The Evolution of Smartlipo Laser Assisted Liposuction
Liposuction is the second most popular aesthetic procedure performed in the world today. Liposuction started as early as the 1920s when a French surgeon called Charles Dujarrier first attempted liposuction by sculpting a ballet dancer’s calves and knees, however due to an arterial injury the procedure wasn’t successful which put a halt on the development of liposuction for more than 50 years. However there was a more common practise; the surgical option, more commonly known as the tummy tuck. From the late 19th century the surgical technique to remove fat had been performed for many years - the most common example being the tummy tuck - and it worked in a very simple way. The skin is cut, the fat is then removed and then the skin is then re-draped over the stomach. There are some advantages to this technique, such as, you can remove a lot of fat at once, and it is good for the surgeon because they can see what they are doing hence you can achieve skin tightening at the same time by removing any loose skin during the operation. However, the downsides often outweigh the advantages: it is performed under general anaesthetic, entails a lengthy period of downtime and you are left with a very obvious scar, which is not what every patient wants.
It wasn’t until the late 1970s that Arpad Fischer, Georgio Fischer, Yves-Gerard Llouz and Pierre Fournier developed modern liposuction techniques in France and Italy. Before the seventies, fat could only be extracted in lumps through large skin incisions which caused extensive permanent large scarring. The greatest innovation of these surgeons consisted of the use of cannula. A type of tube open at both ends which removed large quantities of fat through the incisions, leaving less scarring. The cannula which was joined to a high vacuum bottle was capable of removing the fat cells by working underneath the skin. It was therefore possible to treat large areas with only one or two small scars. Thanks to this suction method, remarkable changes were achieved in the body contours of the patients. Even though these cannulas produced remarkable changes, the instruments were cumbersome and rudimentary. The method therefore called for a general anaesthetic, the bleeding and bruising could be excessive, and the recovery slow and difficult. Traditional liposuction was introduced in the early 1980s and became the standard technique for the next twenty years, it works by making a small incision in the skin and sucking out the fat with the liposuction device, but the problem lies in the fact that we have two different types of fat: deep, loose fat and superficial fat. Liposuction tackles the deep fat but can’t remove the superficial fat because it is very vascular; if you attempt to remove it with liposuction you risk too much bleeding and damage to the skin. It was obvious; we needed to find a solution to the superficial fat.
By the 1980s the techniques had become very popular in the United States and in 1985 Jeffery Klein revolutionised liposuction by perfecting the tumescent technique. Before this, all liposuction procedures were performed under general anaesthetic which mean the procedure was associated with significant surgical blood loss and a longer recovery time. However now that the tumescent technique had allowed the procedure to be done under local anaesthetic it significantly reduced the amount of blood loss, discomfort, haematoma and recovery time. This new form of liposuction under local anaesthetic was known as Tumescent Lipoplasty. Large amounts of liquid consisting of a solution with adrenalin and a much diluted local anaesthetic was infused into the fatty tissue in the areas to be aspirated. This tumescent solution provided the necessary local anaesthetic during the procedure, allowing the patient to remain calm and comfortable during the operation. The large quantities of diluted adrenalin in the tumescent solution make the blood vessels in the area contract, therefore reducing blood loss and haematomas to a minimum. Consequently the surgeon can take all the time he needs to remodel the area, aiming for, and achieving far better results. Tumescent anaesthesia also allows for rapid and comfortable recovery, reducing the convalescing time from several weeks to just a few days. In some cases it required blood transfusions, with prolonged recovery times accompanied by profuse bruising. In fact, some surgeons still continue to use this old type of liposuction today and recommend the transfusion of a one unit of blood for every litre of fat aspirated. Tumescent Lipoplasty instead does not require any transfusions and bruising is kept to a minimum. While the results of the old type of liposuction consisted of being able to remove the fat without extensive scarring, with Tumescent Lipoplasty it was possible to sculpt treated part of the body and improved figure. Small, more delicate cannulas produce smoother contours, achieving a greater slimming of the skin allowing it to fit snugly over the new structure that is carved in the fat. Seeing that there is no blood loss, extensive areas can be treated in one single session with the achieving of really spectacular changes.
All research at the time was dedicated to finding ways to tackle the superficial fat. The first approach was applying heat to the surface of the skin in an attempt to emulsify the superficial fat underneath - not through an incision - and lots of different forms of energy were experimented with, including laser, radiofrequency and ultrasound. These techniques were often combined with traditional liposuction, but they didn’t have the desired result because the more energy you apply through the dermis, the more you risk damaging or burning the skin before you even have an impact on the fat underneath.
Today there have been many advances in the liposuction technique and there are now many different types of liposuction available; all performed under local anaesthetic. These include suction-assisted liposuction (SAL), power-assisted liposuction (PAL), ultrasound-assisted liposuction (UAL), twin cannula-assisted liposuction (TCAL), external ultrasound-assisted liposuction (EUAL), waster-assisted liposuction (WAL) and finally Laser-assisted liposuction (LAL).
