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 15


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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
4.9 out of 5 stars 90 reviews

PAL vs UAL vs traditional

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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
4.6 out of 5 stars 40 reviews

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

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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
4.6 out of 5 stars 13 reviews


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Power assisted liposuction or PAL uses vibration of the cannula to help the surgeon extract fat faster.  There may be less trauma with this approach as well.  The vibration breaks up the fat so it is easier to remove by suction.  This is quite safe as the vibration cannot really hurt the skin.  In terms of results, there is probably not much difference between PAL and traditional techniques.  For recovery, as the surgery is shorter and there may be less trauma to the body, it may be less painful and recovery shorter.

UAL, or ultrasonic liposuction, uses a very high frequency vibration to achieve a similar effect.  However, the degree of vibration is much higher and heat is produced, which can cause burning of the skin.  The fat is liquified by the ultrasound prior to removal.  Some surgeons say this is an advantage to remove the fat more precisely and less trauma, but I feel the risks outweigh the benefit.  Although some suggest that UAL can cause skin tightening, most surgeons uses laser assisted liposuction such as SlimLipo to achieve this instead.  I feel that laser energy is more selectively targeted towards the skin and can be precisely delivered, which I feel is safer that UAL.  


Shim Ching, MD

Shim Ching, MD
Honolulu Plastic Surgeon
4.6 out of 5 stars 51 reviews

Modalities of liposuction

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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

ultrasound or power-assisted liposuction

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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
4.9 out of 5 stars 39 reviews

Difference between Power Assisted Liposuction VS. Ultrasound Assisted Liposuction

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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

Power assisted or ultrasound

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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 . 

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

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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

Ultrasound Assisted Liposuction Works Well For the Abdomen

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We like the Vaser Liposuction system for the abdomen as it emulsifies the fat and heats the tissues.  We have found a decreased bruising and swelling as well as pain following body contouring with the Vaser.  However your physician may feel differently and I would go with whatever your physician recommends following a consultation.  In general we see a lot of women whom would be happier in the long run with a mini tummy tuck or full tummy tuck in situations when the skin is super loose.

Charles Perry, MD
Sacramento Plastic Surgeon

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.