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Introduction to Toronto Liposuction

Liposuction (also known as Lipoplasty) is one of the most popular of the cosmetic body procedures performed by our plastic surgeon, Dr. Lawrence Tong. Liposuction involves selective removal of fatty tissue from various areas of the body using tiny incisions. The result can be a smoother, flatter, and sexier appearance with only a moderate down time.

Is Liposuction the right procedure for me?

Diet and exercise can shed fat; however, there is no way to selectively get rid of fat in targeted areas. Some areas of your body are ‘programmed’ to retain their fat stores. As you lose weight through diet and exercise, your body will lose fat in a genetically determined manner. As the rest of your body gets thinner, the problem areas may stay the same, potentially emphasizing your problem areas.

In female patients, these areas tend to be the thighs, abdomen, flanks, back, and buttocks. In men, it is usually the flanks (love handles) and abdomen.

Liposuction achieves its results by removing the fatty tissue in targeted areas of your choosing. Sometimes, Liposuction may be the only way to get rid of your problem areas, without having to lose so much weight that you look emaciated everywhere else. If you need targeted fat removal, Liposuction may be the appropriate procedure for you.

Who is a candidate for Liposuction?

If you have areas of unwanted fat that persist despite plenty of diet and exercise, you may be a candidate for Liposuction. Candidates for Lipoplasty ideally are not obese, but have well defined areas of fat accumulation. Patients should have a BMI (body mass index) that is below 35, and ideally less than 30. As BMI increases, the result tends to be less optimal, and the risks of complications tend to increase.

One important consideration is the condition of your skin; patients with poor skin elasticity, stretch marks, or scars, may not be optimal candidates for the procedure. The procedure is performed in young or older patients alike. Dr. Tong will examine you, and advise you on whether you are a good candidate for a particular area.1

Important Considerations about Liposuction

Not a Weight Loss Procedure

Liposuction is not considered a weight loss procedure. Even though the visual effect on your appearance can be dramatic, the actual weight of the removed fat may be relatively small.

Will Not Help Cellulite

Liposuction does not help cellulite. Cellulite is a condition that occurs near the skin’s surface; Liposuction is not performed near the surface because doing so risks making contour irregularities, and skin healing problems.

You Need an Experienced, Board-Certified Plastic Surgeon for Liposuction

The prior paragraphs highlight the need for an experienced, Board-Certified Plastic Surgeon to perform your surgery. Unfortunately, Liposuction has been, and still is performed by non-surgeons, sometimes with disastrous results. During his many years of practice, Dr. Lawrence Tong has evaluated and treated many unfortunate patients with terrible cosmetic outcomes performed by non-surgeon physicians. The take-home message is that Liposuction may be an easy procedure to learn, but it is difficult to master. Being able to perform the procedure is just one of the ingredients for a successful Liposuction outcome. You need to choose a surgeon who will make sure you are a good candidate, offer you alternative procedures, appropriately perform Liposuction in a proper manner, and be able to take care of any complications that may arise.2

What are the Different Types of Liposuction?

Tumescent Liposuction

Tumescent Liposuction (or variations of it) is the most common method of Liposuction. It refers to the technique where a special mixture of IV fluid and medications (tumescent fluid) is injected at the beginning of the procedure, in the area of desired fat removal.

Tumescent fluid:

  • Makes the tissues tense, allowing easier removal of the fat
  • Provides fluid resuscitation to the patient
  • Greatly reduces blood loss
  • Provides post-surgery pain control

Most of the tumescent fluid is removed as the Liposuction proceeds, but approximately 20% remains, to be slowly absorbed by the body or leaked out through the incision. Tumescent liposuction is performed with a liposuction instrument called a cannula that is connected to a vacuum source; gentle back and forth movements of the cannula, with the vacuum source present, allows for removal of the fat.

Power Assisted Liposuction (PAL)

In contrast to regular Tumescent Liposuction (above), Power Assisted Liposuction uses a mechanized suction instrument (a cannula) that oscillates very quickly, at the tip. This allows for more thorough fat removal and requires less physical effort on the part of the surgeon. Using less physical effort results in a more precise degree of fat sculpting. Power Assisted Liposuction employs the use of tumescent fluid, in addition to the mechanical tip. This is Dr. Tong’s preferred method of liposuction.

Ultrasonic Assisted Liposuction (UAL, Vaser)

Ultrasonic Liposuction uses sound waves to break up the fat before it is removed. This method also allows for more thorough fat removal with less physical effort. Its disadvantage is that it generates heat within the body which can cause thermal injury, and has a higher risk of fluid collection post-surgery.

Laser Assisted Liposuction (Smart Lipo)

Laser Assisted Liposuction uses a small laser to ‘melt’ the fat before it is removed. Laser Assisted Liposuction has been purported to be able to shrink the overlying skin, because of the heat that is generated by the laser. The scientific data on this has been weak; most surgeons agree that the degree of skin shrinkage, if any, is very mild.

