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What is liposuction?

Liposuction is the term used to describe body contouring and the removal of localized focal fat collections by gentle aspiration, through small hidden incisions, using liposuction technology.  Modern liposuction is not merely the removal of localized areas of unwanted fat, but the simultaneous control and contraction of the soft tissue that lies over it. In more old-fashioned liposuction techniques, commonly called Tumescent Cannula Liposuction, a very diluted local anesthetic was inserted into the fat to swell up the fat and make the fat numb. Then, a small, blunt tipped microcannula was inserted under the skin into the area to be contoured and the fat removed by sucking it traumatically through little holes at the end of the cannula. The old-fashioned liposuction techniques were successful in removing the fat, but very often the patient would complain of uneven skin or skin laxity after the removal of the supportive under-layer of fat.

Before Liposuction Toronto Anesthetic Applied to Buttocks

Figure 1. Tumescent local anesthetic fluid being inserted into the fat.

Liposuction Toronto Microcannula Used to Suck Fat During

Figure 2.  A. Blunt tipped microcannula used to; B. Suck out the fat.

The goal of modern liposuction, as pioneered by Dr. Mulholland and SpaMedica, is the use of energy-assisted devices to heat, liquefy and coagulate the fat just prior to its aspiration and removal, making the removal of the fat, in its liquefied state a more gentle process with less bruising, swelling and pain than older techniques. Even more importantly than improved recovery, the use of this heat energy provides a very strong internal contraction. Dr. Mulholland teaches his energy assisted liposuction all over the world, authoring numerous articles and coining the use of heat as energy assisted liposuction. The use of energy to heat the soft tissue stimulates skin tightening, contraction and enhances skin tone after liposuction. The modern era of liposuction, coined by Dr. Mulholland as energy-assisted liposuction, is thus the application of energy just prior to the removal of the fat to make the fat liquefied and coagulated and easy to remove and to induce a reciprocal contraction of the overlying soft tissue to ensure smooth, tight contours. The new “gentle era” of energy-assisted liposuction has made the lipo experience much less painful for liposuction Toronto patients, with less bruising and swelling and, more importantly, has allowed significant contraction of soft tissue, with up to 30% area contraction after an energy-assisted procedure, making liposuction a viable option for patients with unwanted extra fat contouring and areas of localized fat. Where in the past a tummy tuck, an arm lift, a thigh lift or a neck lift might have been necessary, but now a small minimal-incision, minimally-invasive, energy-assisted liposuction can be performed and lead to excellent contours and shapes.


Dr. Mulholland has been a pioneer in the development of the art and science of energy-assisted liposuction. He has personally taught hundreds of physicians from across the world the art and science of this very refined and artistic procedure. The forms of energy-assisted liposuction that Dr. Mulholland has helped develop and teach include VASERLipo™ (VASER liposuction or UAL), SmartLipo™ (laser-assisted liposuction or LAL) and radiofrequency-assisted liposuction, also called BodyTite™ (RFAL). Dr. Mulholland is a world renowned expert in these modern forms of energy assisted liposuction.

VASERLipo™ involves the use of an ultrasonic energy released through a small probe into the fat. The ultrasound waves gently vibrate and implode the fat cell, creating a soft, liquefied, milkshake-like substance.

Liposuction Toronto Vaser Lipo Probe Using Ultrasound to Liquefy Fat

Figure 3. A. The VASERLipo™ probe gently using ultrasound energy to B. cavitate, liquefy and separate the fat for aspiration.

Once the ultrasound has liquefied the fat, Dr. Mulholland then uses a very small, blunt-tipped microcannula, which is a hollow metallic tube with little holes at the end, to gently aspirate and remove the liquefied fat from the unwanted localized areas of excess. The real advantage of VASERLipo™ is its gentle nature and the ability to still use the fat to fat graft following the liposuction.

