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Laser-assisted lipo evolving, but combo therapy is best, physician says

Dr. Butterwick
La Jolla, Calif. — Because no specific wavelength has proven superior as an adjunct to liposuction, one dermatologist suggests combining laser-assisted devices with standard tumescent liposuction in certain situations.

For efficacy and safety, says Kimberly Butterwick, M.D., a La Jolla, Calif., dermatologist in private practice, tumescent liposuction is tough to beat. In a study including more than 700,000 outpatient surgeries performed in Florida — where it's mandatory to report adverse events occurring in outpatient procedures performed in physicians' offices and surgical centers — researchers found no deaths associated with tumescent liposuction and only 31 deaths overall; 18 of these occurred among aesthetic patients (Coldiron BM, Healy C, Bene NI. Dermatol Surg. 2008 Mar;34(3):285-291; discussion 291-292. Epub 2007 Dec 20).

A 68-year-old female patient before (left) and five months after CoolLipo treatment for skin tightening, then liposculpture of the neck. (Photos: Kimberly Butterwick, M.D.)
Over the years, she adds, manufacturers have introduced modifications such as power-assisted, water-assisted and laser-assisted liposuction, along with internal ultrasound-based liposuction, with varying degrees of success. With these modifications, "The goal has always been to make the procedure faster, with quicker healing and tighter, smoother skin. But the truth is that with tumescent liposuction, if you do it properly, patients heal very quickly anyway."

In one of the few studies that compared all of these modified forms of liposuction against each other in the abdominal region, Dr. Butterwick says, "Researchers showed that compared to internal ultrasound or water-assisted liposuction, laser-assisted liposuction and power-assisted liposuction preserved the highest numbers of septal fibers — those are what we need to achieve skin tightening (Fatemi A. Am J Cosmetic Surg. 2011 Sept. 28(3):163-168)." In fact, she says that laser-assisted devices produce the most skin tightening. "That's the primary reason for using them," she explains.

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