Laser-Assisted Liposuction 'Still Finding Its Place'

DANA POINT, CALIF. – In the opinion of Dr. Gordon Sasaki, laser-assisted liposuction is still "finding its place" as a treatment option for invasive body shaping.

"We have to keep in mind that gold standard still is traditional liposuction," Dr. Sasaki said at the Summit in Aesthetic Medicine, sponsored by Skin Disease Education Foundation (SDEF). "Any other types of devices that come on the market have to be measured against that."

While there are currently six devices cleared by the Food and Drug Administration for laser-assisted liposuction, Dr. Sasaki discussed the one he has the most experience with: Cynosure's Smartlipo, which contains a laser that fires at three wavelengths: 1,064 nm, 1,320 nm, and 1,440 nm.

"I believe that the primary effect of laser lipolysis is collagen for tissue contraction, more than skin accommodation, redistribution, or retraction," said Dr. Sasaki, clinical professor of plastic surgery at Loma Linda (Calif.) University. "I think the secondary effect is lipolysis."

Since June 2008, Dr. Sasaki has treated 252 patients with Smartlipo. Their average age was 48 years, 91% were female, and their average body mass index was 24.9 kg/m². Per case, the average total infiltrate was about 2,500 cc, the average total aspirate was about 2,400 cc, and the average total amount of fat removed was about 2,000 cc.

"That means the average fat/aspirate ratio is 87%, which is comparable to other liposuction methods," said Dr. Sasaki, who has a private aesthetic plastic surgery practice in Pasadena, Calif.

Preoperative medications include 5-10 mg of diazepam or Norco 10/325 as needed. After making 5-by-5-cm preoperative markings in the skin, he delivers 50-100 cc per 5-by-5-cm² of tumescent anesthesia to the treatment area. Next, he delivers deep laser energy to the skin. For example, his protocol for the 1440-nm laser is to deliver 1,000-1,500 J per 5-by-5-cm² to the body area and 200-500 J per 5-by-5-cm² to the face.

The next step involves liposuction, which enables "a better clinical assessment of the contouring," he explained. "You remove all of that debris, so when you bring in the heating for the subdermis of the skin the process goes much faster because you don’t have to heat up the materials that you have already destroyed."

This is followed by shallow laser-assisted liposuction "where the skin is heated in a controlled fashion to 38-42  C," Dr. Sasaki said. "At this time, I use either the 1,440-nm laser or a combination of the 1,064-nm and 1,320-nm, depending upon its usages either for the skin of the facial area or to other parts of the body."

For postoperative management, he uses quarter-inch Penrose drains, which are removed the day after the procedure.

"I use compression garments as long as the patients can tolerate them, usually for 1 or 2 weeks," he said. He also uses external ultrasound treatment to smooth out the areas of lymphatic drainage and light-emitting diode skin rejuvenation sessions for inflammation.

Dr. Sasaki said that off-label uses of laser-assisted liposuction "are beginning to be investigated to expand its potential therapies in other areas, especially cellulite."

Dr. Sasaki disclosed that he has been a paid consultant for many laser and device companies, including Cynosure.

SDEF and this news organization are owned by Elsevier.

DANA POINT, CALIF. – In the opinion of Dr. Gordon Sasaki, laser-assisted liposuction is still "finding its place" as a treatment option for invasive body shaping.

"We have to keep in mind that gold standard still is traditional liposuction," Dr. Sasaki said at the Summit in Aesthetic Medicine, sponsored by Skin Disease Education Foundation (SDEF). "Any other types of devices that come on the market have to be measured against that."

While there are currently six devices cleared by the Food and Drug Administration for laser-assisted liposuction, Dr. Sasaki discussed the one he has the most experience with: Cynosure's Smartlipo, which contains a laser that fires at three wavelengths: 1,064 nm, 1,320 nm, and 1,440 nm.

"I believe that the primary effect of laser lipolysis is collagen for tissue contraction, more than skin accommodation, redistribution, or retraction," said Dr. Sasaki, clinical professor of plastic surgery at Loma Linda (Calif.) University. "I think the secondary effect is lipolysis."

Since June 2008, Dr. Sasaki has treated 252 patients with Smartlipo. Their average age was 48 years, 91% were female, and their average body mass index was 24.9 kg/m². Per case, the average total infiltrate was about 2,500 cc, the average total aspirate was about 2,400 cc, and the average total amount of fat removed was about 2,000 cc.

"That means the average fat/aspirate ratio is 87%, which is comparable to other liposuction methods," said Dr. Sasaki, who has a private aesthetic plastic surgery practice in Pasadena, Calif.

