Q: What are the pros and cons of power-assisted liposuction?

Pros The fat-removal results from PAL are permanent. Its speed and efficiency lessens time under anesthesia as well as trauma to surrounding tissue sometimes caused by the elbow-grease-driven jabs of SAL. There’s no risk of thermal damage. Most surgeons, when discussing power-assisted liposuction versus laser liposuction (like Smartlipo), note that heat-free PAL is far safer. Both techniques dislodge fat cells and make them easier to remove, but Smartlipo, which heats the fat upwards of 900ºF, can cause third-degree burns if not performed properly. PAL carries fewer side effects, like the seromas and bruising born of more aggressive liposuction techniques. Smaller incisions can be made with PAL versus Smartlipo and VASER, because there’s no need to insert a rubber stopper to safeguard the skin from heat. With PAL, the incision need only accommodate the diameter of the cannula. Cons Energy-based technologies, like VASER, may be better than PAL at breaking up stubborn fat in fibrotic areas like the back, and in men with gynecomastia , the pecs. Unlike its energy-based counterparts, PAL can’t trigger collagen production to tone the skin or the kind of contraction that creates the cut look of high-def liposculpture . For high-definition effects, doctors typically rely on ultrasound or radiofrequency devices. Like all forms of liposuction, PAL comes with swelling, soreness, and a prolonged commitment to compression garments—in other words: an uncomfortable recovery.

Question 1

What is power-assisted liposuction (PAL)?

Accepted Answer

A popular body-sculpting technology, power-assisted liposuction (PAL) uses a cannula attached to an oscillating handpiece that drives it back and forth to break up unwanted fat cells—without the addition of heat—before suctioning them out of the body.

Compared to traditional suction-assisted liposuction (SAL), which relies on manual jabs of the cannula, PAL is faster and more efficient—a boon to both surgeons (reduced fatigue) and patients (less time under anesthesia).

PAL can be used on its own, to dislodge and extract fat cells, or paired with a complementary technology like VASER (ultrasound energy), Smartlipo (laser heat), or BodyTite (radiofrequency energy)—all of which help liquefy the fat, making it easier to remove, with less trauma to the surrounding tissue. The heat also contracts the skin slightly.

As with all forms of lipo, PAL can be used all over the body—on the abs, love handles, back, bra rolls, upper arms, inner and outer thighs, knees, and ankles as well as under the chin. Since liposuction is not a weight-loss method, ideal candidates should be within 30% of their ideal weight, with small pockets of pinchable fat that resist diet and exercise. Good skin elasticity is also a must, as lax or stretch-marked skin will sag instead of snapping back post-op.

PAL is sometimes referred to as MicroAire or MicroAire power-assisted liposuction, but MicroAire is simply the brand name of one particular power-assisted liposuction machine.

Question 2

What are the pros and cons of power-assisted liposuction?

Accepted Answer

Pros

The fat-removal results from PAL are permanent.
Its speed and efficiency lessens time under anesthesia as well as trauma to surrounding tissue sometimes caused by the elbow-grease-driven jabs of SAL.
There’s no risk of thermal damage. Most surgeons, when discussing power-assisted liposuction versus laser liposuction (like Smartlipo), note that heat-free PAL is far safer. Both techniques dislodge fat cells and make them easier to remove, but Smartlipo, which heats the fat upwards of 900ºF, can cause third-degree burns if not performed properly.
PAL carries fewer side effects, like the seromas and bruising born of more aggressive liposuction techniques.
Smaller incisions can be made with PAL versus Smartlipo and VASER, because there’s no need to insert a rubber stopper to safeguard the skin from heat. With PAL, the incision need only accommodate the diameter of the cannula.

Cons

Energy-based technologies, like VASER, may be better than PAL at breaking up stubborn fat in fibrotic areas like the back, and in men with gynecomastia, the pecs.
Unlike its energy-based counterparts, PAL can’t trigger collagen production to tone the skin or the kind of contraction that creates the cut look of high-def liposculpture. For high-definition effects, doctors typically rely on ultrasound or radiofrequency devices.
Like all forms of liposuction, PAL comes with swelling, soreness, and a prolonged commitment to compression garments—in other words: an uncomfortable recovery.

Question 3

How much does power-assisted liposuction cost?

Accepted Answer

Your cost will depend on the size and number of areas you have treated as well as the expertise level and practice location of your surgeon.

Question 4

Power-assisted liposuction before and after pictures

Accepted Answer

The power-assisted liposuction photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

What happens during a power-assisted liposuction procedure?

Accepted Answer

As with any modern liposuction surgery, a PAL procedure starts with the administration of anesthesia—typically general, although IV sedation is an option for small areas—paired with an injection of tumescent fluid or wetting solution into the treatment site, to help numb the area and reduce bruising, blood loss, and post-op pain.

Once the area is swollen with fluid, doctors make several tiny 2–3 mm incisions in the skin in order to insert the cannula. They then guide the vibrating instrument through the fat layer, being mindful to stay in a safe and appropriate plane.

PAL is a common player in SAFELipo, a gold-standard body-sculpting technique developed by Shreveport, Louisiana, board-certified plastic surgeon Dr. Simeon Wall Jr. SAFE is an acronym for separation, aspiration, and fat equalization. During the first step, surgeons attach a special “basket” or “exploded-tip” cannula to a PAL handpiece, using the motorized tool to gently separate fat globules from surrounding tissue before removing (or aspirating) the fat and smoothing out (or equalizing) any loose bits that remain. This prevents the dermis from sticking to the underlying muscle and causing contour irregularities—a common liposuction side effect.

Once the desired amount of fat is extracted, the surgeon closes the incisions with absorbable or removable stitches. PAL is an outpatient procedure, so you’ll go home the same day.

Question 6

What should you expect during recovery?

Accepted Answer

The duration and intensity of your power-assisted liposuction recovery will depend mainly on the size of areas treated and the extent of your procedure. If you had PAL on your arms only, for instance, you can expect about three to five days of downtime; for 360 or circumferential lipo, figure 7–10 days of pain and swelling.

Some doctors place surgical drains after lipo, to keep fluid from collecting under the skin and causing what doctors call seromas. How aggressively you were treated, the volume of fat removed, and the amount of energy used during surgery all influence the need for drains. (Drastic fat reductions and excessive heat contribute to fluid buildup.) Drains usually come out within one week, around the same time stitches are removed.

Your surgeon’s team will fit you for compression garments following surgery and ask you to wear them for several weeks following power-assisted liposuction, to reduce swelling and bruising and encourage the skin to adhere smoothly in order to head off lumps and bumps.

Your doctor will give you a time frame for resuming exercise, since this too depends on your individual procedure. Generally speaking, you’ll need to limit yourself to light cardio at first and very gradually work your way back to weight training and more intensive workouts.

Question 7

How soon will you see power-assisted liposuction results, and how long will they last?

Accepted Answer

You’ll notice an overall slimming effect right away, but swelling can take weeks to subside, so your final results—subtle nuances, in particular—may not be evident for three to six months or more.

Once fat cells are removed, they’re gone for good, so PAL results are considered permanent. If you gain weight following PAL, however, any remaining fat cells can expand in size.

Talk to your physician about the best way to maintain your weight following liposuction.

POWER-ASSISTED LIPOSUCTION (PAL)

Jolene Edgar

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Jolene Edgar

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