By Allison Adato
November 20, 2006 12:00 PM

Colleen Donovan doesn’t mind trading a little pain for beauty. The Long Beach, N.Y., esthetician had breast implants put in 14 years ago and regularly gives clients glycolic acid facial peels. But despite always wanting “thighs that don’t touch,” she had never considered liposuction, used to sculpt targeted areas of the body. “Lipo scared me—I don’t like the dimpling, puckering effect,” says Donovan, 37, referring to a sometime side effect of the procedure, which can leave behind unsightly pockets where the fat had been. And so despite her considerable efforts—she bikes, swims, and works out three times a week with a trainer—she had all but resigned herself to the idea that her inner thighs would maintain permanent contact.

But then last fall, Donovan got a phone call that seemed to bring with it the promise of the body she wanted—without any of the drawbacks she worried about. It was from Dr. Bruce Katz, a dermatologist whom she knew professionally, asking if she’d like to take part in the trial study for a new device called SmartLipo. Done under local anesthesia, the procedure is known generically as laser lipolysis and uses a laser light to zap away fat—yielding, he told her, better, faster, less painful results than from traditional lipo. “I thought it would satisfy something that I’ve always wanted to change about my body,” Donovan recalls. “I was so excited.”

After all, who hasn’t dreamed of unwanted fat vanishing as easily as that second serving of Häagen-Dazs? Granted, SmartLipo doesn’t work quite like that—but with the Food and Drug Administration’s Oct. 31 announcement that it had approved the use of the device in this country, many are saying that, for now, SmartLipo may be as close as humans can come to that fat-melting fantasy. In fact, as soon as the FDA gave the okay, Katz, the first U.S. doctor trained in the technique (there are about 100 around the world), began “booking five or six surgeries a day,” he says, with “rock stars, actors, and business people calling,” as well as patients from as far away as Kuwait. Already, Katz’s schedule is filled through mid-February, and there is also a waiting list of doctors who want to learn how to use their own SmartLipo machines—the first new FDA-approved lipo technology in four years—which sell for $75,000.

So what is all the fuss about? According to Katz and other doctors familiar with the technology, which has been readily available in other parts of the world, including Italy, Brazil and Singapore for as long as five years, SmartLipo offers several key advantages over traditional lipo. First among them: Where regular lipo leaves skin looking “like a deflated balloon,” says Katz, in the spots where fat has been removed, the laser used in SmartLipo helps stimulate the production of collagen—which can tighten the skin in the surrounding area.

In addition, because patients need only a local anesthetic, instead of general, they remain awake during the procedure and can stand up periodically during the surgery, allowing the doctor to eyeball his work. Because he can tweak as he goes, it is less likely that the patient will need to return for touch-ups, which occur in about 20 percent of regular lipo patients.

Finally, unlike old-school lipo, which sucks out solid fat through a metal tube, laser lipolysis uses a glowing optical fiber (the doctor can watch it under the skin) to selectively target and dissolve fat. The liquid fat is then either drained or absorbed by the body’s lymphatic system and excreted (see Q&A for more details). Using the lasers, there is less blood loss and trauma, which helps explain why fewer than one percent of laser lipolysis patients suffer complications. By comparison, conventional lipo has up to a 10 percent complication rate and, according to a 1998 study (the most recent available), a fatality rate of 1 in 5000.

Similarly, because the incision through which the laser is inserted is so tiny, patients rarely need stitches to close the wound. All these factors add up to a much shorter recovery time. “You can go back to work in two days!” raves Katz.

Not everyone in the medical community, however, is convinced of SmartLipo’s superiority. “Is this something that is potentially helpful? Yes. Is it some great paradigm shift? It’s not,” says Dr. Michael Kane, a Park Avenue plastic surgeon, who doesn’t believe that laser lipo will soon replace the old model. He’s not alone: Even some of SmartLipo’s proponents strike a cautious tone about its potential for changing aesthetic surgery as we know it. As Dr. Alberto Goldman, a Brazilian plastic surgeon who has been using it for five years says, SmartLipo “is an advance, not a miracle.”

Try telling that to Donovan, who on Oct. 6 had Katz sculpt her thighs, hips, and back with SmartLipo. All told, the surgery lasted three hours. Donovan left the office thirty minutes later, with a tight-fitting bodysuit under her clothes that she wore 24 hours a day for the first week to reduce swelling in the areas that were lasered. She was back to work in a week, and returned to the gym, taking step class and a body-sculpting class, within four weeks.

A month after the surgery, Donovan’s body isn’t yet fully healed (this can take up to six months), but she is thrilled with how her body looks—despite the residual swelling and what she calls a “little funky” area on her left thigh that is slightly concave. At her six-month exam, Katz can determine whether a touch-up of the area is needed. But even now, “I love what I’m seeing,” says Donovan. “Those pockets of flesh in the back? Totally gone. Saddlebags—gone.”

Best of all, her thighs no longer touch, giving her, at long last, the body of which she had long dreamed. “It was definitely worth it, 100 percent,” she says. “I could not be happier.”


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