VASERLipo™ removal of fat with a small microcannula in Liposuction Toronto

Figure 4. Gentle aspiration and removal of the VASERLipo™ fat with a small microcannula

It is very common for Dr. Mulholland to have patients who want to remove fat from the areas of excess localized collection, and transplant it onto other areas, such as the buttock, breast or face. VASERLipo™ is the best energy-assisted device for fat transplantation as the gentle ultrasound energy does not kill the fat cell, just loosens them for removal, preserving them and keeping them viable for transplantation. The weakness of VASERLipo™ is that it does not provide significant soft tissue contraction, so other energy-assisted devices must be used after the VASERLipo™ procedure to ensure the suitability of the skin and soft tissue once you have used the ultrasound to cavitate or liquefy the fat.

There are two types energy-assisted liposuction devices that have proven, strong internal soft tissue contraction, each of which has been pioneered and taught by Dr. Mulholland, and deploys to optimize skin tightening following liposuction. SmartLipo™, also called laser-assisted liposuction, and BodyTite™, also known as radiofrequency-assisted liposuction. SmartLipo™ uses a small laser probe to emit laser energy, which coagulates and liquefies the fat, closes off small blood vessels to minimize the bruising and facilitates easy aspiration of the fat with a microcannula to minimize pain and discomfort. The advantages of SmartLipo™ over VASERLipo™ is the heat that is generated will lead to a reciprocal contraction and tightening of the skin, thus allowing body contouring, but still achieving skin tightening.

Studies have shown that six to 12 months after the liposuction, up to 17% area contraction of the skin can occur following SmartLipo™. This SmartLipo™ contraction of the skin minimizes the risks of irregularities, laxity and optimizes the ability of patients to avoid more invasive incisional procedures like tummy tucks, arm lifts, thigh lifts and neck lifts.

SmartLipo Laser Used to Liquefy Fat in Liposuction Toronto Patients

Figure 5.  SmartLipo™ laser fiber (which is only 1 mm in diameter) uses gentle internal laser energy to liquefy fat tissue and coagulate small blood vessels.

The final energy-assisted liposuction device that Dr. Mulholland is well known for pioneering is called BodyTite™, or radiofrequency-assisted liposuction (RFAL). BodyTite™ uses electrical current waves to coagulate and liquefy the fat and the blood vessels to minimize any post operative pain, bruising and swelling. But the electrical current waves, much like an internal Thermage® and internal Venus Freeze, causes a radiofrequency soft tissue contraction of up to 35%. The use of BodyTite™ has allowed Dr. Mulholland to perform Radiofrequency assisted liposuction contouring of the abdomen, arms, necks, inner thighs and other areas, which have some laxity and  where previously soft tissue excisions and skin removal, such as tummy tucks and lifts, would have been required.

Liposuction Toronto BodyTite Energy Assisted Liposuction Illustration

Figure 6. The BodyTite™ energy assisted liposuction uses an internal probe that release electrical current that coagulate blood vessels, liquefies fat, aspirates it and tightens skin.

The art of modern liposuction is the application of heat energy at the time of the aspiration to stimulate the artistic removal of the fat. Dr. Mulholland will often use two or three of these devices on liposuction Toronto patients – VASERLipo™, SmartLipo™ and BodyTite™ – all during the same case in different areas in different layers of unwanted fatty contour to optimize the results. It is Dr. Mulholland’s 20 years of liposuction contouring experience, expertise with modern energy assisted liposuction technologies and the artistic refinement of shapes and curves that combine to yield the outstanding liposuction results that Dr. Mulholland is known for amongst his patients and peers.

How is liposuction performed?

Whether Dr. Mulholland is using VASERLipo™, SmartLipo™ or BodyTite™ radiofrequency-assisted liposuction, the procedure is generally performed either under local anesthesia with oral sedation or local anesthesia with IV or general sedation. Most liposuction Toronto patients who are not prone to anxiety have liposuction performed with the modern, gentle energy assisted liposuction techniques under local anesthesia and oral sedation. Local anesthesia is inserted into the area of unwanted fat. The fat then becomes totally anesthetic, much like a dental procedure, and the gentle extraction can be performed.

