I am frequently asked by patients, reporters and market researchers about the latest trends in plastic surgery. Most new technologies promise surgical results with no recovery time. I like to keep up with what's new, but listen with a critical ear. At the recent American Society of Plastic Surgery Meeting I had the opportunity to speak with several vendors of new technology, and it struck me that many plastic surgery procedures are hard to beat in terms of efficacy.
For example, there are several new(ish) technologies claiming to provide liposuction results without the need for surgery. A few have clinical research to show that the technology is safe and effective. When comparing to surgical liposuction, these alternative procedures have a shorter recovery and lower cost per treatment; however the degree of effectiveness is debatable, and the number of treatments required can outstrip the lower cost per treatment advantage. The clinical studies that do exist show that noninvasive methods can result in hundreds of cc's of fat reduction (up to a pound of fat) and repeated treatments are usually necessary to achieve the desired results. Compare this to surgery which can remove thousands of cc's (up to eleven pounds) in one treatment. Upper limits will depend on the amount of fat available to be removed.
This is not to say that there is no roll for more limited procedures, and if they improve, one day they may indeed replace liposuction. I am excited about being able to move in this direction, but more effective treatments are needed before they can truly compare to liposuction. There is a reason that liposuction is the most frequently performed cosmetic plastic surgery procedure - it works. As with any procedure, careful patient selection is the key.
No matter what the topic, it pays to ask critical questions. I am always suspicious of oranges that claim to be as good as apples. New procedures have the connotation of better, but old procedures that persist today have withstood the test of time. The strengths and weaknesses have been defined, leading to increased safety and predictability. We can't make progress without change, but if something sounds too good to be true ... it probably is.
By: Joseph Mele MD, FACS