Incisions for Liposuction

Any surgical procedure will leave some type of scar, but a skilled plastic surgeon is an expert at minimizing the size and appearance of scars. Fortunately with Liposuction, the scars are 2-3mm in length and tend to heal so that they are not noticeable. Single small incisions placed in strategically hidden areas are all that are needed to allow the Liposuction cannula access to the fatty layer. The scar will blend naturally with the surrounding skin and hides with the natural curvatures of the body. Dr. Tong will discuss all incision options with you thoroughly.

Details of the Liposuction Procedure

Dr. Tong performs surgery in the CPSO accredited private surgery centre at 199 Avenue Road. Toronto. Liposuction is usually performed under anesthesia (general anesthesia or IV sedation). In select patients, certain areas of Liposuction may even be done awake (under local anesthesia only).

Dr. Tong begins the Liposuction procedure by first making the small 2-3mm incisions(s), through which the Liposuction instrument, or cannula, will aspirate (remove) the fat. Next, he thoroughly disperses the tumescent fluid within the fatty area(s) of concern. Dr. Tong then performs the Liposuction with careful, controlled back-and-forth movements of the cannula. The cannula is a thin tube with a closed, rounded tip. When the cannula is attached to the vacuum source (the Liposuction machine), the fat is gently removed through the openings located on its sides. As the surgery proceeds, Dr. Tong monitors the thickness of the fatty layer, careful not to remove too much or too little fat. A smaller diameter cannula is also used to fine-tune and feather the areas of transition at the periphery. Dr. Tong stitches the incisions together with a single suture at each site. A dressing is applied and the patient is placed in a compression garment.

Recovery from Liposuction

Liposuction Recovery Immediately after Surgery

Immediately following Liposuction at our Toronto practice, you will gradually awaken from anesthesia and are monitored in a recovery area. Soon, you will be released to go home in the care of a friend or family member.

Liposuction Recovery at Home

When recovering from Liposuction at home, we encourage you to take it easy, and not perform any strenuous activities. Bruising is typically mild to moderate in the areas of surgery. The areas of Liposuction may feel sore, like a bruise. Dr. Tong will prescribe narcotic pain medication that you can use to control discomfort. Depending on your pain tolerance, you may go back to work in as early as 3 days. Most patients are back to work one week after surgery. You may begin exercise one week after surgery if you wish.

Return Visits after Liposuction

Your first post-operative visit with Dr. Tong will occur one week after surgery. At that first visit, he will remove your stitches. Expect to have some swelling and bruising in the areas of Liposuction. You may not see a significant difference in your appearance until more swelling resolves. Dr. Tong will see you again 6 weeks after surgery to check on your progress. You will have further post op visits 6 months, and 1 year after surgery. Photographs are taken at these visits to document your progress. These photos are for your medical record and are not disclosed without your written permission.

Like any procedure, Liposuction has risks and complications associated with it. The risks are low, but do exist. At your consultation, Dr. Tong will go over the pertinent potential risks and complications associated with Liposuction.

Specific Areas for Liposuction

Abdominal Liposuction

The abdominal area is a common focus of Liposuction treatment at Dr. Tong’s practice in Toronto. Tummy Liposuction can be a great option for you if you can ‘pinch more than an inch’. Abdominal Liposuction is performed with three incisions: one in the navel and two more in the lower abdomen, below the bikini line. The treated area extends from the panty line up to the edge of the ribs, and laterally to approximately the hip bones.

The love handles are not addressed directly with abdominal Liposuction, but may be treated simultaneously if desired.

If you have stretch marks, you may end up with a more wrinkled appearance; make sure your surgeon discusses the expected outcome. If you have an overhang of skin (e.g. over a C-section scar), Liposuction will not fully correct your problem, and an Abdominoplasty (Tummy Tuck) or Mini Tummy Tuck may be considered. Otherwise, Liposuction of the abdomen can reduce your abdominal fatty layer so you look sleeker, smoother, and thinner. See Dr. Tong’s before and after abdominal Liposuction photos.

Flank (‘love handle’) Liposuction

If you have concerns about ‘love handles’ or ‘muffin top’, you can attain great results with Liposuction of these areas. The goal is to give you more of a tapered, hourglass-like waistline, without the roundness and bulges of ‘love handles’ or ‘muffin top’.

The flank Liposuction procedure is generally performed with the patient lying on his or her tummy, as this provides better access to the areas to be treated. Two small incisions are made in the lower flank, below the bikini line. This permits female patients to wear ‘low rise’ jeans or bikinis without concern about revealing a scar. The actual area of Liposuction extends from the top of the buttocks to the top of the waist, and extends forward to include the love handles. The flank area is the most commonly treated area of Liposuction in men. See Dr. Tong’s before and after flank Liposuction photos.

Inner and Outer Thigh Liposuction

Do you have outer thighs that bulge outwards? Do your inner thighs rub together? The thighs are a particularly good area for Liposuction because the fat deposits are well localized. The most popular areas of the thigh are the outer thigh and inner thigh, although the front and back of the thighs also frequently undergo Liposuction.

