I need input into which of the following systems is better for LASER assisted lipolysis. I am looking at Cynosure SmartLIPO (1064) cost ~$125,000, Sciton Pro-Lipo (1064) cost ~$80,000, and Cool-Touch CoolLIPO (1319) cost ~80,000. Has anybody had any experience with any of these system? Efficiency? Service? Is the SmartLIPO worth the extra cost?
Thanks
RFojo MD

We have the combination system with 1319 and 1064 from Sciton. We looked at all three as well. Went with Sciton because of cost and value. We are also doing 1319 EVLT with the system. There is no difference between Sciton and Smartlipo. Same wavelength. We also have a couple of other Sciton platforms for our aesthetics and they have performed well. Haven't had any problems thus far.

Dexter,

What did you pay for your 1064/1319 system? I am looking at it as well. The Smartlipo rep has been in recently and they have a dual 1320/1064 combination unit called the Multiplex coming out and they want $165,000 with a one year warranty and another $10,000 for their smart-sense motion sensing handpiece.

My husband has the cooltouch in his practice because he started doing laser vein ablation three years ago and the laser liposuction was an add on piece for it that he purchased over a year ago. We are amazed at how well the cooltouch does for skin tightening. Many of his cases look far better than the pics on the cooltouch website. After speaking with other docs who have performed as many lipo cases as he has, they all have agreed the cooltouch is the best for skin tightening and the prolipo and smartlipo is good for breaking up the fat. The only downside with the coollipo is that you have to pay extra for each usage. We are currently looking at getting a prolipo, so we can use the cooltouch for the tightening and prolipo for breaking up fat. Hopefully, also will reduce the amount of time it takes to do each procedure since it is typically taking us one hour for each laser assisted liposuction we are doing PER AREA. All of our patients have about 5 areas they want done, so it is taking 5 hours! (even with our power assisted lipo). We believe prolipo is better than smartlipo simply because prolipo has more watts. Prolipo has 25 watts, wheras the newest Smartlipo has 18 watts. This is not proven, but we believe more watts equals more energy, and therefore more fat melting in lesser time. (btw,our cooltouch has 20 watts). We have also looked into the Smartlipo because of brand recognition. They have a kick a** marketing campaign and many of patients have heard of it and will request it. A word of advice we were given from a doctor friend in Dallas, if you decide to buy a Smartlipo, make sure to lease one because we were told the Smartlipo lasers are not made as well as the Cooltouch and they wear out. Currently we have 3 Cooltouch lasers, 2 that we use for laser vein ablation and the first two we have had for three years and still going strong! In my opinion, if you want the best skin tightening results, buy a cooltouch.

Wendy: For "skin tightening" with the Cool Touch are you using the 1320 nm wavelength in a non ablative (external) treatment or are you talking about tightening accompanying liposuction? What spot size(s), energy fluence(s) and pulse durations are you finding work well? Body as well as face?

LH,

sorry for the delay. i didn't see your post from 5/21 until this morning. we were already doing EVLT 1319 with our laser and added 1064 so what we paid would be different (and more) than what you would pay. I hear around $100K though for the dual wavelength. Again, the great part for those of you who don't know there is no proprietary fiber like the other manufacturers. This eats you alive.

LH,

Since you have been talking to the Smartlipo guys I thought I would ask a couple of questions. Did they move on their price? I heard they were as low as 125K and 3 year warranty. What is the fiber cost? Any good info you can share would be appreciated. Looks like they are multiplexing now as well. Did you demo?

If anyone else has any information on this please share.

I just attended the Cosmetic Boot Camp in Colorado Springs. Now it looks like Palomar has their Aspire platform with the SlimLipo using 920nm. Dr. Weiss who also did studies on the SmartLipo and CoolLipo says that this is dramatically easier to use, safer, less downtime, and that this is a company that is finally using science to melt the fat. Now they are working on the 980nm for adjacent skin tightening to add on to the Aspire. Does any know more on this? Talking with other people at the meeting it seems that people are tired of the SmartLipo and their over promise with under delivered results. Please keep me updated on what people hear from this - I am tired of spending money on the "wrong" companies.

I bought the 10w (like new) recently for $55k. I actually had 3 offers for about that price. The fibers are around $450 if you shop around.

Cynosure only gives a one year warranty, which scared me off from buying new. I find the gently used ones to be a much less risk. But make sure to get a qualifed (non-cynosure) tech to check it out (and maybe give you a service plan) before buying used.

