Exchanging Clinical Information and Treatment Protocols about Laser Assisted Liposuction. SmartLipo and the others.

This area is going to grow significantly and is going to change a lot. I think we are going to see changes in optimal wavelengths occur.

Currently available in the US:

1. Cynosure SmartLipo - they are now "multiplexing" the 1064 and 1320 wavelengths. I have not seen one study that makes this a superior over others.

2. CoolLipo- 1320nm you buy the laser and then you have to pay to use it on a per use basis.

3. Sciton ProLipo - They have FDA approval for the 1064 currently at 20 watts but they can easily do 40 watts. They should be getting 1319 FDA approval soon which they will have 15 watts. I here they have other research coming on laser lipo.

4. Palomar SlimLipo - it is 920nm and also a blended 920/980. (these are the wavelengths that you will see but I think the actual wavelengths are 924nm/975). they theory is that the 920 does a better job on the fat than any of the other wavelengths and the 980 give better subdermal heating than the 920nm.

5. Syneron LipoLite - 980nm

6. LaserTight - 980nm

I have talked to many user of the various systems and not one of them feel that they are stand alone procedures. All feel that you must at least do mechanical suction with it.

I have been doing research on this stuff over the last 6 months and my current feeling is that a diode wavelength somewhere between 914 and 925 are going to be the best and least expensive lasers to use for lipolysis. There are 3 main peaks for fat absorption they are around 920,1210 and 1700's. As you can see the 2 most common wavelengths (1064/1320) are not in this. the other 2 wavelengths are much more expensive to produce.

As I have talked to many users, most feel that the 1319/1320 wavelengths are the best choice for subdermal heating. Thus giving you skin tightening. I talked to one person that has used the Smartlipo, SlimLipo and the Sciton 1319. He feels that if he had his way he would use the 920 for lipolysis and the 1319 for skin tightening.

I have personally been hounding one of the companies to make such a system.

I still think there are many questions to be answered and i am frustrated that not one of the companies can give a straight forward answer. It seems as though the companies do just enough research to get FDA approval and then they stop. I wish they would really do more research to help find what is best not just another way to sell their laser.

LH, excellent summary.
We have access to the president of LaserTight if you would like to correspond with him.
Send me an email and I will forward.

Jeffrey E. Epstein, MD : JEE
Jeff4459@aol.com

Jeff,

I have already spoken to Michael.

Synerons LipoLite uses an Nd:Yag at 1064nm , not 980nm as you wrote above.

JK,

You are correct.

LH

Does anyone have experience using Ultrasonic Lipo? Do you get any skin tightening from this modality alone?

Does anyone have experience using Ultrasonic Lipo PLUS Laser?

Equipment selection in this area is really challenging - so many choices and so little data available.

Stephanie,

If you are a physician, I would go to Dr. Jeffrey Kleins course in California. He is the doctor that invented the tumescent technique for liposuction. The course is called liposuction 101. He does an excellent job of teaching tumescent lipo and goes through the different modalities.

I saw Jeffrey Klein lecture at R. Rox Anderson's Harvard Course. He was excellent. I would guess that his course is excellent. ps. he tells the truth (what he really thinks). He says that he is a skeptic and a cynic. We need more experts like him (rather than those who will say anything if you pay them enough!).

Just wondering if anybody has used Syneron's Lipolite ? Is it getting any traction ?

I've been using the Smartlipo since its inception 2 years ago. I only have a 6 watt system because I don't see the sense in spending another $40K for a few more watts. At 6 watts of power and with the absorbtion coefficient of the ND:Yag, it causes liquifaction of fat at a rate of 1cc/min. A 12 watt system would therefore only "melt" fat at a rate of 2cc/min. To liquify fat you need to bring the temperature above 65-70 degree C from room temperature. Not only must one heat the fat, but also the surrounding tumescent fluid, therby decreasing its efficiency.
If one, on average removes 1500cc of fat from the abd and love handles, you can easily calculate that it would take over 25 hours of lasering to get the same results as plain old liposuction with a canula, which takes approximately 3 hours.
I use my smart lipo selectively. It is fantastic on the neck and jaw line as there is usually only 30-50cc of fat to remove.
I also use it for "touch ups" in areas where there is some lumps remaining a few months after tumescent lipo. I also use it at the end of my case to smoothout uneven areas...its great for that.
It is definitely not a stand alone piece of equipment except in very limited circumstance.
The real benefit of Smartlipo is its marketing apeal.
Just one lipo docs opinion...

Thanks for the feedback. Appreciate it. But isn't syneron's Lipolite more cost effective ? Also, what is the marketing appeal that you spoke about ? Thanks

Does anyone have the user/instruction manuals for a 6 or 12 Watt SmartLipo machine? Photocopies would be fine with me and I would be happy to pay for it. I just bought a 6 upgraded to a 12 but the manuals were not included.

Lipodoc: did you see the study in Dec 09 ASLMS journal - 10 W with smartlipo machine no different than standard tumescent liposuction? You might want to re-consider that upgrade....

This is in response to the comment by lipodoc. I am really frustrated with my 12 volt smartlipo. very minimal results. I won't use it even if someone will give it to me free. My patients are very unhappy. I do not have "25 hours" to do a liposuction. I really really need to get in touch with someone else who is going through similar pain as me as I know we can help each other. The more people who can join me, the better it will be for all of us. PLEASE REPLY. Thanks so much.

What does Dr Jeff Klien think about laser liposuction? I am interested in knowing.