk, or the main risk is that you burn the skin or that you burn the fat,” Joffrey said. “Then you have dead fat lying in there and it is a cause for infection.”

Joffrey said the cost of the procedure depends on which areas are being treated. He said for a single area laser liposuction might cost $3,500, but that most patients usually get two areas treated at once. He said this can cost between $5,000 and $6,500. Insurance usually doesn’t cover cosmetic surgeries like laser liposuction.

Samuel Klein, professor of medicine and nutritional science at Washington University in St. Louis said laser-assisted liposuction “doesn’t seem to have an effect on metabolism.”

Klein’s research is in metabolism in humans. He does clinical research in obesity and nutrition. 

“Liposuction makes patients move better and be more active but does not improve blood pressure or insulin levels,” he said.

Klein does not recommend patients get the procedure because it does not have an effect on the body other than cosmetic changes.

Chenese Lewis, a plus-sized model and president of the Hollywood chapter of the National Organization for Women, said she thinks plastic surgery like liposuction is popular because of America’s cultural ideals.

“Our society generally celebrates one form of beauty—it’s thin, it doesn’t diversify beauty of different sizes, shapes and colors,” Lewis, 31, said. “The problem some people have is low self esteem. It doesn’t matter how much lipo you get, it doesn’t improve your quality of life. They’re never satisfied. The real thing they need to work on is their beauty inside.”

Lewis added that plastic surgery tries to encourage “perfection” in society, particularly among women.

“I think usually people do it to try and create a perfect image of themselves, but no matter what you do you’ll never be perfect,” Lewis said. “There is so much more a woman has to share with the world than outer appearance.”

Bredt agrees.

“You can’t worry about being perfect or not perfect,” she said.  “You’ve gotta get the new attitude of looking good for your age. Love your body.”

Bredt added she didn’t get laser liposuction because she was unhappy with herself as a whole.

“It’s very important that I already loved my body” prior to having the procedure done, she said. “I didn’t like one area of it. That doesn’t mean I wasn’t happy with myself.”