Sorry everyone. I have been very busy and have not had the time to catch up on the posts. Palomar will come down to about $80 to 85K on their 18 watt system. I think they know it is going to be worthless in a few months. The are muti-plexing a 1320 and 1064. Apparently you can fire the lasers separately or alternating. The theory is that the 1320 does a better job of lipolysis and the 1064 does a better job of coagulation. This one will go for around $125K if you push real hard.

I am not sure if the coagulation is all that important because of the tumescent anesthesia. The anesthesia itself with the epinephrine does most of it any way.

I have talked to a number of docs using both the 1319/1320 and 1064. The general consenses is that they are using the 1319 for larger de-bulking and the 1064 for smaller areas. They seem to think the 1064 is a little safer in smaller areas and you get a lot more heat generation at 1320.

I have also seen the palomar rep and what they are bringing out is a 920nm combined with 975nm. If you look strictly at the absorption coefficient of fat it best absorbs at 920-930 nm. So the theory is that this will make the easiest laser for lipolysis but you miss coagulation at 920-930 so they are adding the 980 to improve on the vascular component.

There is a 980nm diode that has aready FDA approval for laser lipolysis. It ws just released a few months ago. It is called LaserTight. They are even using it to do infra-orbital fat pads. They have trademarked the term "EyeTight". The thing is if you look at the absorption coefficient of fat it is more efficient at 1320 than it is at 980. So what is the best?

I have also talked to a guy who is an insider in the laser industry. He knows a fair number of engineers etc. He says a significant amount of the research for laser lipolysis is starting to focus on the use of wavelengths in the lower 900nm range.

Science seems to support this but as far as I can tell (or find) there is only one formal paper looking at the absorption coefficient of mammalian fat and they used liquified pig fat. The question I have to ask is, is all mammalian fat the same? Also, is liquefied fat different than solid fat contained with in fat cells. I live in the midwest and once the fat has been liquified it is a different color than the fat I see in humans during surgery. I have not been able to answer this question and neither can any of the companies.

So the next question is does it really matter in the long haul? Or is all of this just a bunch of mental masturbation? Does it just come down to getting comfortable with the wavelength(s) you are used to working with, then using them to the best of your capabilities?

Nospam,

You should have waited as you can get a 10 watt smartlipo for mid $40's now and as soon as the Smartlipo multiplex hits it will be even more devalued. You can likely get a 6 watt system in the $20's. I have been debating if I should just but a used 10 watt system and using it for a while. I will be able to get it at 1/3 the price and with laser lipolysis research being so fluid is it worth it to sink $120k into something that may be outdated in 6 months.

Sorry everyone. I have been very busy and have not had the time to catch up on the posts. Palomar will come down to about $80 to 85K on their 18 watt system. I think they know it is going to be worthless in a few months. The are muti-plexing a 1320 and 1064. Apparently you can fire the lasers separately or alternating. The theory is that the 1320 does a better job of lipolysis and the 1064 does a better job of coagulation. This one will go for around $125K if you push real hard.

I am not sure if the coagulation is all that important because of the tumescent anesthesia. The anesthesia itself with the epinephrine does most of it any way.

I have talked to a number of docs using both the 1319/1320 and 1064. The general consenses is that they are using the 1319 for larger de-bulking and the 1064 for smaller areas. They seem to think the 1064 is a little safer in smaller areas and you get a lot more heat generation at 1320.

I have also seen the palomar rep and what they are bringing out is a 920nm combined with 975nm. If you look strictly at the absorption coefficient of fat it best absorbs at 920-930 nm. So the theory is that this will make the easiest laser for lipolysis but you miss coagulation at 920-930 so they are adding the 980 to improve on the vascular component.

There is a 980nm diode that has aready FDA approval for laser lipolysis. It ws just released a few months ago. It is called LaserTight. They are even using it to do infra-orbital fat pads. They have trademarked the term "EyeTight". The thing is if you look at the absorption coefficient of fat it is more efficient at 1320 than it is at 980. So what is the best?

I have also talked to a guy who is an insider in the laser industry. He knows a fair number of engineers etc. He says a significant amount of the research for laser lipolysis is starting to focus on the use of wavelengths in the lower 900nm range.

Science seems to support this but as far as I can tell (or find) there is only one formal paper looking at the absorption coefficient of mammalian fat and they used liquified pig fat. The question I have to ask is, is all mammalian fat the same? Also, is liquefied fat different than solid fat contained with in fat cells. I live in the midwest and once the fat has been liquified it is a different color than the fat I see in humans during surgery. I have not been able to answer this question and neither can any of the companies.

