Power-assisted lipectomy (
PAL) is a form of liposuction that makes the removal of fat easier and safer. For the first fifteen years since the advent of liposuction in the late 1970's, the technique required that the surgeon's arm move back and forth rapidly as he held the suction cannula, thereby using the movement of the suction cannula through the fat to break up the fat. Surgeon fatigue was a significant factor with this technique, especially when multiple areas of the body were suctioned. Furthermore, many surgeons developed "overuse" syndromes in their elbows and shoulders from all of this movement.
In the early to mid 1990's, a method of liposuction known as
ultrasound-assisted lipectomy(
UAL) came into vogue. The liposuction cannula was attached to a device that created ultrasonic energy. The ultrasonic energy was transmitted to the end of the cannula, where is dissolved the fat cells by essentially exploding them. The melted fat cells (not unlike melted butter) were then suctioned out very easily. Reports of surgeon fatigue and overuse syndromes among surgeons plummeted. This was because the ultrasonic energy replaced the need for a lot of arm and shoulder movement by the surgeon. In fact, surgeons were instructed to hold the liposuction cannula delicately and move it back very slowly and gently, like playing a violin. Slow movement of the cannula would allow more ultrasonic energy to reach the fat, melting the fat more easily. This method was especially useful in parts of the body where the fat was tougher and more fibrous. This included the upper abdomen, the back and the chest in men.
There were, however, a few downsides with
UAL. Because the ultrasonic energy created heat at the end of the cannula, burns were possible. There were many reports of skin burns when UAL was introduced to the market, but proper training significantly decreased the incidence of burns. Also, because
UAL melted the fat, there was a high rate of fluid collections called
seromas. When a
seroma develops after liposuction, it usually needs to be drained with a needle in the office. Several drainage sessions (called asperations) may be necessary, depending on the amount of fluid present.
Several years ago, a mthod of liposuction known as
power-assistd lipectomy (
PAL) was developed. With
PAL, the suction cannula is attached to a power source that moves the cannula rapidly back-and-forth, not unlike a small jackhammer. This rapid back-and-forth (or reciprocating) motion helps break up the fat so the surgeon does not need to expend large amounts of energy by moving his arm back and forth as much. In fact, as with
UAL, the surgeon purposely moves the cannula back and forth slowly (like holding the violin) in order to allow the reciprocating motion of the cannula to do the work for him. The reciprocating motion is also very good at breaking up tough areas of fat, just like
UAL is.
In summery,
PAL has many of the advantages of
UAL but without many of the risks, such as skin burns. It is a true advance in the field of liposuction.
