Off to a chic fete in the tropics, I’m tearing through my closet for the perfect dress. Other guests include bombshell movie stars. This is no time to shirk the glamour gods. Lifelong shopaholic, I own racks of “perfect” dresses. Like this one I’m trying on now: a floor-sweeping silk Valentino with thigh-high side slits in a batik banana palm print. Ideal. But I won’t be wearing this. It’s sleeveless.
Ditto for the pink, ribbon-tied Prada that fits me like a glove — also sleeveless.
I feel sorry for these dresses. They should be going to lots of parties. Instead, they hang, forlorn and unworn, in the dark. My wardrobe a graveyard of lovely frocks that I riffle pass, searching for one that shrouds my upper arms.
Wandering boutiques, constrained to the sleeved selection, posing hopefully in an endless series of merciless, mirror-lined change rooms. Arms akimbo like Barbie limbs; thinking: “Well, if I just never touch the sides of my body with my limbs, this dress is fantastic on me.” Placing it back on the hanger, vowing once again to take up yoga, I think of Nora Ephron whose 2006 memoir I Feel Bad About My Neck featured a cover photo of the author, black turtleneck yanked up to her cheekbones.
Post-40, arms are the great betrayer. That jiggly-wiggly top shaft, unappeased by mere calorie counting, demanding endless toning — or sleeves. Past is prologue: I accept that I’m not the sort of lady who’s adding “100 push-ups” to my daily to-do list. There must be a cheat for this. After all, I’ve been taking my face in for anti-aging tech since I was 33 and, 16 years later, it only looks 38. Confident there’s some equally genius beauty equipment that can be aimed at the rest of me, I book my slack, sleeveless arms for a consultation.
A week later, I meet with Claudia Nicoara. Medical esthetic consultant at Toronto’s SpaMedica, she prods my arms, explaining that the problem is twofold. Natural laxity caused by reduced levels of skin-firming collagen, which depletes as we age, and recurrent weight loss and gain — that 12 pounds I’d spent decades putting on and off before applying a more vice-like grip on my diet. Yes, the clinic has a fix for this, says Claudia. A radio frequency (RF) device called Freeze that triggers collagen production by heating the dermis.
It’s the same technique as Fractora, the popular procedure that’s kept my face taut well past its best before date. “What about the fat?” I ask, grabbing at my arm. Claudia tells me my arms aren’t fat — which shows you how crazy Claudia is — adding that if the clinic applied thermal fat reduction to my arms, I’d just wind up with more lax skin in that area.
We agree to tighten up my arms. Only now, I’m stuck on the words: “thermal fat reduction.” I feel as if I’m in a dream as Claudia describes how new technology, spot focused at a chub zone, heats and liquefies fat cells, which are then excreted via urination. Yes, you read that correctly: you can just pee the fat out. I decide to shape up my inner knees (a handful there I’d happily jettison … ) and my thighs (who doesn’t want thinner thighs?). Between the fat-reducing sessions and the skin-tightening procedures, this will likely take as many appointments as if I just went to the gym and moved my arms and legs.
But I can do this lying down. I factor in the brisk 40-minute walk to and from the clinic as “cardio.” Best of all — thermal lipo — I won’t die of surgical complications while at it.
The most commonly performed cosmetic operation, classic liposuction, is major surgery. The Tumescent method – a large volume of diluted lidocaine (anesthesia) and epinephrine (to mitigate bleeding) injected into fat, which a surgeon breaks up by thrusting at it with a cannula prior to suction extraction — has been around for decades.
A 2000 study by Penn State flagged the procedure’s late ‘90s death rate at about 20 in every 100,000 patients, a figure above the national average for automobile fatalities. Poor patient health, excessive fat removal, too much fluid and anesthesia injected, all flagged as risk factors, liposuction was vastly improved by the Vaser technique in 2001, which introduced energy-emitting devices that liquefied fat with ultrasonic waves before it was removed.
Downtime vastly improved — melting fat, rather than stabbing at it, causing less injury to surrounding tissue — the new technique also offered smoother results as fat was evenly liquified for removal, rather than carved out, which requires additional finesse. But both techniques required that patients wear oppressive post-operative compression garments — for up to a month — to help the skin contract and mitigate swelling across areas where fat had been removed. Hack doctors and loose protocols presented other hazards.