The Tumescent technique is the infiltration of dilute local anesthesia, making the fatty tissue numb with loss of pain in Toronto Patients

Figure 7. The Tumescent technique is the gentle infiltration of dilute local anesthesia, making the fatty tissue numb with loss of pain sensation and allowing gentle energy assisted liposuction to be performed without the need for general anesthesia.

Once the local anesthesia, also called tumescent anesthesia, is completed, the energy-assisted devices – VASERLipo™, SmartLipo™ and BodyTite™ – are deployed to liquefy, coagulate and tighten. Once this phase has occurred, this liquefied, coagulated fat is immediately aspirated with a gentle, small, blunt-nose tipped microcannula.

Liposuction Toronto Micorcannula's Small Size Illustrated

Figure 8. This figure shows the very small size of the modern microcannulas, which are used to finally remove the liquefied fat. Their tiny size helps minimize the risk of pain, bruising or discomfort.

What are the most common areas for liposuction to be performed?

The most common areas to have liposuction performed with energy-assisted devices in women include the abdomen, love handles, flanks, bra line, outer thigh, inner thigh, inner knees, neck and jaw-line and, rarely, the calves and ankles. For men, the most common areas of liposuction include unwanted breast tissue – called gynaecomastia – as well as love handles and double chins.

Common areas where liposuction is performed on Male and Female Toronto patients

Figure 8. Common areas where liposuction is performed.

Who is a candidate for liposuction?

The best candidates for liposuction are those prospective liposuction Toronto patients who have unwanted deposits of fat that detract from their ideal shape and contour and have tried their best at diet and exercise to modify their shape and figure. Good candidates are medically healthy patients without uncontrolled illnesses such as diabetes, heart disease or hypertension. Contraindications to liposuction include anyone who is unrealistic about the shape and figure they can achieve, are medically unwell, excessively overweight, or have excessively loose and damaged skin.

What kind of anesthetic is used?

Liposuction is performed under tumescent local anesthesia. Tumescent local anesthesia is an extremely dilute local anesthetic that is then inserted gently into the fat, distending the fat and providing loss of sensation during the procedure. The tumescent anesthesia also distends and expands the fat cells, exposing them to the ultrasound energy of VASERLipo™ or the laser energy of SmartLipo™ and/or the radiofrequency electrical current of BodyTite™. Many liposuction Toronto patients undergo their liposuction procedure under this local anesthesia and oral sedation, while, other patients who are more prone to anxiety may elect to have the liposuction performed under intravenous sedation.

Is liposuction painful?

Modern liposuction, using energy-assisted devices, pre-coagulate and liquefy the fat, turning it into a sort of “fat mango milkshake” and this is very easy to aspirate making it a very gentle procedure. Energy-assisted liposuction techniques like the VASERLipo™, SmartLipo™ and BodyTite™ have been shown in peer-reviewed medical studies to be far less painful and have far less discomfort, bruising and swelling than old-fashioned liposuction techniques where energy is not used. This means much less pain, and discomfort and much quicker return to work and activities for Dr. Mulholland’s liposuction Toronto patients.

SmartLipo is a lot less painfull than traditional Liposuction Toronto

Figure 9. A published comparative study showing SmartLipo™ patients (in green) had far less pain and returned to work faster than old-fashioned liposuction (in orange)

How long does liposuction take?

Depending on the thickness and size of the localized zones of fat to be contoured, the procedure often takes approximately 30 to 45 minutes per area and multiple areas are usually treated.

How long is the recovery following liposuction?

Modern liposuction using energy-assisted devices such as SmartLipo™, BodyTite™ and VASERLipo™ have a very rapid recovery. It is not uncommon for individuals to undergo moderate sized multiple-area liposuction on an afternoon and return to very light, sedentary work/non-work-related activities the following day. It is usually recommended, however, that patients take two to three days off after your lipo-contouring procedure to allow time for rest and recovery.

