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What is Power Assisted Liposuction?

Author: Letty's Staff Writer

PAL is the acronym that stands for power assisted liposuction...


If you can't decipher this technique by its name – don't worry – you aren't by yourself.

We're going to make everything much clearer.

But – first – to really understand the evolution of various liposuction techniques (including power assisted liposuction) we must go back into the history of liposuction. This will help us to understand more fully the challenges that early liposuction surgery presented to clinicians and how innovative young doctors developed solutions to overcome them.

The Difficulties of Early Liposuction Surgery:

When liposuction first came on the scene there were several difficulties that presented themselves to practicing surgeons.

1. One of those difficulties that spurred surgical advancement was that:

Liposuction required quite a bit of muscle strength to perform.

Surgeons had to not only physically manipulate prone and anesthetized patients, but had to use handheld devices to cut through and suction out fatty pockets all while moving them in a delicate back and forth motion.

This is not an easy feat. As a result – over time many surgeons succumbed to over-use injuries of the wrist and hands.

2. Another difficulty associated with liposuction had to do with:

Preventing excessive blood loss.

Early liposuction was called "dry" liposuction because no additional fluid was added to the treatment area before the extraction of fat took place. As a result patients frequently lost quite a bit of blood – and most required transfusions.

3. One final problem that I will mention here in this article (this of course is not an exhaustive list of early challenges) is:

The requirement for general anesthesia.

General anesthesia is by nature more risky. Whenever you can eliminate it during surgery... you may be making the operation safer. Many of the early liposuction surgeries became fatal – not necessarily because of the surgery itself but due to a negative reaction to the anesthetic.

For the above reasons new liposuction technology has often centered around ways to ease a surgeon's discomfort, or to decrease a patient's blood loss and morbidity both during and after surgery.

Klein to the rescue:

If you could somehow create the right surgical instruments or design methods to solve the above issues you would make liposuction safer for patients and easier to perform for surgeons.

You'd have a win-win situation – for sure!

Well in 1985 a young California surgeon had been working on solving a couple of the problems that liposuction presented. He developed a fluid cocktail that consisted of epinephrine (to minimize blood loss) and lignocaine (to help with pain) and physiological saline.

Not only was the fluid revolutionary – but how he used it was rather ingenious.

Dr. Klein injected the fluid under the skin and over the muscle – until those areas were firm and tight. This state of being full and taut is called "tumescence". That is actually how tumescent liposuction got its name. This procedure constricted blood vessels in the area which minimized bleeding and blocked pain in the area...

And that gave patients and surgeons another option to general anesthesia for surgery.

What about that 'muscle' problem?

This still sort of leaves the problem of the handheld surgical devices being clunky and unwieldy for surgeons.

In 1995 Dr. Charles Gross and ear-nose-throat surgeon at the University of Virginia (located in Charlottesville, Virginia) described a new technique which used an engine-powered rotating blade attached to the suctioning device along with an endoscopic device so that he could have direct visual control during liposuction surgery.

This power-assisted device was the beginning of a new series of devices whose design was used to take away some of the work doctors would have to do "cutting" through fibrous tissues and removing underlying fat during surgery.

The theme here is that if the doctors have an easier time of it – then patients will too...

In conclusion:

Long story, right?... But that's how power assisted liposuction came to be.

This article has carefully avoided adding any assessment of the relative safety of this liposuction technique. However, I will say that when it comes to plastic surgery that taking your time to chose a qualified surgeon and having them properly advise you about your specific risks – is always advisable.

As usual – good luck and good you.

I thought this video was really helpful:

Dr. Julie Voss of Seattle performs submental liposuction for this patient...

Power Assisted Liposuction References:

  • Jancin, Bruce. "Go slow on tumescent fluid in facial liposuction. (Rapid Absorption Risks Toxicity)." Skin & Allergy News. vol. 34.2 (2003): 23. General OneFile (2 Mar 2010).

  • Donley-Hayes, Karen. "Just a little off the top: micro-liposuction is the 'spot cleaner' of cosmetic surgery. (SECTION: body)." Cosmetic Surgery Times. vol. 12.1 (Jan-Feb 2009): 22(1). Expanded Academic ASAP (20 July 2009).

  • "Neck Lift – Treatments and Procedures." The Cleveland Clinic (24 Apr 2008). Web search (17 May 2011).

  • Wachter, Kerri. "Surgical options for the aging face explored." Skin & Allergy News. vol. 40.8 (2009): 22. General OneFile (15 May 2011).

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