PAL Technique

PAL liposuction for lipedema

PAL liposuction (Power-Assisted Liposuction) uses a cannula with micro-vibration that enables efficient, even removal of fat, and is especially useful in the fibrous tissue of lipedema. Here we explain how it works, when it is chosen over WAL, how it preserves the lymphatic system and what recovery is like.

What it is

What PAL liposuction is

PAL stands for Power-Assisted Liposuction. The cannula vibrates at high frequency (Microaire-type systems) and releases the fat with less effort, making it possible to treat large areas more evenly and in a more controlled way.

In lipedema this is especially valuable: the tissue is often fibrous and dense, hard to treat with conventional techniques. PAL is part of our lipedema surgery, within the Advanced Care Method.

PAL (Microaire) liposuction cannula in the operating room
Why in lipedema

Why PAL is useful in lipedema tissue

Fibrous tissue

Advanced lipedema develops fibrosis: the fat becomes harder and more nodular. The micro-vibration of PAL works this tissue better than a traditional cannula, with more uniform extraction.

Large volumes with control

By releasing the fat with less manual force, it allows large areas (legs, arms) to be treated while maintaining control and reducing tissue trauma.

Lymphatic preservation

As with any technique in lipedema, its real value depends on performing it while preserving the lymphatic channels; that is why the team matters, not just the technology.

Comparison

PAL, WAL, VASER or traditional: which and when

No technique is "the best" for everything. This comparison includes the variable that is almost never compared and which is decisive in lipedema: preservation of the lymphatic system.

TechniqueHow it worksBest forLymphatic preservationTypical recovery
PAL (vibration)Vibrating cannula, power-assistedFibrous tissue and large areasHigh with a specialised teamEven, moderate
WAL (water)Pressurised saline jet that releases the fatLarge volumes with a gentle approachHigh: respects vessels and lymphaticsUsually associated with less bruising
VASER / UAL (ultrasound)Ultrasound that liquefies fat before aspirationDense fibrosis and definitionVariable: heat requires careful techniqueModerate
Tumescent / traditionalInfiltration and manual aspiration with a cannulaSmall volumes, cosmetic useLess specific control over lymphaticsVariable

PAL and WAL are often combined in the same surgery depending on the tissue and the area. Medical, individualised decision.

Choice

PAL or WAL for my case?

The real question for someone who already knows they have lipedema is not "which technique exists" but "which one for my area and stage". This is the logic we follow:

  • Very fibrous tissue or advanced stages: PAL usually provides more effective extraction.
  • Large volumes with priority on lymphatic gentleness: WAL fits as the base.
  • Most cases: a combination of both, with Renuvion® if there is laxity.

The final choice is always medical and individualised after the assessment.

Protocol

PAL within the Advanced Care Method

PAL is not an isolated act: it is part of a protocol coordinated by the same team.

  • Prior diagnosis: clinical assessment, 3D scan and vascular study with Doppler ultrasound.
  • Surgery: extraction with PAL, combined with WAL and, if there is laxity, with Renuvion®.
  • Recovery: compression, lymphatic drainage and follow-up during recovery.

Discover the full Advanced Care Method and how the lipedema surgery works step by step.

Recovery

Recovery, step by step

Recovery is gradual and is part of the result. We break it down by phases (compression, lymphatic drainage and medical follow-up) in lipedema surgery recovery.

Frequently asked questions

Questions about PAL liposuction

What does PAL mean?

Power-Assisted Liposuction: power-assisted liposuction, with a cannula that vibrates at high frequency.

How is PAL different from traditional liposuction?

PAL releases the fat with micro-vibration, allowing more efficient and even extraction, especially in fibrous tissue.

Is PAL useful in lipedema?

Yes, especially in the fibrous tissue and large volumes typical of lipedema, always within lymph-preserving medical surgery.

When is PAL recommended over WAL?

PAL stands out in fibrous tissue; WAL in a gentle approach to large volumes. They are often combined. The decision is medical and individualised.

Can it be combined with Renuvion?

Yes. If there is laxity or a risk after extraction, Renuvion® can be added in the same procedure.

Is it the same as cosmetic liposuction?

No. In lipedema it is applied within medical surgery, with a prior diagnosis and lymphatic preservation. See the lipedema surgery.

Can the removed fat come back?

The removed lipedema fat does not return, but lipedema is chronic and requires maintenance; management continues after surgery.

Does it require hospitalisation?

It depends on the extent of the intervention; it is assessed case by case during surgical planning.

How long is recovery?

Light activity usually resumes within a few weeks and the result settles over several months.

Medically reviewed content. Content produced by the medical team at Lipedema Advanced Care and reviewed by Dr. Alexo Carballeira Braña, plastic surgeon (SECPRE-recertified) specialised in the treatment of lipedema, registered with the ICOMV. Meet Dr. Alexo Carballeira and the rest of our medical team.

This information is for educational purposes and does not replace a medical consultation or diagnosis. Lipedema is a chronic condition; it has no cure, but its symptoms can be treated. Every case requires an individualised assessment. Last updated: July 2026.

Dr. Alexo Carballeira

PERSONALISED CARE

Begin your journey to
freedom from lipedema

"My commitment is to offer you a precise diagnosis and complete support throughout the process."

Dr. Alexo Carballeira
Utilizamos cookies para darte la mejor experiencia en nuestra web.    Configurar y más información
Privacidad