Invasive vs. Minimally Invasive vs. Non-Invasive: Which Lipo Procedure is Right for You?

Invasive vs. Minimally Invasive vs. Non-Invasive: Which Lipo Procedure is Right for You?

If you’re thinking about getting a cosmetic procedure designed to remove unwanted fatty deposits from under your skin, chances are you’re thinking about liposuction. Today, you have more options than ever before for this type of cosmetic procedure.

More choices mean you have more to consider when making your decision. One deciding factor might end up being what level of downtime your schedule will allow. Here is a general overview of the different types of liposuction and cosmetic fat removal procedures.

A Side by Side Comparison of Fat Removal Procedures

Traditional Liposuction



Anesthesia General anesthesia (you are asleep during the procedure) Local anesthesia (you are awake during the procedure) None (you are awake during the procedure)
Incisions Large incisions Small incisions None
Results Noticeable improvement at 3-9 months, final results at 1 year Noticeable improvement at 1-3 months, final results at 6 months Noticeable improvement at 6 weeks, full results at 12 weeks
Downtime Days and weeks of downtime 1-2 days of downtime and often less No downtime – Return to normal activity immediately
Areas of Body that Can be Treated Most areas of the body Most areas of the body Currently approved for abdomen and flanks. It is being used “off label” to treat most areas of the body. Likely will not be long before FDA clears it for all areas.
Bruising Extensive deep tissue bruising that lasts weeks and even months Minimal bruising, if brusing occurs it typically resolves in 2-3 weeks No bruising
Candidacy Best for those that have a high volume of fat to remove. Addresses deep tissue fat best Best for those who are within 20lbs of their ideal body weight Best for those with a BMI of 30 or less
Compression Garment Yes, typically worn for up to 6 months post procedure Yes, typically worn 3-4 weeks post procedure No compression garment
Procedure Time Actual operating time is typically around 1-1.5 hours. Traditional liposuction is performed either in a hospital or surgical center Average procedure time is 1-1.5 hours, typically performed in an “in-office” operating room As little as 25 minutes
Permanent Destruction of Fat Cells? Yes Yes Yes

Traditional Liposuction: The Most Invasive Option

Traditional liposuction was once the gold standard in liposuction and is often what comes to mind when we think about surgical fat removal. In this process, patients are given general anesthesia to put them in an unconscious state. This requires an anesthesiologist, so these procedures are often done in hospitals or surgery centers.

To perform the procedure incisions are made in the skin and an instrument called a cannula is inserted. Some surgeons use a manual cannula which has to be aggressively used to scrape the fat. Others use a powered cannula which shaves or bites the fat to remove it from the skin. While the fat is being loosened by the cannula constant aspiration or suction is being used to eliminate the fat from the body. The traditional liposuction technique is considered the most invasive.

This type of liposuction is effective and still remains popular, and is routinely used to treat larger problem areas with high volumes of fat.  However, this procedure causes tremendous tissue trauma resulting in extensive bruising. For this reason traditional liposuction has the longest recovery time with patients reporting pain, discomfort and bruising. Typically a compression garment is required to be worn for six or more weeks following traditional liposuction. While this method can remove a lot of fat it does nothing to tighten the skin and can often leave you with crepey, lose skin.

Smartlipo: Minimally Invasive Liposuction

Smartlipo is a form of laser assisted liposuction that uses laser energy to liquefy fat prior to being removed from the body. Smartlipo is actually the name of a particular laser. Not all laser assisted liposuction procedures are Smartlipo. The latest version of Smartlipo is the Smartlipo Triplex which houses three different wavelengths of laser. This technology allows for fast and efficient melting of the fat, skin tightening and protection of the surrounding skin tissue. Smartlipo is performed under local anesthesia, so this procedure is not limited to hospitals or surgery centers, in fact many offices have an in-office operating room where these procedures are performed.

The incisions that are made are much smaller than the ones used for traditional liposuction. As a result, this is a minimally-invasive procedure. The local anesthesia is a numbing fluid comprised of lidocaine and epinephrine. It is infused under the skin allowing the patient to be awake for the procedure all while having no pain. Once the area is numb, a thin cannula with a laser fiber threaded through it is inserted under the skin. The laser melts and liquefies the fat and then aspiration or suction is connected and the melted fat is removed from the body.

Recovery time from Smartlipo is very quick. You will feel sore for a several days post-procedure, but you should be about to go about your daily activities. In most cases a compression garment will be required to be worn for approximately 3 weeks. Smartlipo is considered to be both effective and convenient.

SculpSure: Non-Invasive Liposuction

Relatively new to the market is SculpSure, a non-invasive, laser lipolysis treatment designed for full body use. It basically uses the power of heat and light to elevate the tissue temperature and disrupt the fat cells. Then, the body naturally eliminates the fat cells over a period of weeks. Because there are no incisions or anesthesia needed, this is the least invasive procedure used to sculpt bodies and reduce the amount of fat in the treated area.

The procedure is very quick, in many cases just 25 minutes, depending on the number of applicators used. Various templates are available for this procedure so the doctor or clinician performing your procedure will determine the best configuration to treat your desired area. The templates are belted on and the laser applicators are snapped into place.

