A ^Retired Plastic Surgeon's Notebook

Seattle Plastic Surgeon Discusses the Risks of                         Laser Liposuction.

I just returned from the annual meeting of the Northwest Society of Plastic Surgeons. The best presentation was a panel on new technologies – when, how and why or adopt them or, in many cases, not adopt them. A very interesting statistic was presented. Ninety-five percent of new technologies – meaning the latest and greatest, gotta have it, cannot survive without it – did not exist 5 to 6 years after it’s introduction. Wow, what a number. Laser liposuction was one of the featured new technologies that this panel of plastic surgeons did not think would make the cut. In fact, a recent survey of fully trained (as opposed to the imitation) plastic surgeons who had used laser liposuction, over 96% did not like it. This is the first time that I have heard that 96% of any kind of surgeons agree on anything. http://www.abplsurg.org/

One of the panel members, arguably the most laser friendly plastic surgeon on the planet, summed up laser liposuction with this comment: “Last time I checked, the subdermal plexus still existed.”

Stay with me; You are about to learn something important. Take a look at the illustration of your largest organ (the skin) above. See where the pink (skin) turns yellow (fat). That is the subdermis and that is the target of the laser in laser liposuction. After removing fat, the laser is used to heat up the subdermis in an effort to get the skin to shrink. I always get the image of bacon frying for some reason. Well, it’s not nice to heat this layer because the blood vessles that supply the skin live here. If a large enough area of blood vessles is fried, the skin will die. Dead skin is a very, very bad thing.

Non-laser liposuction spares most of the blood vessels because the intruments used (cannulas) are blunt and push the vessels aside rather than damage them. Because most skin has some elastic quality, the overlying skin usually shrinks to some degree once the underlying bulk is reduced.

I have seen my share of skin necrosis in patients who have heard the siren song of laser liposuction thinking it would spare them the necessity of a truly skin tightening procedure such as tummy tuck. I remain sooooo glad that I did not invest in one of these very, very expensive gizmos. It would be keeping our old furniture in our basement storage unit company.

Seattle Plastic Surgeon discusses the limitations of some of the newest, most expensive and most advertized gizmos.

Take a look at this “before” and “after”.

As promised, here’s the inside of the brochure that shows the “results” and you can be sure these are the best results the company could come up with. The “CoolSculpting” gizmo is promoted as a non-invasive body contouring procedure. I would say non-invasive and ineffective.

Most of the doctors that will purchase this device or one of the dozens similar to it are non-surgeons. These doctors do not know how to do an abdominoplasty (tummy tuck) so they offer this instead. I’m sure they go into it with high hopes but how can they not be disappointed at such a “result’? Once they have paid the $$$$$$ for the gizmo, they need to promote it to make sure they get a decent return on investment.

If any of my abominoplasty patients had a result like this, they would feel ripped off. I suspect the doctors using “CoolSculpting” are going to have some unhappy patients. Geez, everyone could have saved all that time, money and gnashing of teeth by referring those patients to me!