So the next question is does it really matter in the long haul? Or is all of this just a bunch of mental masturbation? Does it just come down to getting comfortable with the wavelength(s) you are used to working with, then using them to the best of your capabilities?

Nospam,

You should have waited as you can get a 10 watt smartlipo for mid $40's now and as soon as the Smartlipo multiplex hits it will be even more devalued. You can likely get a 6 watt system in the $20's. I have been debating if I should just but a used 10 watt system and using it for a while. I will be able to get it at 1/3 the price and with laser lipolysis research being so fluid is it worth it to sink $120k into something that may be outdated in 6 months.

Oops, the first paragraph should have said Cynosure not Palomar.

Sorry,
LH

Thanks for the great posts! I think $40k for a used 10w SmartLipo is going to be a bit ambitious, unless it is fairly worn out. It will still be a good machine when newer technologies come out.

If I ever see a used 6W for 20k, I'll probably grab it to use for parts :)

LH, contact pmdoc.

Nospam,

Remember it is not about the asking price. It is all about what you will pay. The 6 and 10 watt units are going to be considered outdated in a few weeks. I have been looking and these are the numbers I have been told to expect to pay. I am just trying to decide if I want new or I want used.

LH,

It seems to me that the older units are underpowered and it takes forever to melt enough fat to do a good treatment. I hear that there is a 960 nm unit that melts fat much better/faster and costs around 70k? Palomar is also coming out with a 960 nm unit.

I will check into the exact price and the name of the company so you can look into this if you are interested.

LH:
Long time no chat. Glad you are back. Please shoot me a line at pmhdoc@gmail.com

LH,

Check out LaserTight. It is a 980 nm laser.

www.lasertight.com

Tell them you heard about them through MedicalSpaMD.com

Mike is the guy you want to talk to.

CHMD,

I have already talked to Mike multiple times as well as a few docs that have been using it. I am hoping to see it in action in the next month or so. I am trying to find someone in the midwest with it. The only issue is that it is a small company and will it survive? Mike just basically orders the machine made by another company and has his logo on it.The nice thing about the 980nm is that it is very easy to transport and they have a fairly good history of reliability.

Again, the question comes down to what is the best wavelength?

I am also trying to get the price of the Palomar system. I am not sure if they have released the pricing yet or not. I have a few of the docs that are currently using it and I am hoping to talk to them next week. I am going to add laser lipolysis very soon but I am not 100% on which company or which wavelength(s).

I do understand that the older systems take a little longer but is that all bad. When I am first adding it, I only plan to do smaller areas and when I feel comfortable I can start doing larger areas and then go to Vaser for larger areas. Laser Lipolysis is still meant for smaller areas or to assist in liposuction. I have seen some great results with that.

I am just looking to do what is right for my patients and my clinic. I do not want to feel like those docs that bought a 6 watt Smartlipo and 3 months later it was outdated. I want a system that will be in my clinic for a minimum of 5 years.

CHMD,

I have already talked to Mike multiple times as well as a few docs that have been using it. I am hoping to see it in action in the next month or so. I am trying to find someone in the midwest with it. The only issue is that it is a small company and will it survive? Mike just basically orders the machine made by another company and has his logo on it.The nice thing about the 980nm is that it is very easy to transport and they have a fairly good history of reliability.

Again, the question comes down to what is the best wavelength?

I am also trying to get the price of the Palomar system. I am not sure if they have released the pricing yet or not. I have a few of the docs that are currently using it and I am hoping to talk to them next week. I am going to add laser lipolysis very soon but I am not 100% on which company or which wavelength(s).

I do understand that the older systems take a little longer but is that all bad. When I am first adding it, I only plan to do smaller areas and when I feel comfortable I can start doing larger areas and then go to Vaser for larger areas. Laser Lipolysis is still meant for smaller areas or to assist in liposuction. I have seen some great results with that.

I am just looking to do what is right for my patients and my clinic. I do not want to feel like those docs that bought a 6 watt Smartlipo and 3 months later it was outdated. I want a system that will be in my clinic for a minimum of 5 years.

