*3.6.3 Complications*

Renuvion patients typically do not encounter any new or different complications than those identified as possible complications for the operation being performed. In fact, when compared to other energy-based devices used in the subcutaneous or interstitial space, such as fiber lasers or RF devices, whether temperature regulated or not, the complication profile is lower, thanks to the volume of unionized helium gas under the flaps, which acts as a simultaneous air conditioner. Renuvion's thermal profile, combined with unionized helium gas, produces a more balanced atmosphere than energy-based systems operating on their own.

Renuvion has a low risk of damage to surrounding tissue because of the following factors:


There are no conductive currents going through the patients' bodies thus safe and effective on multiple types of tissue.

#### **3.7 Power assisted liposuction (PAL)**

Liposuction, a surgical procedure that removes unwanted and resistant fat from the body has been a labor intensive process for the Surgeon as well as the patient, but now there is a procedure that is less intensive and less traumatic: power assisted liposuction (PAL).

Since the introduction of power-assisted liposuction (PAL) by MicroAire Surgical Instruments, the device has undergone many advances to improve mechanical disruption of normal and fibrotic fatty areas and also works within firmer tissues after secondary surgery for superior fat extraction.

PAL is an advancement over traditional SAL that involves using a rapidly reciprocating cannula tip, in "to-and-fro" motion of the operator's arm but at a lower amplitude of 3 mm [58]. The microcannula eases through the fat and sucks the fat out. The cannula is attached to a hand piece, powered by micromotor device, that causes it to vibrate. The vibration (or reciprocation), is 4000 times per minute. This low-speed reciprocation delivers enough energy to the tip of the cannula, so it passes easily through the substance of the fat with almost no physical effort by the surgeon. This causes a "jack hammer effect" causing the breakdown of resistant parcels of fat tissue which are also avulsed and sucked by the reciprocating cannula [59]. This results in greater control of the area to be liposucked and less trauma to the patient. The vibration also assists in passing the cannula through fibrous and scar tissue.

The MicroAire lipoplasty handle (**Figure 18**) is powered by an electric power source. Both the suction and the power source, which reciprocates the cannula, are attached to the proximal end of the hand piece. As in traditional lipoplasty, the incisions are made to comfortably accept the introduction of the cannula chosen for the procedure. A guard should be preferably used to prevent injury to the entry

*Use of Technologies to Improve the Liposuction Outcome Including Skin Texture and Form DOI: http://dx.doi.org/10.5772/intechopen.99947*

**Figure 18.** *Microaire handle and cannula attached.*

points. The use of mechanical energy avoids the side effects and tissue injuries associated with thermal energy, such as deep tissue and skin burns, increased seromas, and painful recovery [60].

The MicroAire powered cannula should be moved slowly so as to break the resistance in the tissue. The sensation of gliding through the tissue should be felt. The end point is the pinch test as well as the obvious absence of lumps and depressions. **Figure 19** shows the pre and post surgery photographs using PAL.
