Expert Doctor


Posted November 27, 2017

SmartLipo, also known as laser lipolysis, uses a combination of liposuction and laser technology to reduce body fat while tightening loose skin. With SmartLipo, a high-energy laser fiber is inserted through a small incision allowing the surgeon to melt the fat for easier removal. The heat from the fiber optic laser can also help tighten loose skin and grant the patient a tighter and more youthful appearance. SmartLipo is not intended to be a weight loss procedure for those who are overweight or obese. The ideal candidate for SmartLipo is a person within 15% to 20% of their ideal body weight with excess fat in localized areas and skin that is only mild to moderately lax. A person who is much heavier, or has excess loose skin hanging from their abdomen, might be a better candidate for a tummy tuck

Am I a Good Candidate for SmartLipo?

GOOD CANDIDATES for SmartLipo are:

  • People in their 20's to mid-50's who require mild to moderate fat removal
  • Patients who wish to treat areas such as the abdomen,  flanks, neck, upper arms, inner and outer thighs, pubic area, bra fat  and the gluteal fold located underneath the buttock (called the “banana roll”)
  • Any patient who wishes to revise their prior liposuction results

Patients who are NOT GOOD CANDIDATES include:

  • Those with medical conditions such as kidney issues, heart conditions, skin disorders and liver conditions
  • Patients who are not in general good health and those who smoke on a regular basis

How is SmartLipo Performed?

SmartLipo is performed under local anesthesia and usually with oral sedation, in the office of the doctor. If multiple areas are treated, especially if they are larger areas, the procedure might be spread over 2 days with some areas treated one day and the remaining areas treated the next day (or several days later depending on the schedule of the patient).

The surgeon numbs the area and makes a very small incision, around 2-3mm in length, for each treatment area. Through this incision, a small cannula is inserted and the local anesthetic is infused into the area to numb it. After this, a tiny fiber optic laser probe is inserted directly into the targeted fat deposit. The laser heats and melts the targeted fat but does not negatively impact the surrounding tissue. The heat from the laser promotes the stimulation of new collagen and causes the skin to experience a degree of tightening. The body heals the internal area with very thin fibers of scar tissue which contract and tighten the skin. The heat from the device is constantly monitored during the process to ensure that the skin does not overheat and burn. Finally, the liquefied fat is suctioned through a small liposuction cannula. The incisions are closed with a single dissolving suture. The incision scars will fade over time and become minimally visible.

SmartLipo vs. Traditional Liposuction

In traditional liposuction, larger incisions are needed to accommodate a larger cannula which is forcefully moved to break up the fat for suctioning. Traditional liposuction does not offer the skin tightening effect since a laser is not used during this method. Another advantage of SmartLipo over traditional liposuction is the ability to provide a much more even appearance with fat removal due to the delicate nature of the instrument.

Alternative Treatments
Ultrasonic liposuction is a comparable procedure to SmartLipo. However, this procedure uses an ultrasonic wave to break down the fat prior to liposuction. Since ultrasonic liposuction uses general anesthesia, there is a risk of blood clots and pulmonary emboli. In addition, the recovery tends to be slower. The cost for ultrasonic liposuction is increased because the patient is paying a facility fee for the operating room as well as a doctor or nurse to administer the anesthetic.

CoolSculpting is an alternative procedure to SmartLipo. With CoolSculpting, the physician freezes the fat rather than heating it. During CoolSculpting, two paddles are placed on the area to be treated. The paddles freeze the fat through the skin to damage and kill the fat cells which are reabsorbed into the body. Since CoolSculpting is not a surgical procedure, any doctor can purchase the machine and offer it to patients while only having minimal training. Because the device is made so that just about anyone can safely use it, its rate of effectiveness requires most patients to undergo multiple sessions to achieve their desired look. With SmartLipo, there is just one procedure performed using a tiny incision to provide the desired results.

A newer alternative to CoolSculpting is SculpSure which uses heat to melt the fat during two treatments. This is a faster and more comfortable procedure than CoolSculpting and is also more effective for most people. The melted fat is just resorbed by the body and patients continue to improve for 3 months after their last treatment.

What is the Cost of SmartLipo?

The average cost of SmartLipo is about $2500-$5000. It varies according to the skills of the person performing the treatment, area of the country where the procedure is performed, the size of the area being treated and the number of areas being treated. When selecting a surgeon, it is not advisable to choose one based solely on a lower cost. Although a plastic surgeon may have some experience with SmartLipo, the procedure may not be their specialty. A surgeon who specializes in the procedure will know how to handle any complications which might arise.

Recovery and Downtime

Since SmartLipo is performed while the patient is awake, the amount of RECOVERY and DOWNTIME is minimized. Patients can expect some bruising, swelling and mild to moderate discomfort. A compression garment is worn after surgery for 5 days (or longer) to minimize the swelling and help reduce discomfort. Patients can shower the morning following the procedure and return to work the very next day.

The doctor may prescribe some pain medication for the first few days which may be needed to control pain. If not, over the counter medications, such as Tylenol can be used as needed. Patients should not take any blood thinning medications before the procedure as these medications can cause bleeding and bruising issues.

Patients will experience numbness in the treated areas which will gradually resolve.

SmartLipo has a faster recovery time, and minimal downtime, than traditional liposuction so patients can return to work the day after having the procedure.

Approximately 5 days after SmartLipo, patients can resume full activities including exercise.


SmartLipo results can sometimes be seen immediately but they usually take weeks to be visible.  Patients will continue to improve over 6 months as most of the improvement happens after 2 months and then continues for 4 more months.

It is important to follow a healthy diet and exercise regularly. SmartLipo removes fat in specific areas. However, they are also part of the total body fat, so most patients will get their best results if they decrease their total body fat through better dieting. When a healthy lifestyle is maintained, the results for SmartLipo can last a lifetime.

Limitations and Risks of SmartLipo

Although undergoing SmartLipo is LIMITED to people within their ideal body weight and in general good health, it can be effective for some people who have a slightly higher percentage of fat. In general, SmartLipo is limited to only removing up to 8 pounds of fat. SmartLipo is not ideal for the elderly or people who have light skin tone around the area of concern. For example, a person who is 65 years old with excessively loose or hanging skin on their arms is going to need an arm lift rather than SmartLipo to correct the problem. However, the same person may benefit from SmartLipo along their love handles as long as they have enough skin tone in that area. SmartLipo is rarely performed on the calves, or areas such as the ankles, due to the fact that those areas are mainly muscle.

SmartLipo has a few RISKS including:

  • Bruising and swelling
  • Pooling of blood under the skin
  • Infection
  • Excessive bleeding
  • Lumps
  • Asymmetric appearance from uneven fat removal
  • Scarring

Experience Means Good Results

SmartLipo is designed to safely eliminate stubborn pockets of fat while tightening the skin thanks to liposuction and the use of laser technology. Choosing a doctor who specializes in SmartLipo greatly decreases the chances of side effects and risks. Furthermore, patients should schedule a consultation with an experienced surgeon that specializes in the procedure to determine if SmartLipo is the best choice to achieve their desired results.


Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with David Berman, MD in Sterling, VA

Article Last Updated on November 27, 2017