The laser assisted liposuction technique uses the Smartlipo's pulsating laser beam which has a photo-mechanical effect rupturing the fat cells' membrane. Combined with this it has a thermal effect which melts the fractured fat cells and coagulates small blood vessels which reduce the bleeding to a minimum.
Both effects together (photo-dynamic and thermal) will give skin tightening results. The deep fat is lasered first, followed by the superficial fat, and then, finally, the fat is suctioned out. Smartlipo seals-off minor blood vessels during the lipolysis procedure and it is thought, in the longer-term that Smartlipo leads to production of collagen and supporting tissues to tighten skin, which results in a sculptured and smooth finish.
SmartLipo is a less invasive procedure than the old traditional form of liposuction and can be used on the same areas that liposuction is used. SmartLipo goes one step further than ordinary liposuction by sucking out both the deep fat and the superficial fat, whilst the laser targets the fat cell membrane and punctures it. The fat then drains out through the lymphatic system, disturbing the structure of the fat cell. Due to the SmartLipo cannula being very small, Smartlipo can be performed on the stomach, legs, thighs, neck and other larger troublesome areas. The LASERLIPOLYSIS treatment does not call for hospitalisation or a general anaesthetic as it is carried out as a day case surgery procedure in a proper surgical laser operating theatre and it is defined by the Healthcare Commission in the UK as a minimally invasive laser surgical procedure. It allows for a rapid recovery and return to a normal lifestyle after one day of the treatment. The results are permanent and produce a harmonious body profile within a very short time without excessive traumas or aggressive treatment. The deposits of fat in the jaw, waistline, hips, abdomen and inner and outer thighs, knees and legs are the areas where laserlipolysis produces the most spectacular results. “Normally any area with an excess of adipose tissue can be improved with laserlipolysis. In women, the most frequently treated areas are the abdomen, hips, thighs, knees and arms. In men, the “life-ring”, abdomen, and enlarged male breasts (gynecomasty) are the most frequently treated areas. An excess of transpiration in the armpits can also be attenuated with this technique. The sweat glands under the arms can be removed without any adverse effects.
Dr Ayham Al-Ayoubi developed the revolutionary laser assisted liposuction technique in 2007. This technique facilitates liposuction, enhances skin tightening, and reduces bleeding, bruising and patient downtime. It is based on lasering the fat tissue using Smartlipo laser energy, followed by skin tightening (taking advantage of the thermal effect of the laser energy). The suction machine or the bodyjet liposuction technique is then used to suck out the liquefied fat. This technique has now been adopted by numerous plastic surgeons and cosmetic doctors worldwide.
Fat used to be left to vacate the body naturally on its own through the lymphatic system in areas such as the knees, but now most of that stubborn fat can be suctioned out. Otherwise the results rely on the patient to follow up the procedure with exercise and a healthy diet and not all patients do this. Also many patients don't want to wait for three to four months to see the results. Therefore it is possible for them to see the results straightaway after the Smartlipo and to feel the skin tightening effect working as they are lying there.
About 50 to 60 per cent of the fat is removed at the time of the procedure and the rest is left to drain out through the lymphatic system. The reason behind this being the maximum amount of fat that be removed, is that if too much is suctioned out at once then you risking leaving the patient with a big dip under the skin, causing indentations. Also because it is performed under local anaesthetic it would be very painful if the cannula went too close to the muscle which can also result in bruising. There is no need to be aggressive because the rest will clear out of the system naturally - within four weeks’ time the patient will have amazing results.
The London Medical and Aesthetic Clinic is proud to be the leading clinic in Smartlipo.
Dr Ayham Al-Ayoubi introduced Smartlipo into the UK in June 2006. One year later, he pioneered the revolutionary Laser Assisted Liposuction technique. Dr Ayham Al-Ayoubi from London Medical and Aesthetic Clinic has also created a brand-new laser breast lift, that doesn’t involve knives or needles. Instead, it uses a combination of laser-lipo and lasers to lift and tighten. The Scar-free Breast Lift is a pioneering technique from Dr A Al-Ayoubi using Smartlipo MPX for breast enhancement and lifting reporting a 4 to 7cm lift, all with minimal pain bruising or swelling, less downtime and quick and efficient results. Smartlipo Scar-free Breast Lift is the most recent application of Smartlipo technology. Fast, efficient, with permanent results, the Breast Lift is like a facelift for the breast and works best on slightly droopy breasts caused by children, ageing or weight loss. Smartlipo MPX technology works by introducing pulsed laser energy through a cannula to liquefy fat, which is then removed from precise sites in the breast area. Fatty deposits are also removed from the arm pit area and the treatment boosts collagen production. The laser energy also coagulates the tissue, thereby sculpting body contours and tightening the skin - which in turn provides the lifting effect. The procedure generally causes no bleeding, swelling or bruising resulting in fast recovery. Taking around 1 hour for the total process the treatment takes place under a local anaesthetic which results in minimal downtime for the patient. Clients can return to work within 2 days, the gym after about a week or so. It’s not suitable for very large breasts, though: ‘It’s perfect for women who have slightly droopy breasts caused by children, ageing or weight loss. It’s like a facelift for breasts.
