62018Jul
Liposuction: is surgery better than non-surgical techniques?

Liposuction: is surgery better than non-surgical techniques?

Traditional surgical liposuction (suction assisted lipoplasty) has been perfected and proven over many decades. Dr Alan Breidahl has had more than 20 years experience with this procedure and has honed his techniques to achieve very good results in the appropriate patients.

In the last few years many alternative ‘non-surgical’  fat reduction techniques have been developed which offer many advantages over traditional ‘surgical’ suction assisted lipoplasty (SAL). Examples of non-surgical fat reduction techniques are fat dissolving injections, cryotherapy where the fat cells are ‘frozen’ and destroyed, as well as ultrasound and radiofrequency methods to attempt to destroy fat cells.

This raise many questions for patients. What are the advantages and disadvantages of these techniques? Do these non-surgical techniques actually work? Are they suitable for me? What technique will give me the best value for my money?

Clearly the advantages of the non-surgical techniques are that they do not require an anaesthetic, have minimal down time and at first glance appear to cost less per treatment.

However the disadvantages of the non-surgical techniques are that they may have only a minimal effect, may lead to undesirable skin changes (including permanent scarring), may lead to uneven results and often require several treatments, such that the overall cost may be more than traditional liposuction.

The advantages of traditional liposuction include a much greater effect with one treatment, often being more cost effective overall.

The disadvantages of traditional liposuction include the need for an anaesthetic (whether that be local anaesthetic with sedation, or a general anaesthetic),  and a significant downtime (usually of about one week). When performed by an inexperienced operator (or the wrong patient selection) there may also be problems of failure of the skin to shrink (leaving redundant folds of skin), uneven results, and rarely skin damage (including permanent scarring).

Do the non-surgical techniques actually work?  From my experience of attending many conferences where the results of non-surgical techniques are presented by various surgeons and companies I believe that some of these techniques do work; usually a little bit, and occasionally well.

Certainly there are the ‘glamour cases’ where some quite good results have been achieved, but these are few. Usually with each technique there is one very good result presented, a handful of quite limited results and then more where I struggle to see a difference in the before and after photographs.

Bearing in mind that surgeons and companies usually only present their best results at these conferences, to my mind I have never seen enough good results that would want to make me recommend these techniques to my patients.  

At the end of the day, my job satisfaction (and reputation) comes from having satisfied, happy patients. Therefore I do not recommend techniques which I believe do not reliably produce good results in nearly every patient. So far I have not seen results from these non-surgical techniques which prompt me to recommend them to my patients.

In my opinion, only traditional liposuction surgery can achieve significant results such as those shown here.

Neck Surgical Liposuction

Surgical Liposuction

Buttock and Thigh Surgical Liposuction

Surgical Liposuction But

Which techniques are best suited to me? To be very clear, neither the non-surgical nor traditional SAL techniques are significant weight loss procedures. The non-surgical techniques are definitely designed for minor contouring, and from what I can see achieve a maximum of about 500 grams of fat loss . Traditional surgical liposuction (SAL) can achieve more significant contouring, but in my hands I rarely remove more than 6 kilograms of fat, and more often it is in the range of 3 kilograms. So if your aim is significant weight loss in the range of 7 kilograms or more, then you are best served by diet and exercise. If you cannot achieve results with diet and exercise, then you may consider gastric balloons, gastric banding, gastric stapling or various sleeve procedures.

If you have just a small area of fat you wish to reduce (500 gms or less), such as a small ‘pot belly’, or small ‘saddle bags’ or smallish upper arm fatty deposits, then you may possibly achieve a reasonable result with the non-surgical techniques, the best of which I believe are the ‘fat freezing’ techniques.

If you have significant deposits of 0.5 – 6 kgs , in particular a significant pot belly, heavy hips, ‘love handles’, significant upper arm fat, inner and outer thigh fat or a fatty neck, then I believe traditional ‘surgical’ liposuction techniques are the best for you. Bear in mind that skin shrinkage is important to achieve a good result. Most patients under the age of 35 years have enough skin elasticity for this to occur naturally. It is important that your surgeon understands that just removing fat is not enough; it is important to remove fat (but not too much), and also to shape the remaining fat and pay attention to methods to enhance skin shrinkage. Hence the term ‘lipo-sculpture’. By paying attention to these details I have been able to achieve good results in patients into their late 50’s.

What technique will give me the best value for my money? There is no doubt that there will be a group of patients who will achieve the modest result they are aiming for with the non-surgical techniques for a reasonable price of about $2,000. However I have had many patients come to me after spending up to $8,000 on multiple sessions of non-surgical techniques, who are not convinced they can see much value for their money. These patients would see better value for their money with a traditional ‘surgical’ approach.

The truth of the matter is that the non-surgical and surgical techniques are for different patients. If you have a small area of less than 500 gms to treat, then the non-surgical techniques may well meet your aims in a more time and cost effective manner. If you are looking to have areas contoured with between 500gms and 6 kg of fat removed, then surgical suction assisted lipolasty (SAL) is what you need. All techniques can lead to side effects and scarring. If you are wanting to remove more than 6 kilograms of fat, then other weight reduction techniques are probably indicated for you, with surgery and SAL helping to perform fine detail re-contouring once you have lost your weight.  

Remember, any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.