Sorry for the double posts. My computer has been acting funny. If anyone has been using any of the wavelengths let me know what you think.

pmdoc,

I tried that e-mail address and it failed for both pmhdoc@gmail.com as well as pmdoc@gmail.com

LH & CHMD,

What price were you quoted for the LaserTight at LaserLight? I talked to a rep from Palomar about their new lipo machine which will not be available until Oct-Nov. If you pre-order the price is $125,000. The price will be $150,000-$160,000 when released, per the rep.

LH,

What is the VASER and how does it fit in? Do you plan to do infraorbital areas?

ProDocs,

The LaserTight is $69,000 but is only 980nm and no option to upgrade. You will not be able to add a second wavelength unless you purchase a second box. I have tried to get Palomars price quotes and so far have not been given the numbers.

CHMD,

Vaser is an ultrasound assisted liposuction. It is probably the best on the market for UAL. I may just start doing power assisted liposuction as it is the least expensive to get in to.

If I were to purchase the LaserTight I would definitely do lower lid fat pads.

If you have the 6 watt Cynosure SmartLipo unit it can be upgraded to the ten watt unit for one third the price of the manufacturer through Spectrum Laser Services (www.spectrumlaserservices.com). Be sure to ask for the lead tech and he can get you the best pricing.

Question posed by MEDSPAGUY... Wendy... are you talking about external or invasive/adjunctive treatment with CoolTouch?
Answer: CoolLipo was FDA approved for Laser Assisted Lipolysis in January 2008. I use it in this fashion specifically the same time as the liposuction, so yes it is the 1320nm wavelength. Clarification: our CoolLipo is 15Watts.
Question what settings spot size/fluence etc. are you talking about?
Answer: NewStarLasers dba CoolTouch manufactures a 1064nm laser (tradenamed Varia) which would have the spot size and fluence adjustments and is marketed for skin rejuvenation as well as spider vein/telangiactasia treatment and acne treatment, etc. NewStarLasers does business as CoolTouch as they purchased rights to a patent for timed cryotherapy associated with the pulse of transdermal long wavelength laser energy dispersement and this is essentially standardly available on all Varia Lasers since 2000. The name "CoolTouch" stuck. It theoretically would be possible to use the 1064nm wavelength energy through a fiber from the Varia for Laser assisted lipolysis (although this would be "off-label" and the manufacturer would likely no longer support the laser as they feel the 1320nm wavelength to be a superior wavelength for laser assisted lipolysis. I do not use the Varia for skin tightening or skin rejuvenation, strictly for ablation of telangiactasias ("red" and "blue" veins). Of course a side effect would be hair reduction in areas treated and I do warn patients of this and all have been happy about the side effect but disappointed I do not offer laser hair removal.
With that said the CoolTouch 1320nm wavelength laser comes in the 10 Watt CTEV as well as the 15 Watt CoolLipo. Theoretically, there is more of a "photoacoustic" effect which would be more likely to disrupt the adipocyte at higher millijoule per pulse.
The 10 Watt CTEV is set at a maximum output of 200 millijoules per pulse.
The 15 Watt CoolLipo laser is set to have a maximum output of 400 millijoules per pulse, seen at 15 Watts and 40 hertz (if my calculations are correct). The ranges of millijoules per pulse of energy closer to 400 millijoules theoretically would melt fat better (more photoacoustic effect) whereas for skin tightening to selectively generate heat theoretically lower millijoules per pulse are necessary.
It does become confusing in that 10 Watts of energy is the same number of joules per SECOND regardless of the Hertz the machine is set at. Although I was at first skeptical I do use exclusively the company recommended 50 Hertz and 8 Watts for skin tightening which should give 160 millijoules of energy per pulse and I generally end up with somewhere in the range of 10000 or more joules of energy per area treated in addition to the joules of energy for the fat melting. For patients that do not need more skin tightening they still do get significant skin tightening only with the energy used for the fat melting. I do not recall what the average amount of joules of energy of fat melting I use is, however a basic recollection for a "mommy" that wants all abdomen tiers and lovehandles/etc, It would probably be 1200 seconds of laser time to melt (multiply that times the Hertz and millijoules per pulse to find out... also remember that at 15 Watts 1200 seconds of energy is the same energy no matter what hertz it is set at... ususally I'll use 40 Hertz and have 400 millijoules per pulse). Neck and face would be better addressed by Dr. Key or others, often I will only use a few minutes there and sometimes only skin tightening.
Currently I'm reorganizing th office to standardize photos's to build value to the services I offer.
Do physicians out there think we can work together to build value to our procedures instead of just buying the next generation of device out there and building values for the MIC (medical industrial complex)?
I guess I am a "CoolTouch" guy and it seems their idea to have a laser with a "card reader" was to only add about $100 to the price of each procedure. A five use card costs me well over US$900 and with the amount of time per procedure I generally use at least 2 or three cards "usages" per procedure (sometimes more)
How much would physicians be willing to pay for a "usage" before adding the cost to the procedure and "passing the bucks" to the patient?
The main reason I am looking at other lasers ProLipo and SmartLipo is that they are "open platform." This means that there is no charge for each usage. As volume increases it does begin to become a problem in terms of using CoolTouch.
Do any physicians charge for "extra" tightening? The only way I can figure to educate patients is to get pictures as well as reproducible photos (which I am still struggling with).