In 2008, Dr Ayham Al-Ayoubi introduced the evolution of laser treatments into the UK from the USA, the second generation Smartlipo MPX. He started to use this evolutionary laser in his laser assisted liposuction technique. This allows him to perform Smartlipo with suction in multiple areas, producing a skin tightening effect.
Smartlipo - I Generation Laser Lipolysis
Smartlipo MPX - II Generation Smartlipo with suction
SmartlipoTriplex - III Generation Smartlipo with suction for large areas
The Smartlipo MPX uses two different laser wavelengths, both targeting the fat cell membranes, blood vessels and water which give the skin a tightening effect, in addition to fracturing the fat cells.
In 2010, the third generation of Smartlipo, known as Smartlipo Triplex, was introduced into the UK and Europe by Dr Ayham Al-Ayoubi. This machine uses three different wavelengths of laser energy and has taken the laser assisted liposuction technique to a different level. It allows the plastic surgeon to perform Smartlipo with suction on multiple and large areas giving a skin tightening effect with no surgical scars and with no down time.
The laser assisted liposuction technique has been adopted by numerous plastic surgeons and cosmetic doctors worldwide.
In addition, Dr Ayham Al-Ayoubi has been travelling worldwide, teaching this revolutionary advanced laser liposuction technique. He performs this procedure at his Clinic in central London, which is the UK's official training centre for Smartlipo laser liposuction.
How the procedure is carried out:
The areas to be treated are marked with a special pen and each area is divided into segments of 5 x 5 cm. A small incision 1 - 2 mm is made with a micro-scalpel in which the local anaesthetic is injected. The local anaesthesia is carried out via longitudinal infiltration of the subcutaneous fatty tissue in anything from ten to twenty directions in order to form a network.
The optical fibre of the laser is inserted into the same incision created for the infiltration of the anaesthetic solution. Its transit through the skin is monitored by means of the guiding light on the laser device itself. The actual treatment begins by slowly moving forwards lengthwise following the lines traced on the skin and trying to constantly maintain the same speed of movement.
The deep fat is lasered first, followed by the superficial fat, and finally the fat is suctioned out. This produces positive results and is relatively painless. Dr Ayham Al-Ayoubi always reminds his patients that it is not possible to have any procedure without some discomfort, but this is a very positive and safe procedure.
After the procedure patients are given surgical compression garments to wear on the treated areas. These need to be worn for approximately two to four weeks. The surgical compression garment helps the skin to contract smoothly to the body’s new contours. As expected and as is explained to all patients before undergoing the procedure, there may be possibly be some welling, bruising and tenderness in the treated areas, the surgical compression garment also aids in reducing these symptoms of pain and discomfort.
The skin tightening in some areas such as hips is immediate. Patients often like to see results straightaway; they don't like to be told that it can take many months to see results. It is performed under local anaesthetic, eliminating the need for a general anaesthetic and an overnight stay, which also means that it can be performed on patients who aren't suitable for general anaesthetics. There are no stitches, just a very small incision that heals very well and quickly. Within three or so months, the patient can generally see the final result.
Another way to speed up the process of the body’s lymphatic drainage is to use radio frequency with the Velashape system. Velashape is a well-known, proven and almost completely painless solution to cellulite and sagging skin.
Combined energies known as elos precisely target and heat fatty tissues within the cellulite treatment area. In addition, the vacuum and tissue manipulation evens out the skin affected by cellulite to reveal a smoother, tighter figure.
The precise heating ensures a safe, effective, fast treatment with no downtime. The net result increases the metabolism of stored energy, increases lymphatic drainage and reduces or shrinks the size of the actual fat cells and fat chambers.
Vacuum and specially designed rollers for the mechanical massage smooth out the skin to facilitate safe and efficient heat energy delivery.
At our clinic, Smartlipo laser assisted liposuction is performed by Dr Ayham Al-Ayoubi, the UK's leading Smartlipo surgeon. The procedure is carried out at the Cadogan Clinic which is considered to be the ultimate Plastic Surgery day hospital, offering the full range of liposuction treatments, all in discreet, exclusive surroundings.
Smartlipo was approved by the Medicines and Health Care Products Regulatory Agency (MHRA) - UK, June 2006, and the Food and Drug Administration (FDA) - USA, December 2006.
Patients travel from all over the UK and from around the world to have Dr Ayham Al-Ayoubi perform Smartlipo laser body sculpting treatments at our clinic in London, which is the leading training centre for Smartlipo laser assisted liposuction in the UK and Europe. Smartlipo is a wonderfully safe, high quality procedure. It is not yet a replacement for liposuction, although Dr Ayham Al-Ayoubi predicts that it will be in the next four to five years.
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