The outer thigh fat deposits are unflatteringly referred to as ‘saddle bags’. Liposuction of the outer thigh involves making a small incision at the outermost buttock fold. From this site, the entire lateral thigh is addressed in a very thorough manner.

The aesthetic ideal for the inner thigh is to have a gap between them (i.e. not rubbing together) when standing with the feet shoulder-length apart. An incision near the groin crease will address the inner thigh. Sometimes another incision is made at the medial (inner) aspect of the horizontal buttock fold to address fat located at the back of the inner thigh.

The anterior thighs (front of the thighs) may also undergo liposuction. This area must be done with care as over-aggressive removal can lead to contour irregularities. The posterior thigh refers to the back of the thighs. Most patients have some fullness just below the horizontal buttock crease. This area can be addressed on its own, or it is included as part of routine outer thigh Liposuction. Further down on the back of the thigh is also a popular area to have Liposuction. See before and after photos of thigh Liposuction.

Liposuction of the Buttocks

Liposuction of the buttocks is done to reduce the projection of the buttocks (the degree to which it protrudes outwards). If you feel your buttocks are too wide, Liposuction of the outer thighs may be more appropriate. Consult with Dr. Tong to get the best advice for your buttock Liposuction concerns.

Inner Knee Liposuction

The inner knees often form a bulge of fat that can be effectively reduced with Liposuction. Some patients have the appearance of fat at the inner knees which may be due to how the bones around the knee are shaped. It is important to differentiate this from fat as performing liposuction to this area may not provide the expected outcome. Dr. Tong will evaluate the area to make sure it is appropriate for liposuction.

The incision is made on the inner knee either at the front or the back, depending if other areas of Liposuction are being performed at the same procedure. See Dr. Tong’s before and after photo of knee Liposuction.

Mid Back Liposuction

The mid back refers to the back above the waistline. Most commonly, patients have concerns about a ‘roll’ of fat and its associated crease that runs just below the bra line. Dr. Tong has coined this area as the ‘bra roll’. Liposuction of this area is quite effective at eliminating the roll and decreasing the depth of the accompanying fold. Women love the results because they can wear form fitting tops or backless dresses without the fear of exposing bulges and folds. The incisions are placed along the level of the bra strap so that it can be covered by a bra or swimwear. See Dr. Tong’s before and after mid back Liposuction photos.

Liposuction of the Arms

If you have thick or bulky upper arms, Liposuction may be your answer to a leaner and trimmer look. Liposuction of the arms is performed in the upper arm. The first step is to determine if you are a good candidate for arm Liposuction. If you have any significant hanging skin, or flabbiness, Liposuction could worsen this appearance. Some patients seeking Liposuction of the arms are actually better candidates for an Arm Lift (Brachioplasty), which is a combination of Liposuction plus direct skin and fat removal.

Dr. Tong will determine whether arm Liposuction would be beneficial for you. The incision is made on the back of the arm just above the elbow. In the right patient, arm Liposuction can make a significant difference in arm size, and yielding excellent results by making them more proportioned with the rest of your body.

Miscellaneous Areas of Body Liposuction

In addition to the common areas of liposuction described above, Dr. Tong also treats additional parts of the body, such as:

  • Anterior axillary fold (excess fat at the front of the armpit region)
  • Posterior axillary fold (excess fat at the back of the armpit region)
  • Ankles and calves
  • Mons pubis (fatty excess around pubic region)
  • Nape of the neck (fatty deposit at the base of the neck in the back)

Get Educated about Liposuction

It is crucial that you do your research when considering Liposuction. The most important decision is to choose the best suited Board-Certified Plastic Surgeon. During your consultation, you will receive substantial information. Dr. Lawrence Tong will make sure that you understand the important details, and that all of your questions are answered. You will have the opportunity to view photographs of many examples of his work. Our goal is to make you an educated patient. We feel that a better educated patient will make better decisions about their surgery, and their surgeon, too.

To learn more about how Dr. Tong can help you with your Liposuction needs, set up a consultation by giving us a call at (416) 972-0999. Or let us give you a call; just fill out our contact form and we will call you on the same or the next business day. No referral is needed.

See Dr. Tong’s work in our Liposuction before and after photos.

Body Liposuction at a Glance

What the procedure does
Removes fat selectively from targeted areas
Duration of the result
Years to permanent
Length of time to perform the procedure
Depends on area(s); usually 45 minutes to 1 hour per area
Type of anesthetic most commonly used
IV sedation or general anesthesia, local anesthesia for smaller areas
Length of time off of work
7-10 days
Time to get back to exercise
1 week for heavy exercise
Pitfalls your Plastic Surgeon should avoid
  • Poor candidates (loose skin, scars, significant obesity)
  • Over removal causing contour irregularity

Dr. Lawrence Tong has either authored or reviewed and approved this content.