Is a liposuction garment required after my procedure?

The recovery process is also characterized by the patient wearing a post-liposuction garment. A post-liposuction garment is a high-tech, Spandex-like, Lycra® type of compression garment. The liposuction garment is used to shrink-wrap the overlying soft tissue while it heals in the ideal shape, position and contours. In general, these liposuction garments can be worn under any clothing and are quite comfortable. They provide very comfortable support during the healing process.  Generally, liposuction garments are worn 22 hours a day for three weeks. The garment is light, comfortable and allows going to the bathroom without taking it off. After three weeks, the liposuction garments are worn for support during the day and left off in the evening and overnight.

When can I resume exercising after my liposuction?

Liposuction Toronto patients can usually return to low-impact activities such as walking, stair climber, ellipticals within the first 1-2 days. Return to high-impact activities such as jogging, running, aggressive weight training and activities such as hot yoga and stretching should wait till the fourth to the sixth week.

What will I look like after the liposuction procedure?

Immediately after the procedure, there will be some swelling, which is contained by your compression garment. Modern liposuction, using energy-assisted devices such as VASERLipo™, SmartLipo™ and BodyTite™ do not generally result in much bruising. Avoidance of aspirin, if possible, three weeks prior to the liposuction procedure will minimize the risk of any bruising.

What kind of results can I expect after liposuction?

Modern liposuction using energy-assisted devices such as SmartLipo™, BodyTite™ and VASERLipo ™, all deployed during the same procedure in an expert symphonic orchestration of fat reduction, can result in very elegant results. Dr. Mulholland is well-known for his advanced liposuction and body contouring of all body areas. Improvements in figure, shape and contour are virtually assured, as fat is removed in the areas of contour concern. The focus of Dr. Mulholland’s liposuction Toronto patients should be on improvement in body, shape and contour, not on weight.  Naturally, fat is removed, so there will be some weight loss, but the focus is on inches and contour, not kilograms and pounds.

Liposuction Toronto Patient Before and After

Figure 10. Energy assisted liposuction to the hips and tummy 12 months following her procedure.

What are liposuction Toronto patients saying about Dr. Mulholland’s advanced energy-assisted liposuction procedures and techniques?

Dr. Mulholland has demonstrated his energy-assisted liposuction techniques such as SmartLipo™, VASERLipo™ and BodyTite™ radiofrequency-assisted liposuction on multiple TV shows and newspaper magazine articles. The vast majority of liposuction Toronto patients are extremely happy with the results of their body contouring because they realize that no diet and exercise can, in a localized and focal way, reduce unwanted bulges and contours, such as pots, bra lines, love handles, saddlebags, bat wings and inner thigh/inner knee fat, in the way that Dr. Mulholland’s advanced combination liposuction treatments can. Dr. Mulholland’s patients are particularly satisfied because of his expertise in achieving the best possible soft tissue contraction after the removal of the fat, ensuring the best possible probability of tight, soft, compact, shapely figure enhancements after liposuction.

How long will the results of my liposuction last?

The results of your liposuction will be life-long. The fat that is removed will not return.  It is very important to have weight maintenance after liposuction and stay within five to ten pounds of your liposuction weight to ensure permanent contour and figure enhancements. Excessive weight gain following your liposuction procedure will result in fat being accumulated, not to the liposuction area, but to other areas where traditionally you would not have collected fat; again, compromising figure, shape and form.

Can secondary or repeat liposuction be performed?

Repeat liposuction can be performed and occasionally is performed to enhance the contour figure in 1% to 2% of cases where there may be a small amount of residual extra fat or, in recalcitrant scenarios, where patients put on a little weight a few years after their original liposuction, in which case secondary lipo-contouring can be performed.

How long will the results of my skin tightening last after energy-assisted modern liposuction?

