Liposuction: Does the fat come back and, if so, where?

August 24, 2012

New study provokes discussion

There is a nagging question that plagues those contemplating liposuction, discussed in an August 2012 Allure magazine blog: “If you gain weight after the procedure, do the new pounds pile on throughout the body – or only in areas that haven’t been treated?”

For years, doctors have noticed that those liposuction patients who consume too many calories and don’t exercise enough usually don’t put on tummy weight after abdominal liposuction but, in a year’s time, store new fat in other bodily areas such as the arms, the back or the breasts.

Dr. Eric Swanson, a plastic surgeon in Leawood, Kansas decided to put this theory to a test; his results were published in a well-respected plastic surgery journal that evaluated photographs of 301 nonobese liposuction patients. Lower body dimensions were measured by photos before and at least three months after surgery. To assess whether or not there was fat increase in the upper body (fat redistribution), upper body measurements were compared among 67 women who underwent cosmetic breast surgery in addition to lipoplasty and 78 women who had breast surgery alone.

The most significant outcome was, according to the study abstract, “There was no difference in upper body measurements when comparing patients who had simultaneous liposuction and/or abdominoplasty with patients who had cosmetic breast surgery alone. Measurements in 46 patients with at least 1 year of follow-up showed no evidence of fat reaccumulation.” Study results show the average weight change was a loss of 2.2 pounds after lower body liposuction and 4.6 pounds when patients also underwent abdominoplasty. Liposuction effectively reduced abdominal, thigh, knee, and arm width.

The conclusion that there is no evidence of fat regrowth gives one plastic surgeon pause. Dr. Gerald Pitman, clinical plastic surgery professor at the NYU School of Medicine, who has written extensively on this subject, feels that, “Liposuction is a superb method for correcting body disproportion with spot fat reduction but it is of no value for losing weight.” He is concerned that the study may lead patients to believe that they can eat as much as they want without consequences, which is untrue. Further, contrary to this study he says, “In my experience, the patient who gains weight after liposuction does increase the size of the body, and usually in areas that haven’t been treated.”

Whether it’s true or not, this has not decreased interest in liposuction procedures in the US. According to the American Society for Aesthetic Plastic Surgery (ASAPS) 2011 statistics, lipoplasty is once again leading as the most popular cosmetic surgical procedure in the United States.

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