Smart lipo: does it tighten the skin?

Sometimes marketing hype gets way ahead of the science.

That's certainly the way it seems to have been with the current generation of laser-assisted liposuction devices. Promises of skin tightening have been made by most of the manufacturers of these devices (SmartLipo and others) - with very little science to back up the claims.

I keep seeing unhappy laser-assisted liposuction patients (performed elsewhere) for second opinions. While they may be thinner, the treated areas are lax and have a worsening of the cellulite appearance, with a wavy, irregular appearance. Is this an issue related to the technology itself, the user of the technology, or is it one of patient selection? Regardless of cause, for these patients, the "reality" of Smart Lipo just didn't match their expectations.

Finally, in this month's issue of Aesthetic Surgery Journal, is the first scrap of science looking at whether this technology actually causes skin contraction. That's the good news. The bad news is that, in my opinion, the study design is somewhat flawed, so that this new study doesn't really answer the question about which method is best.

Here's what was done: Skin-marking tattoos were used to mark out 5 cm squares on the tummies of some volunteers, who then underwent treatment with the SmartLipo MPX laser-assisted liposuction device. The lasered fat was then aspirated out with a standard liposuction cannula. Digital photography was then used at 1 and 3 months postoperatively to check the degree of skin shrinkage.

The shrinkage of the 5 x 5 cm area was reported as 22% at one month, and 17% at three months, versus the baseline measurements. In plain english, a 17% reduction in area means that the square that started at 5 cm on a side went down to 4.56 cm on a side, a change of about two-tenths of an inch on each side of the square. While this change was reported as statistically significant, it isn't clinically very impressive at all.

Additionally, the study didn't compare the effects of standard liposuction (without laser) to the laser-treated areas. Some or all of this 17% change might just be a result of the skin's natural elasticity - an expected shrinkage once the fat was removed. So, we still don't really know the most important point - whether this is an improvement over standard liposuction, or not.

Bottom line: Finally! Some science on Smart Lipo. It's about time!

In my opinion, the 17% reported reduction in area at three months post-op is not particularly impressive. This degree of contraction is minimal, at best.