There’s no suction or pulling involved the applicators lay flat on the skin. It works on a modulation of heating and cooling (10 seconds cooling, 20 seconds heat). The laser penetrates the skin and heats up adipose tissue where the fat cells reside. The heat shocks and damages the fat cells, your body’s immune system sees them as trash and flushes them away. This process can take up to 12 weeks to complete, but many people can begin to see change as early as six weeks. Once the treatment is complete you can immediately return to normal activity (ie. work, the gym, anything). There’s no recovery time. Some patients have reported some mild tenderness in the area for a few days.

You’ll have to decide for yourself which fat removal option works with your lifestyle and tolerance level. Whichever one you choose, however, make sure you consult with a medical practitioner who knows about cosmetic procedures and can administer them safely and effectively.


Sharon Lewis

Previously, I had the SulpSure treatment for my lower stomach it did not work as I hoped it would. I am now thinking about the Smartlipo; however, I am concern about the side effects. What are the side effects?

Lindsay Spires

I’m sorry to hear that you didn’t see the results you had hoped for with SculpSure. I don’t believe you had SculpSure with us. Did you have 2 treatments or just 1? Smartlipo is certainly a great option and does provide a bigger reduction than even 2 treatments of SculpSure. Smartlip is a very safe procedure. Dr. Kulkin has been performing Smartlipo since 2008 and we have done almost 9,000 cases. We have had no major complications, meaning our patients have not experienced an infection and no one has ever had to visit the emergency room. In the right hands this procedure is very safe.
We welcome you to schedule a consultation with Dr. Kulkin. Please let us know how we can help.



I am considering having a lipo procedure the less invasive the better, but I do want to see results and I’m on a budget. I am looking to lose about 20 lbs in my tummy. I’ve read the “Smartlipo” also tightens the skin. What is the average price and how many procedures are required for the results I’m looking for?

Lindsay Spires

Hi Susan,

Smartlipo does offer skin tightening, however there are limitations to how much skin tightening it can provide. Basically the way your skin looks at the time of the procedure is how your skin should look afterward; you will not be left with loose, saggy skin once the fat is suctioned out. It certainly will never take the place of a tummy tuck, as it can’t re-tighten already loose skin.

You mentioned that you are looking to loose 20lbs; Smartlipo is not a weight loss procedure per se. Smartlipo takes off more inches than pounds. You could have this procedure done and the scale may reflect a 5-8lb weight loss, but you lost 2-4 inches off of your waistline (this is just an example). I just want to set realistic expectations in case you are concerned with what your scale reflects. Any weight loss you can achieve through diet and exercise before or after your Smartlipo will only enhance the results from your liposuction procedure.

Smartlipo is a one time procedure. We don’t have set prices for our Smartlipo procedure, as everyone’s needs are so different. I can provide you with a broad price range for the abdomen area (upper, lower, sides and waistline). On average most women run between $4900-$6000. In order to get an accurate quote we invite everyone to schedule a free consultation with Dr. Kulkin, that way he can understand what you are looking to achieve and if this procedure is the right one for you. Please let me know if you have any additional questions or if you would like to schedule time to meet with Dr. Kulkin.


I have a BMI of 33-34 and think I prob need 20lbs of distributed fat removed and mainly inches from my waist arms and back.
I am scared for pain and don’t want much downtime what would you recommend?

Lindsay Spires

I believe the decision comes down to how much reduction you are really looking for with these different procedure options. Minimally invasive procedures, like Smartlipo will deliver much more reduction than a non-invasive procedure and the results are much more predictable. Don’t get me wrong we love SculpSure and it does a nice job for our patients, but we have to rely on your body to process and get rid of the disrupted fat cells so it is harder for us to predict how much reduction any one patient is likely to see. You also need at least 2 treatments to get this best results with SculpSure or any non-invasive procedure. Smartlipo or minimally invasive treatments are a one-and-done type treatment. I would advise you to schedule a consultation so that we can discuss your options with both procedures and then you can decide for yourself which one is right for you.
You mentioned you were apprehensive about pain. There is minimal downtime with Smartlipo. You are up and moving same day and next day. You should anticipate feeling very sore like you have done one heck of a work out, but it shouldn’t keep you from your day to day activities. Following a SculpSure treatment there is zero downtime. You may have some mild tenderness if you mash on the area afterward, but most patient don’t even notice it.
Let me know if you have other questions. Happy to help.


Can it be done for a person with a BMI over 50? Or rather would it make sense?

Lindsay Spires

Non-invasive and minimally invasive procedures are better designed for smaller problem areas. That’s not to say that individuals that weigh more or have higher BMIs won’t see a reduction, but the reduction would probably not great enough to justify the cost. These procedures are just not designed for high-volume fat removal.

Lindsay Spires

Unfortunately, I don’t have a referral for you. There are many non-invasive therapies available for fat reduction. I do encourage you to do your research and read reviews. We use SculpSure as our non-invasive therapy for fat reduction. I’m sorry I can’t be of more help to you. Best of luck to you!


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