MY SECRET: I work my tail off and it takes several hours for every case that needs skin tightening which is ALL of the cases. I also seem to get everyone in town that already had a tummytuck or some other cosmetic procedure and they want me to "fix it." -Wendy's husband

Wendyh, I would love to talk to you as I have the Coollipo, too and have had some questions about doing the neck. As for the abdomen or other areas that need some fat taken off as well, I am doing liposuction first, then doing the tightening mode and I find this is working well and saves on my card usage. Please email me at slotstein@gmail.com

I am new to the medspa arena. I have not incorporated an laser yet and mainly offer botox, dermal fillers, chemical peels, microdermabrasion, etc. I was looking at laser assisted lipolysis and in general, laser equipments. Any advice on what laser to start with (I am very interested in laser assisted lipolysis though). Are they worth the money? It seems that the equipment, the maintenence, and everything associated with laser is expensive.
And so many different brands. I hear a lot about SmartLipo from patients but more about Vaser from colleagues and then here, the Coollipo.

Nikki,

I a not sure what kind of physician you are but I would tell you to get some hands on with lipo before you invest in laser lipolysis or vaser.

Nikki,

I have extensive experience with all 3 major liposuction techniques-laser, ultrasound, and traditional using PAL.. As far as I am concerned, there is no benefit with the laser or ultrasound-my results with traditional lipo using the PAL machine is exactly the same as laser or ultrasound. I would recommend buying a PAL system (at most 14k) and going at it.

Nikki,

I have extensive experience with all 3 major liposuction techniques-laser, ultrasound, and traditional using PAL.. As far as I am concerned, there is no benefit with the laser or ultrasound-my results with traditional lipo using the PAL machine is exactly the same as laser or ultrasound. I would recommend buying a PAL system (at most 14k) and going at it.

Nikki,

I have extensive experience with all 3 major liposuction techniques-laser, ultrasound, and traditional using PAL.. As far as I am concerned, there is no benefit with the laser or ultrasound-my results with traditional lipo using the PAL machine is exactly the same as laser or ultrasound. I would recommend buying a PAL system (at most 14k) and going at it.

Nikki,

I have extensive experience with all 3 major liposuction techniques-laser, ultrasound, and traditional using PAL.. As far as I am concerned, there is no benefit with the laser or ultrasound-my results with traditional lipo using the PAL machine is exactly the same as laser or ultrasound. I would recommend buying a PAL system (at most 14k) and going at it.

Hello all,

I am writing to let you all know about a brand new product that has come to market. I see a lot of interest surrounding non-invasive lipo lasers so I think that our product will spark some excitment.

Meridian Medical has launched the Lapex BCS Lipolaser (www.lapexbsc.com) which is the ONLY laser to use paddles that remain static against the skin. This means that the Lapex BCS penetrates deeper into the subcutaneous layer giving maximum treatment results and more importantly can target those key areas that are most troubling to the client.

In addition to using multi treatment paddles, the Lapex BCS is the only laser therapy that uses Enhancement Probes to stimulate the lymphatic drainage and optimizes the processing of released molecules.

Our clients have experienced TREMENDOUS success with this machine and we are more than excited to bring this product to the rest of the country.

Please contact me for further information or to schedule a demo. Libby@nelasersource.com

I own a Smartlipo & also a VASER. A very good friend of mine owns the Sciton. Here is my opinion. The Sciton is a superior unit. The unit itself is bulletproof and they do not kill you with $$$$ upgrades as Cynosure has a track record of. Someone recommended PAL as an option. There is one distinct advantage other than price as PAL is a better sculpting tool. I say this because you see PAL results in real time, with the Lasers as well as VASER, you first break down the fat and then remove it. When all is said and done, it is technique more than anything else that provides results.