Risks, benefits and procedure of Power Assisted Lipoplasty (PAL)

Power-assisted lipoplasty (PAL) is a relatively new procedure that removes fat and assists with contouring of the body. Power-assisted liposuction is a kind of lipoplasty. Also known as power-assisted liposuction and power assisted liposculpture, this procedure is gentler for the patient and causes less bruising, swelling and discomfort. However before you can understand how power assisted lipoplasty works, you need to know about liposuction.

First of all it is important to understand that liposuction and lipoplasty essentially describe the same procedure. Liposuction removes fat from unwanted areas of the body. The device that is used resembles a tiny vacuum cleaner with a tube that resembles an intravenous tube for a hose. This is called a cannula. The cannula is also used to “put existing fat in its place” and reshape the fatty area. As it actually removes mass and volume from the body it is an effective way to change the body’s shape and contour. Liposuction is an appropriate method for removing fat from beneath the chin, under the arms, the outer breasts, the belly, hips, flanks and thighs.

In ordinary lipoplasty, the surgeon makes an incision and the area beneath the skin is flushed with lidocaine (a local anesthetic), saline (salt water) and epinephrine (a drug that prevents bleeding during surgery.) Then fatty tissue (known as fascia) is suctioned out from beneath the skin’s surface with the cannula. Depending on how large the area is to be vacuumed by the cannula, the patient may have skin removed or “pulled up” by surgery and secured using surgical stitches.

Liposuction or lipoplasty does come with many potential side effects such as bruising, bleeding and risk of infection. These side effects have been minimized by a new development in lipoplasty called Power Assisted Lipoplasty or PAL.

The difference between regular lipoplasty devices and power-assisted wands is that the tip of the suction tube has the capability of vibrating. This vibrating cannula whirs at a high enough speed to create a particularly high frequency vibration. This high vibration, in essence, disturbs and emulsifies the fat cells making them easier to suck up and remove from the body. This causes less trauma and bruising to the surrounding tissues.

Like standard lipoplasty, power assisted lipoplasty is more useful for a smaller areas that need minimal fat removed. Power assisted lipoplasty is an appropriate way for removing fat from beneath the chin, under the arms, the outer breasts, the belly, hips, flanks and thighs.

Power assisted lipoplasty is also used for more delicate operations such as liposculpture which is employed to remove small amounts of fat to contour such things as cheekbones or the muscle definition of the calves.

Lipoplasty is not recommended for individuals who need a great volume or area of fat to be removed. A lipoplasty is also not recommended for obese individuals who are over 50% of their body weight. A weight management program might be prescribed for these individuals instead.

Another caveat is that like all liposuction procedures, power assisted lipoplasty should not be expected to correct sagging skin. In fact, if the plastic surgeon is too aggressive with the cannula, cellulite or sagging skin can be the result. This is also why plastic surgeons always leave some amount of fat behind during lipoplasty procedures. There must be some sort of elastic tissue left to support the overlying skin after the excess fat is removed.

Power assisted lipoplasty is always performed in conjunction with what is called tumescent anesthesia. The tumescent technique fills the area to be suctioned before hand with an injection of saline, local anesthesia and substances that shrink the capillaries and prevent bleeding. The good thing about this procedure is that it does not require treatment with narcotics or anesthesia, which greatly minimizes the recovery time. Better results are achieved aesthetically as the patient is conscious and allowed to “pose” for the plastic surgeon allowing for fat to be removed in a more efficient manner.

When power assisted lipoclastic and tumescent anesthesia are used together as a team of treatments, they greatly shorten recovery time. The operation is less stressful for the plastic surgeon as well as the patient as there is no monitoring of the patient’s condition as there is under general anesthesia. The rotating head of the power assisted lipoplasty wand (cannula) also allows the surgeon to be more precise when it comes to removing fat. Perhaps the most important benefit of these two techniques used together is the way they can minimize damage to surrounding tissues and the size of any scars. The reason that scars appear smaller after power assisted lipoplasty is because the surgeon needs only to make the tiniest of incisions to accomplish the removal of fat.

Like normal lipoplasty, power assisted lipoplasty is also risky for individuals with vascular, heart or nerve problems. If you are a smoker you will be advised to quit smoking before you have the operation to minimize the risk of bleeding. You may also be asked to eliminate aspirin and other medications that cause excess blood loss.

Before considering any type of liposuction, ask your plastic surgeon if they practice power assisted lipoplasty. This advancement in the science of the permanent removal of fat has gone a long way towards improving the overall safety and accuracy of plastic surgery and it is in your best interest to take advantage of the short recovery time and precise results that this procedure offers.