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Creating Contour

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Though liposuction has been in use in plastic surgery practices since the 1970s, it was not until Jeffrey Klein, MD, developed the tumescent technique in 1985 that the procedure gained widespread popularity. More than 25 years later, traditional tumescent liposuction continues to evolve with new technologies—such as power-assisted liposuction (PAL), ultrasonic devices and laser lipolysis systems—and new techniques, such as liposculpture and the use of fat grafting to create balance and reduce postprocedure irregularities.
“Liposuction is unlike any other surgery,” says David Amron, MD, of Spalding Drive Plastic Surgery and Dermatology in Beverly Hills, California. “It’s not cutting and sewing. It’s such a tactile procedure. It’s more of a blind yet precise sculpting procedure under the skin.”

Easier Fat Removal

Making fat easier to remove is the aim of most new liposuction technologies. Grant Stevens, MD, of Marina Plastic Surgery Associates in Marina del Rey, California, is a fan of PAL. He has been performing liposuction since 1983, and has experienced the evolution of technology from dry to wet to super-wet and tumescent, up to today’s ultrasonic and laser-assisted devices. He has participated in clinical trials for several liposuction technologies.
“I love using power-assisted liposuction because it’s much easier on me and on the patient,” he says. He uses MicroAire’s PAL LipoSculptor (
The power-assisted cannula reciprocates at 400 strokes per minute, requiring much less physical force to manipulate. “It essentially cavitates itself,” Dr. Stevens says. “There’s less bruising for the patient, because you’re not leaning into it.”
Adam Schaffner, MD, a New York City-based plastic surgeon, also uses PAL in his practice. “There is less pain, less swelling and less bruising for the patient and shorter operative times,” he says.
Sharon Giese, MD, uses the Vaser ultrasound-assisted device (Sound Surgical Technologies, The ultrasound provides both heat and cavitation so the fat is released from the surrounding structures more easily, requiring less physical exertion from the doctor and resulting in less trauma to the patient. Additionally, the heat helps to tighten skin in the treated areas. “It makes what can be a rough operation a really smooth one,” says Dr. Giese, who finds ultrasound especially useful in the face. “Ultrasound makes liposuction safer in the face, in the tighter planes of the neck or jowl. You’re able to be more precise and work with more finesse. The heat from the ultrasound also stimulates collagen, so you get exceptional skin tightening. With no cutting, you can get a phenomenal amount of skin shrinkage,” she says.
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