We can provide cover for laser lipolysis within your medical malpractice insurance policy.
If you are looking for insurance to cover laser lipolysis, please contact the team on 0800 6343881 or email cosmeticsales@hamiltonfraser.co.uk.
Hamilton Fraser covers doctors, surgeons, dental hygienists, dental therapists and nurses who have completed the relevant theoretical and practical training.
Lipolysis is the process by which fats (lipids) are broken down in our bodies through enzymes and water. It entails hydrolysis, the chemical breakdown of a compound – triglyceride, for instance – which is broken down into free fatty acids and glycerol, due to a reaction with water.
Lipolysis procedures are nonsurgical body contouring treatments which break down and reduce fat cells by targeting smaller deposits of fat on specific parts of the body using laser, heat, cooling, radiofrequencies or an injected medication.
Lipolysis is a minimally-invasive method of dissolving small and medium unwanted localised pockets of fat that are resistant to diet and exercise, with the aim of shaping the body, without the risks associated with traditional procedures such as liposuction.
Lipolysis is generally used to target localised areas of fat and can be used on many areas of the body including:
- Arms, for example ‘bingo wings’
- Back
- Belly and flanks
- Buttocks and ‘love handles’
- Neck and a ‘double’ chin
- Thighs, for example ‘saddle bags’
There are several types of lipolysis procedure including:
- Injection lipolysis treatment: this popular procedure involves a fat dissolving injection that can be used almost anywhere on the body to break down stubborn areas of fat, which is then eliminated through the body’s own lymphatic system, without the need for liposuction or surgery.
- Laser lipolysis: injection and laser lipolysis are the most popular techniques. Laser lipolysis uses laser energy to change the shape and appearance of the patient’s body by breaking fat cells apart, reducing the volume of fatty tissue. Laser lipolysis uses mainly the Smartlip laser, but other devices include the OSYRIS Pharaon laser lipolysis system and the CoolTouch CoolLip.
- Radiofrequency lipolysis: this non-invasive procedure uses ultrasound waves and heat to target fat cells. It heats up fat cells over a general area from a distance of one centimetre to the skin, to damage them and break them down over time, without making any physical contact or impacting other types of cells in the skin. Vanquish and truSculpt are two types of radiofrequency lipolysis.
- Cryolipolysis: this non-invasive alternative to liposuction and laser lipolysis uses very cold temperatures to destroy fat cells (for example, CoolSculpting). It involves the localised application of a low temperature device which kills off fat cells beneath the surface of the skin. Cryolipolysis is a quick treatment that preserves the surrounding skin.
Whether they do it through injection, laser, heat or via freezing cells, all types of lipolysis aim to reduce fat cells by damaging them in a minimally invasive way, so that the body expels them naturally, without bruising or scarring. However, the procedure varies depending on the type of lipolysis being used. Here, we look in more detail at laser lipolysis.
During the procedure, a fine fibre-optic probe is inserted under the skin to deliver a laser energy that breaks up fat cells, transforming them into an oily substance that is either naturally eliminated by the body or sucked out during the treatment.
As with any procedure, the patient should always have a consultation with the practitioner prior to the start of treatment to take the patient’s medical history, discuss any pre-existing health conditions or prescription medications the patient is taking, manage expectations and talk through potential side effects and aftercare. Patients should be advised to stop taking blood thinners and anti-inflammatory drugs for two weeks prior to the procedure, and to avoid any activity that might irritate the area that is going to be treated for a week prior to the procedure, including using tanning treatments and shaving.
If agreed that the procedure can go ahead, the patient should sign a consent form to confirm that they have understood any risks associated with the lipolysis treatment being carried out. At Hamilton Fraser, we recommend that practitioners take photographs which can be used for a ‘before’ and ‘after’ comparison if needed at a later date.
The procedure usually takes less than an hour, although the precise treatment time and method varies depending on the device used, how many areas are being treated and whether suction is being used. One of the most popular devices is the Smartlipo device. With this procedure, a local anaesthetic is injected into the treatment area and tiny incisions are made where the unwanted deposits of fat are present. A fine fibreoptic probe is inserted under the skin through the incision and moved back and forth under the skin, pulsing laser light into the fatty tissue. This breaks up the fat deposits, transforming them into an oily substance which is eventually eliminated by the body, either by being massaged or vacuumed out of the area. The advantage of not ‘sucking out’ the fat is that damage to the blood vessels and nerve endings is minimised. However, in some cases, suction is more beneficial to the speed and results of the treatment so increasingly practitioners are offering aspiration of the released fat after laser lipolysis to speed up and enhance the results achieved. The low level laser energy also helps to stimulate collagen production in the skin, resulting in skin tightening.