Shockingly, it wasn’t until 2011 — with the liposuction death of Krista Stryland, a 32-year-old realtor and mother — that Ontario’s College of Physicians and Surgeons overhauled the province’s wholly unregulated cosmetic surgery clinics. Found “incompetent,” Stryland’s Toronto physician Dr. Behnaz Yazdanfar, a family doctor unaccredited to perform plastic surgery, was fined $219,000 and had her licence suspended. After which, only formally qualified specialists were permitted to perform cosmetic operations and private clinics were subjected to rigorous inspections that required them to meet hospital standards.
Outside of the Kardashians — for whom plastic surgery is an over-share family pastime — celebrities are understandably mum on the topic of surgical enhancements. But everyone from Demi to Mariah are rumored to have signed up for some “assisted slimming.” As the more candid Dolly Parton put it: “If I see something saggin’, baggin’ or draggin’, I’m gonna have it nipped, tucked or sucked.”
Of course, there’s much to be lauded in simply accepting yourself, lumps and all. Stylist Trinny Woodall once remarked: “Don’t look at your legs and think: ‘They’re fat.’ Think: ‘These things carry me around all day, and I don’t have arthritis. Oh, and I’ve got great ankles!” Easy for her to say? Five foot 10, skinny Trinny looks to weigh about 120 pounds, and even she’s vlogging about micro-needling her body with a derma-roller to “break down fat.”
Oddly, it’s the Yeezy clan that stands out as a cautionary tale for everything that can go horribly wrong with liposuction. In 2007, Kanye West’s mother, Donda, a 58-year-old former chairwoman of Chicago State University’s English department, died the day after her procedure, which was blamed on shoddy post-op care, while the entertainer’s 2016 breakdown, hospitalization and oddball antics have recently been tied to his getting hooked on painkillers following his own procedure. “I had plastic surgery because I was trying to look good …” West admitted during a May 2018 radio interview. “I got liposuction because I didn’t want y’all to call me fat… and they gave me opioids.”
“Vaser greatly reduced swelling, bruising and downtime, along with the sometimes uneven finish of tumescent liposuction,” explains Dr. Mulholland, the Toronto plastic surgeon who launched Yorkville’s SpaMedica 20 years ago. “But neither procedure really dealt with poor contraction in treated areas — the loose skin where fat had been removed.” A huge leap forward, today’s Thermal procedures are non-invasive, require no anesthesia, are far less painful, have zero recovery and offer excellent skin tightening. “We can now reduce fat by up to 17 per cent per zone,” adds Mulholland, “while firming surrounding tissue by up to 35 per cent.”
Two days later, I’m standing in my knickers while a technician in a white lab coat marks areas to be targeted by SculpSure. Danielle tells me she’s had this procedure on her tummy – twice – and she’s very pleased with the results. I lie down and she straps me to an octopus-like contraption whose multiple arms are capped with RF emitting pads. Fastened to my thighs and knees, six in total, I’ve equipped myself with mint tea and a magazine for the appointment … which is not as relaxing as I’d assumed.
A beauty vet with a PhD in lasers, I’ve spent two decades reviewing every new procedure. Thermage, Fractora, IPL, Pico, I’ve done it all. Blessed with a superior pain threshold, if it works, I’ll endure it. The essential beauty math is: Results x Pain ÷ Cost + Downtime. I’d score Pico and IPL, which eliminate sun damage, a two out of 10 on the “ouch” hierarchy, though some women find those painful. On the other hand, if I don’t massage an inch of numbing cream into my face 45 minutes before a Fractora, which tightens skin, I swear like a f*cking sailor through the entire session. Then deem it well worth the torture as it’s so effective.
Lying here, SculpSure heating my fat cells into a liquid I can pee out, I’d score it a solid eight on the Richter scale: 25 minutes I spend conjugating profanities I cannot share in print. I’m doing the more painful zones, closer to the bone, says Danielle. The tummy isn’t so bad, she adds, likening that to “childbirth contractions.”