SmartLipo™ can induce 17% area contraction and is good for heat treatment directly under the skin during your liposuction procedure. With BodyTite™, up to 35% soft tissue contraction occurs through the vertical fibres in the fat called the fibroseptal network. Dr. Mulholland often combines these procedures, together with VASERLIPO™, to give you the most outstanding results that modern liposuction can deliver. However, as you age, degradation of skin laxity inevitably may occur in the areas of previous contouring.  In order to enhance and maintain the 35% area contraction that you’ve achieved, Dr. Mulholland will often include post-operative bulk heating radiofrequency treatments for his liposuction Toronto patients to “protect their investment”. These gentle outpatient, no downtime, painless bulk heating RF treatments are performed starting in the sixth week following the liposuction procedure, with treatments being once every three to four weeks, for six sessions. The bulk radio-heating frequency devices deployed include such devices as the Venus Freeze, the Accent®, bulk heating RF Thermage Body™, Excelis™ and BodyFX™. These treatments help maintain the increased collagen content and elasticity of your skin, achieved through your energy-assisted liposuction, to improve and protect the skin tone over your liposuction treated areas for years and years after the procedure.

Is there any maintenance required following my liposuction?

There is no liposuction maintenance required for the fat that has been removed, as it is permanently gone.  However, maintenance skin-tightening, body heating treatments, such as bulk heating radiofrequency devices like the Venus Freeze, Accent®, Exelis®, VASERShape™, Forma™ or Thermage® Body are deployed in your post operative program to ensure optimal skin contraction and tightness.  Once your series of post-operative treatments have been completed, Dr. Mulholland will recommend a single treatment every three months to maintain skin tautness, elasticity and contour.

Liposuction Toronto Venus Freeze  Radiofrequency Bulk Heating Device

Figure 11. The Venus Freeze is one of the many radiofrequency bulk heating devices that is used to “protect the skin tightening investment” achieved during the energy assisted liposuction procedure.

How much will my liposuction procedure cost?

Dr. Mulholland has a range in liposuction pricing, depending on the size and amount of fat and number of areas to be treated. In general, single-zone modern energy-assisted lipo with three combined devices such as VASERLipo™, SmartLipo™ and BodyTite™ deployed during a treatment will start at between $3,999.00 to $6,999.00 for the first zone with subsequent zone discounting for second, third and fourth zones.  Generally, depending on the size of the patient and their Body Mass Index, patients can have three to four zones performed with total body contouring for $9,999.00.

Why choose SpaMedica and Dr. Mulholland for your liposuction?

Liposuction is an art.  That art meets science with the application of energy-assisted devices.  The use of energy-assisted devices is a highly specialized skill; one that Dr. Mulholland has been an innovator and pioneer, with an impeccable worldwide reputation. He has helped develop the BodyTite™, SmartLipo™ and VASERLipo™ procedures and has taught hundreds of physicians from around the world. He has more combined energy-assisted device experience than any other physician in Canada and is sought out by patients from all around the world for lipo-contouring procedures. In choosing Dr. Mulholland, you’re getting one of the foremost experts in the world in advanced modern liposuction using energy-assisted devices. The SpaMedica team is well-known for their service experience, care and attention to your postoperative and preoperative needs.  In addition, Dr. Mulholland and SpaMedica combine postoperative skin tightening in addition to lipo-contouring to ensure the best possible results.

How do I schedule a liposuction consultation?

To schedule a liposuction consultation with Dr. Mulholland, patients can simply call 877-695-2835 or fill out the e-mail consultation request form and a SpaMedica customer service representative will promptly respond to schedule a consultation with Dr. Mulholland and his team so that you may find out more about your body contouring opportunities with energy-assisted liposuction.  Call or e-mail now to begin the process towards a new figure, shape and form.

SpaMedica® YORKVILLE
Cosmetic Surgery and Laser Skin Care Spa:
66 Avenue Road Suite 4
Toronto, Ontario M5R 3N8
Tel: 877-695-2835