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Laser-assisted liposuction might provide an option for people who want stubborn pockets of fat removed but fear they'll be left with loose skin.
Traditional liposuction, a fat-removing cosmetic surgery procedure, is generally reserved for people with firm skin to reduce the risk of sagging afterward. But the addition of lasers could spur tightening of the skin, researchers say.
The researchers looked at the extent of skin tightening in nearly 2,200 women and men who received laser liposuction in various body regions, including the belly, thighs and arms. The relatively new procedure was approved by the U.S. Food and Drug Administration in 2006.
Three months after laser liposuction, the researchers found that patients had between 20 percent and 80 percent skin tightening, meaning their skin contracted to within 20 percent and 80 percent of what would be expected for the volume of fat removed. The amount that the skin "bounced back" depended on the elasticity of the skin to start with and the body area treated.
The amount of skin tightening with laser liposuction is probably about 50 percent better than what would have been achieved with traditional liposuction, said Dr. Abbas Chamsuddin, study lead author and an interventional radiologist at the Center for Laser and Interventional Surgery in Atlanta.
The researchers did not, however, include a group that received traditional liposuction for comparison. To see how laser liposuction stacks up, Chamsuddin would like to conduct another study in which a second group of patients receives traditional liposuction.
The study is scheduled for presentation Monday at the annual meeting of the Society of Interventional Radiology in New Orleans.
The newer form of liposuction also has the potential to remove more fat than traditional liposuction and lead to less blood loss because the laser dries the blood vessels, Chamsuddin said.
The procedures for laser and traditional liposuction have similarities. Both involve injecting a solution into the fat to numb the area and shrink blood vessels in the region (to reduce blood loss), and making a cut of about one-tenth of an inch, Chamsuddin said.
Whereas traditional liposuction involves sucking the fat out in solid form using a hollow pen-like device, laser liposuction melts the fat with a laser before vacuuming it out with a similar pen-like device.
After the fat removal, doctors use a laser of a different wavelength that is absorbed by skin cells to create an "artificial burn" that tells the body to release collagen in the area, which causes the skin to tighten, Chamsuddin said.
A third type of liposuction, which is more common than laser liposuction, uses ultrasound to achieve a similar effect of melting the fat. Chamsuddin said, however, that fat cells absorb the laser energy better than ultrasonic energy.
The average age of participants in the current study was 38, and about 75 percent were women, Chamsuddin said. The most common areas treated were the belly, "love handles," thighs and arms. The volume of fat removed ranged from 30 percent to 90 percent, depending on the body area.
A similar amount of fat can be removed with traditional or ultrasound liposuction, said Dr. Jeffrey Kenkel, a professor of plastic surgery at the University of Texas Southwestern Medical Center at Dallas.
"The main thing being promoted with laser liposuction is improved skin tightening, but there is not a lot of objective evidence," Kenkel said. Although a previous small study found that skin tightening was about 50 percent better with laser compared to traditional liposuction, the degree of skin tightening was low with both procedures and the difference was probably not meaningful for patients, he said.
"You are going to need firm skin no matter what the procedure," Kenkel said.
Kenkel also is worried about the safety of laser liposuction. The lasers heat the skin to high temperatures, which can cause burns and scarring if not used properly, he said.
Chamsuddin thinks the risk of bruising is similar for laser and traditional liposuction. He thinks that the use of laser leads to more pain, however, because it causes tissue burns. In his study, most participants complained of cramping and burning sensations for several days after the procedure.
Although the price of laser liposuction varies, it is generally between $2,000 and $4,000 for the arms, belly and thighs. The price of traditional liposuction can be between $2,000 and $10,000 depending on the body area and facility where it is done, Kenkel said.
Most health insurance plans do not cover liposuction.
The findings of this study have not been published in a peer-reviewed medical journal and should be considered preliminary.
For more information about liposuction, visit the American Society of Plastic Surgeons .