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Aesthetic Surgeons Sort through Data on New Fat Treatments 

New York, NY – The world's top plastic surgeons gathered here recently to discuss “Hot Topics” in fat treatment at the Annual Meeting of the American Society for Aesthetic Plastic Surgery (ASAPS) . SmartLipo TM , a laser-assisted lipolysis (fat destroying) procedure, and two ultrasound-based techniques for fat reduction were discussed and debated. Although SmartLipo received FDA clearance in late 2006, alarm bells rang for many experts when discussing this procedure based on the recent publication of data showing that this procedure was no better than traditional liposuction, and that it may present some risks to the liver and kidneys due to the way it releases free fatty acids when destroying the fat cells.

“We need to sit back and evaluate new technology as scientists before we can recommend it to patients. We now have a well-designed trial demonstrating that SmartLipo TM does not have any significant advantages over standard liposuction, that it may increase operative time, and that it's more costly. The study also raises the very serious concern that the effect of the laser emitted by the SmartLipo TM device releases free fatty acids that could be dangerous for our patients. Suction-assisted lipoplasty remains our standard of care,” said presenter Z. Paul Lorenc, MD.

The data presented by Dr. Lorenc on SmartLipo were from a prospective randomized study published in 2006 by Arturo Prado, MD, in the Plastic and Reconstructive Surgery Journal that compared suction-assisted lipoplasty and laser-assisted lipoplasty. With SmartLipo TM , a laser probe is inserted into the target area through a small incision. The surgeon aims the probe at fatty tissue to rupture the fat cells. Smaller fat cells are then absorbed by the body, while larger areas are aspirated (suctioned). This technique has received significant media attention as a popular ‘fat-melting' treatment with a celebrity following.

“Similar ‘fat melting' technology was promoted about 15 to 20 years ago. I am amazed it could come back 15 years later in a different guise,” noted Dr. Peter Fodor, MD, past president of ASAPS and past president of the Lipoplasty Society of North America.

During Hot Topics two other ultrasound fat treatment techniques were discussed. Liposonix ® and UltraShape ® are both in development and not currently approved by the U.S. FDA. These are ultrasound-based body sculpting devices that may offer some patients a non-surgical alternative to traditional suction-based liposuction. In both techniques, ultrasound is administered via external device. The excess fat targeted by the ultrasound is destroyed and then naturally absorbed and removed by the body.

All studies of Liposonix ® to date have been performed in Mexico. Data from the Mexican research has been submitted to the FDA and a U.S. study is expected to begin soon . Data from studies in the U.S. and Europe, several of which have been published, has demonstrated that UltraShape ® produces measurable reductions in circumference of treatment areas, no serious adverse events, and high patient satisfaction with minimal to no pain or discomfort. This technique is still being refined and improved for more consistent results.

“Ultrasound devices, if approved, could provide convenience for patients who don't want surgery or invasive treatment for contouring of the abdomen, flanks and thighs,” said Benjamin Ascher, MD, UltraShape ® investigator. “In general, the success of any body contouring technique requires selecting the right treatment for the right patient, and making sure the patient has realistic expectations.”

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