SmartLipo technology was designed to improve skin tightening after liposuction. SmartLipo is a surgical method that users lasers to dissolve fat before removing it from the patient’s body.
SmartLipo also can create a high definition sculpting outcome. It allows for the possibility of sculpting the patient’s body by moving beyond simple fat removal and into the realm of muscle definition. SmartLipo can be accomplished using oral sedation and a wetting solution of local anesthesia, where the patient is awake yet sedated with minimal discomfort. This increasing the safety and lowers the anesthetic complications. SmartLipo may provide for less bruising, more skin tightening, more fat removal and may allow for a faster recovery.
Unfortunately for some many patients, the ideal body cannot be attained with diet and exercise alone. Exercise can facilitate weight loss as well as augment the size of one’s muscle mass, further improving the bodies appearance. If you have a stubborn area of fat that is resistant to vigorous activity, Liposuction might be a great option for you.
There are currently numerous medical technologies marketed as adjuvant therapies in liposuction procedures. Dr. Robert J. Troell is performing the first study designed to directly compare two laser lipolysis technologies of different wavelengths known as SmartLipo and SlimLipo.
The two laser technologies are SmartLipo (Cyanosure) using an end light fiber at 1064 nm, 1320 nm and 1440 nm wavelengths of LASER energy (Multiplex). This is a pulse laser wave form and the temperature at the laser tip can reach 850 degrees C.
Alternatively, SlimLipo (Palomar Medical Technologies) uses an end light fiber at 924 nm and 975 nm wavelengths of LASER energy. This is a continuous laser wave form and the laser tip temperature reaches about 70 degrees C.
Laser Procedure Technique
The history and physical examination including appropriate laboratory and cardiac testing are updated and the patient fully consented prior to the procedure. On the day of surgery photographs are taken. The skin of the area to undergo liposuction surgery is marked with a sharpie marking pen noting areas of excess fatty tissue and areas where there are indentations using different colors with circles for excess fat and lines for areas of indentations. The area is marked in grids of 4 x 10 cm to assist in laser energy delivery.
Patients are offered preoperative oral sedating and pain medication (usually intravenous Tylenol) and received oral antibiotics. Team members and the subject were protected by special eyeglasses. A small incision is made near each zone permitting access for treatment. Each of the 4×10 cm target zones is treated with the manufacturer recommended laser energy levels.
Deep and shallow sub-dermal temperatures, as well as surface skin temperatures, were recorded simultaneously in each panel by the manufacturers temperature control software. After the surgical procedure is completed, each incision was approximated with a single suture. Subjects were dressed with super absorbant pads over the incisions and a compression garment for at least 2-3 weeks.
The patient is prepped with a prep solution, such as chlorhexidene, and sterile drapes applied. Anesthesia was delivered in the form of a wetting solution prepared in a one liter normal saline bag combined with between 80-100 cc of 1% lidocaine, 1.0 – 1.5 mg of 1:1,000 epinephrine and 10 cc of 8.4% sodium bicarbonate. The wetting solution is administered by an infiltration cannula to each of treatment areas using a superwet technique.
Laser energy needed to treat each area is determined by the surgeon with the amount of energy per treatment area of 5000-7000 Joules (J) with a treatment duration of about ten minutes for a 20 x 20 cm area. The skin target temperature is between 37-40 degrees C.
Liposuction is usually performed after the laser treatment, although some physicians will perform the laser after the removal of fat to optimize skin tightening with more LASER energy absorbed by the skin.
What can be expected during the recovery from SmartLipo?
Postoperative antibiotic and pain medications are prescribed. A compression garment is worn for three weeks to assist in providing a smooth skin contour and lower the risk of post-treatment fluid collection (seroma). Many of our patients undergoing Liposuction on one to three areas of their body return to work within a 2-4 days after their procedure.
What are the aesthetic outcomes of Laser Lipolysis?
What are the Liposuction Results Comparing SmartLipo to Slim Lipo?
Dr. Troell is completing an Investigational Review Board (IRB) randomized, prospective study evaluating the efficacy of FDA cleared medical devices for laser lipolysis, specifically Smart Lipo and Slim Lipo.
The study will include six (6) subjects in each arm of the study with the patient receiving one modality on one side of the body and a different modality on the opposite side.
A direct comparison of the efficacy of different laser wavelength technologies related to laser lipolysis.
It is known that the optimal fat absorption wavelength of energy is at 915 nm, 1208 nm, 1700 nm and 2300 nm. From previous in-vitro studies of porcine fat in an aqueous environment (water), the 924 nm wavelength was superior over the 980 nm or 1064 nm wavelengths. Because of this data, the hypothesize of the laser lipolysis study is that the Slim Lipo device (924 and 975 nm wavelengths) will yield superior results liposuction results as compared to Smart Lipo (1064, 1320 and 1440 nm wavelengths). Thereafter, the laser device with the best outcome will be directly compared to ultrasound (VASER) technology.
Ultrasound and laser based energy technologies are used in liposuction and in treating cellulite. Using these devices in a direct comparison on the same patient will determine the most efficacious methodology.
- Energy Based Adjuvant Technologies in Liposuction:
- SmartLipo vs. Slim Lipo
- Laser Lipolysis (best method) vs. VASER ultrasound Lipo
Using the treatment protocol recommendations by each medical device manufacturer, the results of treatment are directly compared using patient questionnaires, external ultrasound measurements, body skin temperature measurements, circumference measurements, skin elasticity measurements (Elastometer), skin tightening measurements and photographic documentation.
All subjects are followed at one week, two weeks, one month, three months, six months and one year post-treatment.
The results of the study are continually being acquired and the final data will take about 18 months from the start of the study to be completed.
Dr. Robert J. Troell, MD, FACS (Las Vegas)
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