“Has anyone not been able to take this?” I inquire through clenched teeth, crushing foam stress squeezies shaped like oversized Botox vials. “Just two,” she replies. “Out of hundreds …” I require one session of this, possibly two, for top results. My knees are tender for a week.
For my next visit, pretty, bespectacled Carrie leads me to a treatment room where she applies Freeze, a skin-tightening RF device, to my waggly upper arms. A pain-free 15 minutes per limb that involves gliding a heated roller back and forth, it feels like a hot stone massage with an iron and leaves my skin bright pink. Also effective for droopy knees, eight sessions are recommended, followed by monthly to seasonal upkeep, depending how obsessed you are.
Next, Carrie applies BodyFx, another RF tool but with a kneading-suction motion, to my knees and thighs. This tightens skin while helping to dissolve any loitering fat cells that, as with SculpSure, will be excreted via urine. Quite pleasant until — intermittent pangs of sharp heat — it reaches its max. I’d rate this a four out of 10 on the vanity pain scale.
A month later, the clinic treats my thighs with Vanquish, a brand new RF device. Unlike SculpSure, this is non-painful and — targeting larger volumes of fat — half the price. Where SculpSure applies several 2-by- 4-inch pads, to, for instance, a thigh, Vanquish positions that same thigh between two 10-by-10-inch pads, covering a broader zone in one go. “A patient treating their entire core with SculpSure requires about six smaller areas treated and probably a second round in eight weeks — at a price of $8,000 to $10,000,” explains Scott Mills, who reps Vanquish in Canada. “Targeting a larger area, Vanquish treats that entire core in one session for about half the price.”
Fat reduction (SculpSure, Vanquish) takes a month or two for full results. Skin-tightening effects (Freeze, BodyFX) are accumulative and require maintenance. Unlike fat cells that shrink due to lifestyle changes (diet, exercise) but balloon up again given any opportunity (cocktails, cheese burgers), once fat cells are destroyed and eliminated, they don’t regenerate.
That said, while treated areas have less available cells for fat storage, if you gain weight, the body will store those excess calories as fat in untreated areas. Maintained with lifestyle choices, the procedure is ideal for those with stubborn — diet- and exercise-resistant — fat deposits like tummy, love handles and thighs. It’s not a lasting fix for yo-yo dieters who will simply gain the weight back elsewhere.
Four weeks in, I’m at Michelle Bespoke in Toronto rescuing a torn vintage chiffon dress. “Wow,” says owner Paul di Palma. “What have you been doing? Your arms are much thinner.” A month later, I’m in Senegal, a country wrapped in a white sand coast where a swimsuit is daywear. Arms and legs slimmer and firmer, I’m not dreading climbing into my black maillot. I wouldn’t say it’s a magic pill, I’ve been restricting calories and alcohol while at it, but it definitely makes a discernible difference, speeding any weight loss process along, while the skin-tightening techniques firm things up noticeably. I have something resembling thigh gap.
Progressing from painful invasive surgery to zero-downtime procedures in just the last decade, in my fantasy future slimness will be as easy as entering a room flush with fat-vanquishing light and exiting skinny — possibly with whiter teeth and glossier hair. I’ll simply wave a magic wand over my arms and thighs after too much pasta. Aim a fat-blasting beam at my tummy while binging on Netflix and Häagen-Dazs. Turns out I’m not far off. Outside of the quickly advancing array of high-tech thermal options, home use devices, supplements and topical creams — all aimed at significant, permanent fat destruction — are on the horizon. Effective on smaller zones — under the chin, jowls, eye bags — there are now “lipolysis injections” that destroy fat cells with deoxycholic, a compound produced by the gallbladder that breaks down fatty foods and has the same effect when injected directly into flab.
“Over the last five years, there’s been tremendous progress in the development of techniques that kill fat cells, and the phase of innovation we’re entering now is completely non-invasive procedures that permanently reduce large amounts of fat,” says Mulholland. “In the not too distant future, these techniques will rival tumescent liposuction for the amount that can be removed — all without surgery”.
Finally, we can have our cake and eat (all of) it, too.