Preoperative medications include 5-10 mg of diazepam or Norco 10/325 as needed. After making 5-by-5-cm preoperative markings in the skin, he delivers 50-100 cc per 5-by-5-cm² of tumescent anesthesia to the treatment area. Next, he delivers deep laser energy to the skin. For example, his protocol for the 1440-nm laser is to deliver 1,000-1,500 J per 5-by-5-cm² to the body area and 200-500 J per 5-by-5-cm² to the face.

The next step involves liposuction, which enables "a better clinical assessment of the contouring," he explained. "You remove all of that debris, so when you bring in the heating for the subdermis of the skin the process goes much faster because you don’t have to heat up the materials that you have already destroyed."

This is followed by shallow laser-assisted liposuction "where the skin is heated in a controlled fashion to 38-42  C," Dr. Sasaki said. "At this time, I use either the 1,440-nm laser or a combination of the 1,064-nm and 1,320-nm, depending upon its usages either for the skin of the facial area or to other parts of the body."

For postoperative management, he uses quarter-inch Penrose drains, which are removed the day after the procedure.

"I use compression garments as long as the patients can tolerate them, usually for 1 or 2 weeks," he said. He also uses external ultrasound treatment to smooth out the areas of lymphatic drainage and light-emitting diode skin rejuvenation sessions for inflammation.

Dr. Sasaki said that off-label uses of laser-assisted liposuction "are beginning to be investigated to expand its potential therapies in other areas, especially cellulite."

Dr. Sasaki disclosed that he has been a paid consultant for many laser and device companies, including Cynosure.

SDEF and this news organization are owned by Elsevier.

DANA POINT, CALIF. – In the opinion of Dr. Gordon Sasaki, laser-assisted liposuction is still "finding its place" as a treatment option for invasive body shaping.

"We have to keep in mind that gold standard still is traditional liposuction," Dr. Sasaki said at the Summit in Aesthetic Medicine, sponsored by Skin Disease Education Foundation (SDEF). "Any other types of devices that come on the market have to be measured against that."

While there are currently six devices cleared by the Food and Drug Administration for laser-assisted liposuction, Dr. Sasaki discussed the one he has the most experience with: Cynosure's Smartlipo, which contains a laser that fires at three wavelengths: 1,064 nm, 1,320 nm, and 1,440 nm.

"I believe that the primary effect of laser lipolysis is collagen for tissue contraction, more than skin accommodation, redistribution, or retraction," said Dr. Sasaki, clinical professor of plastic surgery at Loma Linda (Calif.) University. "I think the secondary effect is lipolysis."

Since June 2008, Dr. Sasaki has treated 252 patients with Smartlipo. Their average age was 48 years, 91% were female, and their average body mass index was 24.9 kg/m². Per case, the average total infiltrate was about 2,500 cc, the average total aspirate was about 2,400 cc, and the average total amount of fat removed was about 2,000 cc.

"That means the average fat/aspirate ratio is 87%, which is comparable to other liposuction methods," said Dr. Sasaki, who has a private aesthetic plastic surgery practice in Pasadena, Calif.

Preoperative medications include 5-10 mg of diazepam or Norco 10/325 as needed. After making 5-by-5-cm preoperative markings in the skin, he delivers 50-100 cc per 5-by-5-cm² of tumescent anesthesia to the treatment area. Next, he delivers deep laser energy to the skin. For example, his protocol for the 1440-nm laser is to deliver 1,000-1,500 J per 5-by-5-cm² to the body area and 200-500 J per 5-by-5-cm² to the face.

The next step involves liposuction, which enables "a better clinical assessment of the contouring," he explained. "You remove all of that debris, so when you bring in the heating for the subdermis of the skin the process goes much faster because you don’t have to heat up the materials that you have already destroyed."

This is followed by shallow laser-assisted liposuction "where the skin is heated in a controlled fashion to 38-42  C," Dr. Sasaki said. "At this time, I use either the 1,440-nm laser or a combination of the 1,064-nm and 1,320-nm, depending upon its usages either for the skin of the facial area or to other parts of the body."

For postoperative management, he uses quarter-inch Penrose drains, which are removed the day after the procedure.

"I use compression garments as long as the patients can tolerate them, usually for 1 or 2 weeks," he said. He also uses external ultrasound treatment to smooth out the areas of lymphatic drainage and light-emitting diode skin rejuvenation sessions for inflammation.

Dr. Sasaki said that off-label uses of laser-assisted liposuction "are beginning to be investigated to expand its potential therapies in other areas, especially cellulite."

Dr. Sasaki disclosed that he has been a paid consultant for many laser and device companies, including Cynosure.

SDEF and this news organization are owned by Elsevier.