Laser liposuction: A leap forward in body contouring or too good to be true?

Laser assisted liposuction, or laser liposuction for short, is a newer enhanced variant of liposuction that is becoming increasingly more popular. In traditional liposuction, fat is sucked out of sub-cutaneous fatty tissue through a metal tube called cannula (see our article on traditional liposuction). In laser liposuction, fat is also sucked out via a cannula but there are several important differences.

First, laser liposuction involves liquefying fat using laser before sucking it out. This is less traumatic to the tissues and also allows to use a much thinner cannula. As a result, the recovery after laser liposuction tends to be smoother and shorter. Second, during laser liposuction, laser is also applied to the skin causing immediate collagen contraction as well as subsequent collagen deposition, leading to skin tightening. This reduces or eliminates post-treatment skin sag, an issue common after traditional liposuction, especially when large amounts of fat are removed.

On paper, the benefits of laser liposuction sound impressive. Not surprisingly, it has been marketed as a better and smarter incarnation of traditional liposuction that not only removes fat but also has shorter recovery time and, quite importantly, tightens up the treated area – a kind of liposuction-lite plus free bonus tummy lift (if abdomen is treated) in a single less invasive procedure.

The reality appears to be more complicated. It is well known that controlled damage to the skin (using laser or certain other means) causes skin tightening. Indeed the few existing studies on laser liposuction indicate that it tends to yield tighter skin than traditional liposuction. It also appears that in an optimistic scenario (i.e. when recovery proceeds as expected), the recovery time for laser liposuction is shorter on average.

That said, there are a number of caveats. First, laser is a potent directed energy source which, some experts feel, has a relatively narrow therapeutic window, i. e. its range of therapeutic "energy doses" (the doses that achieve skin tightening without causing skin burns) is relatively narrow. As a result, skin burns can occur as a side effect laser liposuction and the risk is particularly significant if the surgeon is inexperienced with the procedure. In experienced hands, the incidence of burns after laser liposuction appears to be about 1 in a 100 (see this laser lipolysis review for details). If the surgeon is inexperienced, burns are presumably a lot more likely. If you are considering laser liposuction, make sure to find a surgeon who has been doing it regularly for an extended time and has performed it at least a few hundred times.

Second, even if laser liposuction is performed correctly, longer-term skin tightening is not guaranteed. Individual response to laser varies, with some people having dramatic tightening while others – a minimal one. This is due to variations in post-treatment skin remodeling and, in particular, different rates of new collagen synthesis in the dermis. Notably, the skin's capacity to build up new collagen diminishes with age. Therefore older people are less likely to exhibit dramatic skin tightening after laser liposuction and may not be optimal candidates for the procedure.

Finally, there may be cost considerations. Compared to traditional liposuction, laser liposuction requires additional expensive equipment (i.e. the laser). This additional cost sometimes makes laser liposuction more expensive than traditional liposuction. If cost is an issue, make sure to get several price quotes for both procedures. (Make sure that you compare price quotes for the same area of the body.)

The bottom line is that while laser liposuction may offer additional benefits, such as skin tightening and faster recovery, there are also additional risks (skin burns) and sometimes higher costs. Furthermore, even if laser liposuction is administered properly and the patient is well selected (appropriate age, etc), significant skin tightening is not guaranteed due to unpredictable individual variations in skin remodeling.