I have prospective patients come in to the office every single week requesting “smartlipo” or “laser liposuction” without anesthesia. They have often gone to see other physicians that have offered them this procedure, and knowing that I focus my practice on breast and body contouring in my southern New Jersey practice, they come in requesting this procedure.

Liposuction under local anesthesia is safe when done in limited quantities. When I was a resident in training in Dallas I was a co-author of a pivotal studies on liposuction, which measured the effects of various anesthetics and medicines used to perform liposuction. These studies were presented to plastic surgeons at national meetings and published in national journals. The take home message of the studies was that liposuction has a significant physiologic impact and that the medications used to perform liposuction must be respected in quantity used.

I have certainly performed Smartlipo in my office. Whenever I do so, it is in very safe, very careful, small amounts. I have even seen blogs and ads from attorneys who have had cases resulting in horrible outcomes from procedures performed in an unsafe manner. Prospective patients come in all of the time requesting to have many liters removed by “Smartlipo.” This is always turned down as it is simply not safe. Radio ads (which I have heard repeatedly) offering to remove 15 pounds of fat in the office under local anesthesia are not only misleading but dangerous.

My advice is the following: go see a plastic surgeon who has all of the tools to perform your procedure. If he or she only has a smartlipo machine, and does not operate at a hospital or accredited surgical facility, you are likely going to be offered this procedure. If he or she has regular liposuction, power assisted liposuction, ultrasound assisted liposuction and non-invasive techniques such as Zerona, you will have a surgeon who can educate you on all of your options and use the best machine available for your treatment. If he/she is not a plastic surgeon and is not trained in multiple procedures and techniques, you should head for the door quickly. This is not just a cosmetic issue, it is a life or death issue.

New Jersey legislatures currently have a bill in legislation A-3491 which will limit liposuction in the office setting in the state of New Jersey. This bill will limit the amount of liposuction a physician can do in his/her office unless the office has a truly accredited operating facility.

Liposuction is a great procedure; but any surgery carries risk. Large volume liposuction in the “office” without proper monitoring simply is not safe. Even in perfectly monitored conditions, liposuction will carry some risks to the patient. Minimizing risk should be the goal of the patient and of the surgeon. If larger amounts of fat need to be removed, the patient should be educated on the proper procedure, environment, and given reasonable goals.

Be careful out there!