Lipedema is a misunderstood and often underdiagnosed condition that affects millions of women worldwide. Characterized by the disproportionate buildup of fatty tissue—most commonly in the legs, hips, buttocks, and sometimes arms—lipedema can cause physical discomfort, pain, and emotional distress. There is a genetic link, and it is therefore common to find other family members suffering from lipedema.
While liposuction can be an effective treatment, finding a surgeon who is truly experienced in lipedema-specific procedures can be surprisingly difficult. Here’s why—and why choosing the right specialist matters.
1. Lipedema Is Still Underrecognized in the Medical Community
Despite growing awareness, lipedema is still often mistaken for obesity, venous insufficiency or lymphedema. Many patients spend years without a proper diagnosis, which means fewer cases are referred for surgical treatment. As a result, only a small number of plastic surgeons receive the specialized training needed to perform lymphatic-sparing liposuction for lipedema.
2. Treating Lipedema Involves the Vascular Area of the Legs
Most lipedema cases involve the lower body, particularly the legs—a highly vascular area with complex lymphatic pathways. This makes surgery more delicate and higher risk compared to standard cosmetic liposuction.
To protect the lymphatic system and blood vessels, surgeons must use modified techniques:
- Lymphatic-sparing liposuction
- Large tumescence volumes to minimize bleeding
- Smaller cannulas for the lower legs and for the arms and forearms: This approach demands exceptional precision, experience and patience — skills that not every plastic surgeon has.
3. Lipedema Liposuction Is Different from Cosmetic Liposuction
Standard liposuction focuses primarily on aesthetics. Lipedema surgery, however, is also therapeutic, aiming to reduce pain, swelling, and mobility issues. This requires:
- Circumferential treatment, with the patient safely positioned on both the back and abdomen, a 360-degree comprehensive treatment that the VISAGE anesthesiologists and Dr DuPéré have perfected over the years.
- Multiple sessions for large-volume fat removal (up to 15 litres over several procedures).
- Meticulous work in delicate areas to avoid visible cannula tracks, something the lower legs, the anterior thighs and the forearms are prone to, because of the difference in adipose tissue anatomy
- General Anesthesia: Optimal 360-degree results can only be obtained when patients are under general anesthesia. It is not possible to fully anesthetize all the surgical sites with local anesthesia alone, and we want our patients to be pain-free during the procedures. A simple intravenous sedation is also not safe for patients when lying on their abdomen. Therefore, most lipedema liposuction procedures are done under full anesthesia.
These differences mean that only surgeons with extensive lipedema experience—like Dr. DuPéré—can safely and effectively perform the proce dure. It is important to mention that Dr DuPéré has been performing 360-degree liposuction to the lower legs, thighs, arms and forearms for more than 15 years.
4. The Risks of Going Overseas for Lipedema Surgery
Some patients consider travelling abroad for lower-cost surgery. However, this can involve serious risks:
- Lack of follow-up care: Proper aftercare, including lymphatic massages, compression garment management and monitoring complications, is essential for optimal results. Overseas surgeons can’t easily provide this.
- Different safety standards: Regulatory limits in Canada (max. 5 litres removed per session in outpatient facilities) exist to protect patients. Some overseas clinics may bypass these limits, increasing the risk of fluid imbalance, blood clots, or excessive blood loss (VISAGE clinic offers supervised overnight stay for large-volume liposuction)
- Unverified expertise:
- Outside Canada, in many countries including USA, liposuction can be performed by ANY medical doctors, including family doctors, dermatologists, etc., doctors who may have not received the rigorous 5-year training in plastic surgery, which likely explains the higher complication rate with liposuction worldwide
- Not all surgeons advertising lipedema treatment abroad use true lymphatic-sparing techniques. Poor technique can damage the lymphatic system, worsening swelling or triggering lymphedema.
- Emergency care concerns: If a complication occurs after returning home, you may face delays in getting appropriate surgical follow-up.
In a complex vascular area like the legs, expertise and safety protocols are non-negotiable.
5. Why Surgeons Like Dr. DuPéré Are Rare
The combination of factors—under recognition of the condition, the vascular complexity of the legs, the need for advanced techniques, the surgical experience and the time-intensive and meticulous nature of the procedure—means very few plastic surgeons specialize in lipedema liposuction in Canada and the USA.
Dr. Marc DuPéré, at Maison & Clinic VISAGE in Toronto, is one of the few in Canada trained in advanced lymphatic-sparing liposuction for lipedema. His techniques and meticulous attention to details allow for greater precision, smoother fat removal, and reduced trauma to delicate tissues, making it especially valuable when operating in the highly vascular areas of the legs.
Finally, Dr DuPéré’s expertise in post-weight loss plastic surgery is also very appreciated as some patients with lipedema will require various body lifting procedures such as thigh lifts, buttock lifts and arm lifts.
His approach prioritizes:
- Patient safety through staged treatments and supervised overnight stays
- Protection of lymphatic pathways and blood vessels
- Meticulous sculpting for both functional and aesthetic benefits
- Comprehensive pre- and post-operative care
Choosing the Right Surgeon for Lipedema Liposuction
If you’re considering treatment for lipedema, choosing a surgeon with the right training and experience is essential—especially for procedures involving the legs and arms’ vascular structures.
At VISAGE Clinic, Dr. DuPéré combines surgical precision with a compassionate, patient-first approach, helping women not only reshape their bodies but also reclaim mobility, comfort, and confidence.If you believe you may have lipedema and want to explore your treatment options,request your consultation online or call us at (416) 929-9800 to speak with our team. The right expertise can make all the difference—in both your safety and your results.