Usually, one treatment session per area is enough and the patient should be able to see some effects straight away, but this depends on the amount of fat being removed. Skin may appear tighter and feel firmer, but may also feel bruised and tender. It can take up to six months for the full results to be seen because the body continues to process the fat that has been released over a number of weeks.
Laser lipolysis is only recommended for the removal of up to 500 mls of fat in one procedure, but it is possible for a patient to undergo multiple procedures in order to enhance the results of a previously treated area or to treat a different area.
As with all procedures, it’s very important that the patient understands the aftercare required and that this has been documented, for example in an email. Following the recommended aftercare will help ensure the success of the procedure, reducing recovering time and the risk of any complications.
Unlike more invasive treatments such as liposuction, normal activities can usually be resumed within a day or two of the procedure, although vigorous physical activity is best avoided for a week or two after the treatment.
Other post treatment aftercare recommendations include:
- Avoiding alcohol consumption for 12 hours following the procedure
- Keeping the area clean and dry for two to three days following the treatment
- Taking a short course of antibiotics if prescribed
- Keeping a compression bandage on for the recommended period of time
- Avoiding vigorous massage of the treated area for a few months
Although it is minimally invasive and generally well tolerated due to the local anaesthesia, like any procedure laser lipolysis carries the risk of some side effects.
These include:
- Minor bruising, discomfort and swelling. This is normal for several days after the procedure and tends to be worse if suction is used during the procedure, but should subside within a few days
- Numbness caused by the tightening of skin as it becomes more firm and toned
- Dimpling of the skin
- Burns are very rare but if the patient does suffer a burn, there is a risk of infection and scarring
- Some people can suffer an allergic reaction from the local anaesthetic
- If the laser site isn’t properly cared for after the procedure, there is a risk of infection and scarring. In severe cases, blood clots can occur. The patient should be advised to see their doctor if they’re experiencing any unusual swelling, pain, or discharge
The length of time the effects of lipolysis last depends largely on diet and exercise. Any visible results should be permanent, provided the patient doesn’t gain weight. If the patient gains weight, the results from the lipolysis will be reduced.
Laser lipolysis is not recommended for women who are pregnant or breastfeeding or for people who are obese. The procedure works best on small, stubborn areas of localised fat.
There are dozens of training courses available from numerous providers offering training in lipolysis.
Our guide to training in aesthetics contains more information on how to get the most out of training and the importance of making sure it meets the eligibility criteria required for the purposes of insurance.
Only suitably trained and qualified medical professionals should carry out laser lipolysis procedures.
It is very important that practitioners are aware of and comply with the policy conditions, as we are unlikely to make payment if an incident occurs while policy holders aren’t in compliance.
Policy conditions include the following:
- We insure doctors, surgeons, dentists, dental hygienists, dental therapists and nurses
- The insured must have completed relevant theoretical and practical training, as well as adhering to manufacturer guidelines at all times
As with any treatment, all known side effects must be explained to the patient in the consultation and the patient must sign a consent form which outlines that they understand the risks, prior to the procedure.
Although laser lipolysis is a minimally invasive procedure, administering the treatment does involve specialist skills and equipment and, just like any other treatment, it is not totally free from risk. While most patients experience minimal side-effects, and these should all be explained and documented during the consultation, it only takes one patient to react more intensely.
For example, although with laser lipolysis the risk of infection is extremely low, there is a small chance this could happen if the wound doesn’t heal properly. While laser lipolysis is safe for people with diabetes, the risk of infection is increased for these patients. This is because people with diabetes have weaker immune systems than those without.
An example of a possible claim scenario could be that a diabetic patient suffers from an infection following the treatment and becomes very unwell. In this situation, as with any possible claim, it is vital that there is evidence that a thorough consultation was carried out, including discussion on the patient’s medical history, and that this pre-existing condition and the extra associated risks were identified. It is very important that practitioners understand that there must be sufficient evidence in the patient file, and that the consent form, signed by the patient, clearly shows that the risks were explained prior to the procedure. In this situation, given the patient’s medical background, the practitioner needs to be able to evidence that they specifically explained the added risk for a diabetic patient, and took extra precautions, for example prescribing a course of antibiotics to prevent infection. So long as the practitioner has this evidence, liability can be denied by insurers.
Claims top tip: Always make sure you have explained all the potential side-effects of a treatment to the patient, highlighting any increased risk they may be exposed to as a result of a pre-existing condition, and that the signed consent form documents this.
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