Laser lipo: new study fails to impress me

In this month’s issue of Aesthetic Surgery Journal, Dr. Barry diBernardo presented his latest study on skin shrinkage after laser-assisted liposuction. The study was funded by one of the laser manufacturers. Dr. diBernardo has been diligently researching this area for several years, and my impression of him after seeing him in person is one of an honest researcher.Dr. diBernardo measured rectangular areas of skin, based on tattooed markings, on the patient’s abdomen, and also used a device to measure skin flexibility both before and after surgery. One-half of the abdomen was treated with the laser liposuction with the laser turned on as usual, the other half treated with the laser turned off – only suction. Patients were evaluated pre-surgery, at one month and three months afterwards.
Here are my thoughts on the study:
1) Good methodology, but a small treatment group – only 9 patients were studied.
2) Although both treated sides look better, you really don’t see any obvious difference in contouring between the two sides in the photos. Maybe it’s a case of “Good surgeons get good results, regardless of the tool they are using”. The laser side does not look significantly better than the non-laser side.
3) Data for skin shrinkage show an average of 16% area shrinkage on the laser side, versus 13% shrinkage on the non-laser side, at three months after surgery.
In other words, there’s a…wait for it…three percent difference in skin tightening between laser liposuction and standard liposuction. Three percent area change is a very small difference indeed, but it was found to be statistically significant in this study.
I would counter that although it may be statistically significant, the difference is certainly not clinically significant in terms of appearance, and that’s what my patients care about.
4) The skin became stiffer and less pliable after laser liposuction. Is that a good thing? I don’t agree with Dr. diBernardo that skin stiffness is a desired endpoint. After all, beautiful skin should be soft and pliable; scars are firm and inflexible. I suspect that the changes are probably due to increased scar tissue within the dermis, caused by all that laser energy.
Bottom line: Already, laser lipo enthusiasts are pouncing on this study, saying “See – statistically signficant results”. I’m really underwhelmed by the photos of the results, and a three percent difference in skin shrinkage is simply not impressive at all, in my opinion, regardless of what the statistician says.
Maybe it’s a case where believers want badly to find anything that supports their cause, while non-believers are unimpressed. I’m firmly in the latter group. I’ll put the three-phase “SAFE” lipo method I use up against the laser, any day of the week!