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 14


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.

Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 72 reviews

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

liposucton contours...in 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.

Bruce K. Barach, MD
Schenectady Plastic Surgeon
4.5 out of 5 stars 13 reviews

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 22 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 34 reviews

Power vs. Vaser vs Laser lipo - none is a substitue for a tummy tuck

Liposuction removes fat, and anytime this is done the skin overlying that area shrinks to some degree. The question is whether any special technique increases the tightening of the skin more than would happen without it. Power-assisted lipo (PAL) uses a vibrating cannula - the instrument inserted into the fat to suction it out - in order to shake loose the fat cells more effectively. I have seen no data indicating that it causes more skin tightening. VASER is ultrasound, which uses high frequency sound waves to also help with more efficient fat removal. There is some vidence that it might stimulate greater skin tightening through heat, but the more that is applied close to the skin the greater the risk of burns and scarring. The same applies for laser lipo. If there is enough skin laxity to consider a tummy tuck, none of these other technologies will come even close to a comparable result.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 38 reviews

Difference between Power Assisted Liposuction VS. Ultrasound Assisted Liposuction

ALL modern liposuction technique pre-inject and swell (IE tumesce) the fat with a (tumescent) solution of saline or Ringer's lactate containing Epinephrine (to shrink the blood vessels) and a local anesthetic (for reduction of pain). This is referred to as TUMESCENT ANESTHESIA.

After allowing this solution 15 minutes to work
- Ultrasonic Assisted Liposuction (UAL) uses ultrasound to break up the fat before removing it WHILE
- Power Assisted Liposuction uses a hand held engine to move the liposuction tube back and forth to reduce surgeon tiredness as opposed to Manual liposuction in which case the surgeon himself pushes and pulls the tube back and forth through the fat allowing the suction at the end of the instrument to pull the fat out.

On occasion a surgeon would use VASER liposelection (a specific type of UAL) to break up the fat and then remove it with PAL.

Dr. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 85 reviews

Power assisted or ultrasound

when we do abdominal etching procedure , i feel power assisted is safer than ultrasound or laser assisted machines .These ultrasound or laser assisted devices might produce burns in superficial liposuctions. As other doctors explained, expertise of the surgeon is very important than the machine used . 

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

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
3.5 out of 5 stars 2 reviews

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 8 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.