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Surgeon Vs The Machine

Question: Ultrasonic liposuction, laser liposuction, tickle liposuction, body jet liposuction, liposculpture, power-assisted liposuction:  the number of liposuction technologies can be overwhelming.  Should you go to the guy with the laser machine, or should you visit the guy who uses sound waves to break up fat?

Answer: You should probably visit the surgeon who has the best credentials, bedside manner, and before/after photos.  The technology is usually secondary.  In fact, a surprisingly high proportion of the physicians performing liposuction have no formal background in plastic surgery; many are gynecologists, general surgeons, internists, and family doctors.  Their motivation is understandable. As health care reimbursement declines, many move outside their specialty training in an effort to improve their bottom line.  Many of these physicians purchase the “newest technology” and take weekend courses to learn how to use it.  Unfortunately, the machine is just a machine.  It requires extensive training, expertise, and experience to achieve quality liposuction results.

Perhaps the best analogy is that of an artist.  Suppose that you provide a drawing novice the best pencils, canvas, easel, and drawing room that money can buy.  Now give an experienced artist the nub of a used-up pencil and an old piece of typing paper.  Who do you think will produce the better drawing?

By way of disclosure, I have been performing liposuction for 18 years using a superwet technique.  In my private surgery center in Plano, I inject a “wetting” solution of local anesthesia, epinephrine, and saline followed by liposuction via a cannula (hollow tube) connected to a suction machine that produces a vacuum.  The technology is relatively modest; you can judge the results for yourself.  You may also be interested in learning that I have been performing wood and marble sculptures for about 30 years.   I am tired of hearing the term, “liposculpture,” from physicians who have no artistic background and have never sculpted anything in their lives.

I am not suggesting that you should ignore technology altogether.  Certain patients may be better served by certain machines.  However, it is my impression that for the vast majority of patients, the liposuction surgeon is far more important than the machine.

Liposuction of abdomen, hips, flanks, inner and outer thighs


Before front / Before side / Before back


After front / After side / After back

Liposuction of abdomen, flanks, and lumbar regions


Before front / Before side / Before back


After front / After side / After back

Liposuction of knees

Before / After

Before / After

Liposuction of submental (under the chin)

Before / After

Before / After

Ronald M. Friedman is a board-certified plastic surgeon providing liposuction, tummy tucks, and breast surgery to the Plano, Frisco, Allen, Fairview, and McKinney communities.  He is the Director of the West Plano Plastic Surgery on the campus of Texas Health Presbyterian Hospital of Plano.

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© 2018 Ronald M. Friedman, M.D., P.A.

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