I'm curious about Vaser vs. PAL for PAH post CoolSculpting?

In my experience, many patients with paroxysmal fat hypertrophy after Cool Sculpting respond best to Vaser ultrasound liposuction.

Standard PAL alone will not break through the thickened tissues. Vaser allows for better smoothing, removal of recurrent/residual fat as well as skin tightening.

These can be challenging cases and exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

this needs a complex combination for the best results. I treated over 100 clients in the past few years with this condition and there is a lot of fibrosis that needs more than PAL. Best, Dr. Emer.

Histology of PAH fat shows that it looks like normal fat however clinically its pretty firm. I have done a bunch of these and found vaser gives the best results. PAL is excellent - I use it for bigger patients as it saves my shoulder but I dont see any real advantage for PAH as vaser disrupts the firm fat while PAL just makes some fat removal easier for me. I have just about every lipo technology known and I use certain technologies for certain problems. Beware of doc who badmouth some things as they usually dont have the device in question and dont have experience with the device

You should wait at least a year to see full results. PAL allows the PS to break apart and remove fat faster. It is often combined with techniques like VASER liposuction as it utilizes a oscillating cannula tip to break apart the fat. The definitive correction for liposuction deformities requires the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I encounter suboptimal liposuction outcome referrals weekly. VASER liposuction has been the only modality that has consistently corrected liposuction caused deformities. VASER liposuction ensures a smooth contour regardless of severity of contour irregularities by virtue of being able to remove any and all remaining fat comprehensively and uniformly. Finally, when skin redundancy irregularities are observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

I suggest you focus all of your effort and finding the most experienced and talented board-certified plastic surgeon in your area for liposuction and not concern yourself with what brand equipment they use.

You can certainly do VASER and PAL as a combined treatment. I know lots of sergeants use use both of these tools.

Personally I’m not a big fan of VASER because of the number of severely disfigured patience I’ve seen who had that treatment. That said, there’s many talented plastic surgeons who get great results using this equipment.

PAL is my preferred choice of equipment and it’s what I’ve grown a custom to using. I have very many different cannula shapes and sizes.

In the end all forms of liposuction remove fat with a thin stainless steel tube connected to our source of vacuum.

Buy not focusing exclusively on finding the best surgeon you could potential he be excluding the right provider because they don’t have the equipment you think makes a difference.

To get the best results I suggest the following.


Avoid traveling long-distance for elective surgical procedures.

Rely on in person consultations.

Schedule multiple consultations with surgeons in your area who have a good reputation for the procedure you’re interested in.

During the in person consultation to ask each surgeon to show all of their before and after pictures of the procedure you’re interested in. The goal is not to see the best results of their career but to see what average results look like and get confirmation of how many of these procedures that surgeon has performed. Ideally the surgeon should be able to find before and after pictures of patients who are very similar body shapes and contours to your own.

An experienced plastic surgeon should have an abundance of before and after pictures. A highly experienced plastic surgeon will have several hundred or even thousands of before and after pictures for each procedure.

Read all the reviews on various physician review websites avoiding providers with any significant number of justified negative reviews.

Organic unmanipulated reviews tend to follow fairly equally among different review websites. Those with an excessive number of positive reviews on a single website may be a telling sign of aggressive marketing.

The presence of justified negative reviews can be more important than an abundance of positive reviews.

Don’t schedule surgery during the consultation.

Give yourself time to think about important decisions like permanently and irreversibly changing your body.

When in doubt slow down and schedule more consultations.

The outcomes of this procedure are all over the place based exclusively on the skill and experience of the surgeon.

Best,

Mats Hagstrom MD