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Power Assisted Lipo Vs Ultrasound Assisted Lipo- What's the Difference?

Can these really help tighten and leave wanting results for the abdomen?

Doctor Answers 13

It's not the tool, it's the surgeon wielding it.....

liposucton general it does not tighten! good results occur when good surgeons use whatever tools they prefer  to  remedy  a particular problem. you can get good results with pal, ual, and straight suction lipectomy. pick your plastic surgeon carefully...that is the most important ingredient for getting a good outcome...which method he/she prefers is much less important. watch out for all the gimmickery and marketing hype out there for certain devices , many of which are being used by practitioners with very little surgical training.

Schenectady Plastic Surgeon
4.5 out of 5 stars 13 reviews

ultrasound or power-assisted liposuction

ultrasonic liposuction involves the delivery of ultrasonic energy to soften and even liquify the fat prior to liposuction. Power-assisted liposuction uses a device that moves a very small distance back and forth as the cannula moves through the tissue. No supplemental heating energy is delivered with power-assisted liposuction. These devices make it somewhat more easy for the surgeon in cases of more fibrotic tissue, or collagen build-up, but has never conclusively shown that it makes the result better than conventional tumescent liposuction with small cannula.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 33 reviews

Both power assisted and ultrasonic liposuction are designed to make the work of the surgeon easier.

Both power assisted and ultrasonic liposuction are designed to make the work of the surgeon easier. Although I helped to develop the most popular powered liposuction instrument, I no longer use this technique. I also abandoned ultrasonic liposuction a long time ago. After 27 years of performing liposuction, I feel I am getting the best results ever using manual liposuction. Using very small instruments, I can definitely sculpt more precisely. And if I have to work harder, it is worth it to give my patients better results.

William P. Coleman III, MD
Metairie Dermatologic Surgeon
2.5 out of 5 stars 3 reviews

Power Assisted Lipo vs. Ultrasound Assisted Lipo

Ultrasound-assisted liposuction (UAL), namely the VASER uses sound waves to disrupt the fat from its surrounding tissues, namely connective tissues and blood vessels, making UAL less traumatic to these tissues.  Power-assisted liposuction (PAL) is a powered form of Suction-assisted liposuction (SAL) which uses a tube with holes at the end of it (on the sides of the end of the tube) to pull the fat into the the tube using suction pressure to rip the fat out.  This technology tends to be less specific for the fat, thus when removing fat you will be removing some of the connective tissue and small blood vessels along with the fat.

PAL vs UAL vs traditional

I have used all types of liposuction for many years and my conclusions are:
1. Liposuction does not tighten skin. The skin gets pushed out by what is beneath it, so if you remove the fat from beneath the skin, it will shrink down to contour over the treated area, BUT it will not tighten more than it was previously.
2. All forms of liposuction involve the expenditure of ENERGY to remove the fatty tissue. With traditional liposuction, this occurs by friction and avulsion as well as the mechanical energy created by the surgeon. With PAL, the energy is delivered as a rapidly reciprocating cannula that eventually penetrates the fat clusters and is suctioned out. With Ultrasound and laser, the energy is primarily in the form of heat, which may be good or bad depending on the amount. 
3. Contrary to what many believe, all liposuction techniques have 3 main components:
 a. Infiltration of fluid to wet, numb and vaso-constrict (shrink the blood vessels) the tissues.
 b. preparation of the fatty tissue layer for removal.
 c. Aspiration of the fatty tissue by suction.
4. Smaller cannulas are able to penetrate the fat tissue more effectively and efficiently leaving a smoother blanket of fatty tissue behind and in theory a smoother result.
5. You can remove a lot more fatty tissue under general anesthesia vs local awake anesthesia
6. GOOD liposuction is very difficult and analogous to attempting to carve a beautiful marble statue while there is a sheet covering it so you can not visualize completely what the shape that you are creating looks like. 
7. There is a huge difference between liposuction and liposculpture. Most doctors perform liposuction.

Good luck!

Sam M. Sukkar, MD
Houston Plastic Surgeon
5.0 out of 5 stars 15 reviews


Power assisted liposuction (PAL) consists of using a liposuction cannula that oscillates or vibrates to help break up fatty tissue as it is being removed from the body. It allows for a slightly more gentle technique than traditional liposuction to be used and is especially helpful in areas of dense adipose tissue. I have used the PAL for about a year now and have been very happy with the results. Ultrasound assisted liposuction (UAL) also uses vibrating technology, but the vibrations are fast enough to create ultrasound energy that emulsifies fat. The fat is broken up with a separate wand as the first part of the procedure and then traditional liposuction is then completed with cannulas to remove the liquified fat. There is some evidence that when used properly, the energy can induce some additional skin tightening. There is also evidence that when used poorly, that thermal burn injuries can be produced.

In the end, it really does not matter what technology is being used nearly as much as the expertise of the plastic surgeon that is performing the procedure.

William T. Stoeckel, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 62 reviews

Liposuction using Power assisted or Ultrasonic method

Power assisted Liposuction uses a probe that vibrates back and forth and partially dissolves the fat before removing it.

Ultrasonic Liposuction acutally sends sound waves and makes the fat liquid. This allows for more efficient removal of the fat.

It also allows the dermis to contract and gives best results for liposuction of the back or male breast reduction.

Hope this was helpful.

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 172 reviews

Power assisted versus ultrasonic liposuction

The most frequently performed methods of liposuction are standard liposuction and ultrasonic liposuction.  Power-assisted liposuction is the same as standard liposuction, except that the tip of the instrument used to remove the fat is actually motorized to aid in removing the fat.  Many other "forms" of liposuction can be found on the internet, but make sure you do your research into what is really happening if you decide to go with a form of liposuction that isn't standard or ultrasonic liposuction.  Standard liposuction involves the instillation of a numbing fluid underneath the skin into the area of fat to be removed.  This can be done under general, sedation, or even local anesthesia (for smaller areas.) Then, the standard liposuction cannulas (instruments) are used to remove the fat.  Ultrasonic liposuction is basically done the same why, except the tip of the liposuction cannula emits ultrasonic waves.  This emulsifies the fat and allows easier removal of the fat.  Recovery varies depending upon how much fat is removed, but is generally around 1 week.  Compression garments are used to mold the treated areas and to prevent any seromas (fluid collections) from forming.  Exercise can usually be resumed in a week as well.  Results can be seen in about 3-4 weeks after the swelling resolves.  Tightening of the areas treated is actually performed, but a "tighter" look may appear after the fat is removed and the swelling is gone.

Modalities of liposuction

I agree with Dr. Coleman's answer. The take-home point is that neither power assisted or ultrasonic (or laser) liposuction are going to give you a better result than properly performed traditional liposuction. They will be more expensive and have more risks and may make it easier for the surgeon but they won't give better results. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Power and Ultrasound Liposuction

Liposuction involves the use of suction to remove fat, and both power assisted (PAL) and ultrasound assisted (UAL) liposuction were designed to facilitate fat removal. The techniques are different in that PAL uses a rapidly vibrating cannula to increase the speed of aspiration, whereas UAL relies on ultrasound energy delivered to the fat to emulsify it for easier removal. There are different indications and complications with each, and you should discuss both procedures with your plastic surgeon.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.