This is an interesting question, especially since they are both designed to be spot treatments for areas of unwanted fat.
First, let’s look how these two treatments work to eliminate fat. Fat has a poor blood supply compared to muscle or organs. This means that when fat is heated to 47 degrees Celsius, it will die. Both Smartlipo and SculpSure work on this principle.
SculpSure requires no anesthetic. Essentially 4 cell phone size attachments are secured to the area where you want to decrease the fat. (a belt holds them in place against your body). These attachments allow a laser to send wavelengths through your skin to heat the underlying fat. These attachments also cool the skin. The skin is not damaged but the underlying fat is heated to the necessary 47 degrees. It definitely gets warm and is somewhat uncomfortable. However, I had no problems treating my flanks. The entire treatment only takes 25 minutes. I was able to go to the gym immediately afterward with no problem. The company’s research revealed that 24% of the fat will be removed (the body just breaks down the killed fat cells with no problems). Most people should do a second treatment 6 weeks later. A person with more fat may want to do additional sessions and can expect further improvement (though not likely 24% each time). They will continue to improve for 3 months after the treatment.
Smartlipo is done in the office with local anesthetic and usually some oral sedation (if you take oral sedation you need to have a driver). I make small incisions (only 2-3 mm) which allow me to infiltrate the local anesthetic. I then insert a fiber-optic laser fiber directly into the fatty layer and significantly heat the fat (there is a temperature probe in the fiber so that the area is not over-heated). It also heats the underside of the skin which causes the skin to tighten. I then liposuction out the melted fat. You can return to work the next day and resume exercising after 5 days. You will continue to improve for 6 months.
So which is better, Dr. Berman?
Clearly, SculpSure is the easiest. You can do this on your lunch break or on your way to the gym. You do need to repeat this at least twice. There is no bruising and little to no swelling. There may be some minor tenderness but you should not require any painkillers afterward. This is the clear winner for ease of treatment.
Smartlipo is definitely more involved. You can expect to lose a day from work. You should expect some discomfort the next day and many people require painkillers, at least at for a few nights. Many people will get some bruising. The improvement will continue for 6 months. However, if you think about it: The laser fiber is in direct contact with the fat, gets very hot, and the fiber is continuously moved to contact multiple fat cells. Liposuction is then carried out after the laser is removed. Except in very thin people, you can expect more fat to be removed with Smartlipo and more skin tightening to take place. This should be considered a more aggressive treatment.
Ultimately they are both great tools to help get you closer to the body you want. It depends on what you want to achieve, and how easy you want the treatment to be.
It is best when going for a consult, to see a board certified plastic surgeon, who offers both of these treatments, to help you decide which is best for you.