Episode 30: Can I Lose Weight by Having Liposuction
Can I lose weight by having liposuction? The short answer is no, but here we'll explain why that's true and why it's important to be close to your goal weight if you are considering liposuction, to make sure that you get the best results.
What happens to my fat cells when I gain or lose weight?
The basics of this answer go back to a simple explanation of fat biology and how your body deals with extra fat. So when you take in more calories in your diet than you're burning through your daily activities and exercise. Your body has an excess of lipids, which it stores in fat cells. We can think of these fat cells as expandable storage boxes. As the imbalance between diet and exercise grows, ar as we take in more calories than we're burning and we have more lipids to store, the body does that by adding lipids to the fat cells and the fat cells expand.
In contrast, when we're burning more calories than we're consuming, the fat cells contract as lipids leave the fat cells in are used by the body as energy. And while this intuitively make sense, it's important to also say what's not happening. When you gain weight, you're not making more fat cells. You're simply storing more lipids and your existing fat cells and they're getting bigger.
Similarly, when you lose weight, you're not destroying fat cells. Your body is simply releasing lipids from fat cells and those fat cells are getting smaller. And we know this because research studies have shown that once we're adults, the number of fat cells in our body remains roughly constant in the vast majority of cases.
So while the body is constantly making and destroying fat cells, it's doing this at approximately the same rate. So it's making fat cells at the same time that it's destroying fat cells. So it's really the increase in size of fat cells and the decrease in size of fat cells that correlates with weight gain and weight loss, respectively, not the creation and destruction of fat cells.
How does liposuction affect my weight?
So how is all this related to liposuction? When we treat an area with liposuction, we're removing many of the fat cells from that area, we like to say about 75%. And we know that a liter of fat weighs approximately two pounds. So we might think that when we remove a liter of fat, we're going to help our patients lose about two pounds of weight. However, just because we've removed fat cells with liposuction, this doesn't mean we've done anything to alter the balance between diet and exercise of our patient.
So if someone has liposuction and their diet and exercise habits remain exactly the same, their calorie deficit, their calorie balance will remain the same. So if they had a need to store a certain amount of fat before liposuction surgery, they're going to still need to store the same amount of fat after liposuction surgery. But since the fat cells in the treatment area are gone, this is not going to prevent them from storing that fat elsewhere.
Will Other Parts of My Body Get Bigger After Liposuction?
Instead, if we remove approximately a liter of fat from the abdomen, for example, that means that the body's going to have to distribute approximately a liter of fat elsewhere in the body. And that's going to happen by adding lipids to fat cells elsewhere in the body and having those fat cells grow to compensate for the fat cells that were removed during liposuction. And while that may seem alarming, so we just said, we removed a liter of fat from the abdomen, and now is this going to be a really noticeable increase in the fatty volume of a different area of the body?
Fortunately, the answer is almost always no. The body tends to do a very good job of evenly distributing this fat around the body. So that if we perform liposuction of the abdomen, for example, instead of having the right thigh get very large, that liter of fat is going to be evenly distributed in most cases. And the other thing that prevents this from being a major aesthetic problem is that while a liter of fat may seem like a large volume, the body has a very large surface area over which to distribute that volume.
So the body does a really good job of hiding the fat that we remove with liposuction, and that allows the body to maintain its weight as constant. So if we remove a liter of fat from the abdomen that weighs about two pounds, the body's going to redistribute those two pounds evenly throughout itself in most cases.
Now there are some people that will preferentially gain weight in certain areas, and sometimes this can happen after liposuction. But in my practice and my clinical experience, I haven't really seen this to be a clinically significant issue. And I think that's because for one thing, fat distribution does tend to be fairly even, and for another, the volume of fat that we're removing with liposuction is relatively small compared to the overall volume of fat and surface area of the body. So it's pretty easy for it to be evenly redistributed without causing a noticeable change in the appearance of other body areas. So that's what happens if you have liposuction and maintain your diet and exercise regimen.
A very common question that we get asked by our patients is, "If I have liposuction and I gain a lot of weight, is that going to ruin the results?" And the answer here is if we perform liposuction on a given area, in this case let's say the flanks or waist, we've permanently removed about 75% of the fat cells in that area. So now knowing what we know about how fat metabolism works, the body is going to redistribute the fat that used to be stored in those fat cells elsewhere in the body.
So if someone goes on a Twinkie diet and gains a large amount of weight after a liposuction procedure, they're going to have to store their excess lipids somewhere, and they're going to more or less try to distribute those lipids evenly throughout the fat cells in their body. However, now, since there are a lot fewer fat cells in their waist, flanks or love handles, they're simply not going to be able to store as much fat there.
So that individual, after having liposuction of the love handles or flanks, if they gain a lot of weight, they're going to gain a lot of weight everywhere, including where they had a liposuction procedure. But it's going to be a lot less noticeable in the area that they had treated with liposuction, because there are simply fewer fat cells there to expand, to store the excess lipids.
So, again, to answer the question, "Will you lose weight by having liposuction?" The answer is no, and it really is quite important that you're fairly close to your goal weight when you're having a liposuction procedure. And the reason for that is we want to perform liposuction when your body and the shape of your body, the contour of your body is in more or less a steady state. We don't want to be designing a liposuction procedure at a moving target.
You can imagine that if we're looking at your proportions and deciding how much fat to remove to provide a great outcome, if we perform that procedure and then you lose or gain a significant amount of weight, it is going to change your body's proportions, and therefore the aesthetic outcome of the procedure that we've performed.
Similarly, in the case of weight loss after liposuction, we've spoken in previous episodes about the question, "Will I have loose skin after liposuction?" And part of the way we make sure your skin isn't loose after liposuction is we assess your skin quality and make sure you don't have too much skin laxity, and we judge how much fat we can remove without causing your skin to become loose or become lax.
So if we perform that amount of liposuction, we remove a of fat that we judge to be okay without causing excess skin, and then a significant amount of weight is lost after your liposuction procedure. You could see why that might cause excess unplanned for skin laxity. And I did mention that in general, it's as good to be as close to your goal weight as possible for a liposuction procedure.
However, in some cases, liposuction can be very useful and inspiring to people that are looking to lose weight. Some people need a little bit of a jumpstart and if they could see a certain area of their body significantly changed shape with liposuction, they might be inspired to go to the gym and go on a good diet plan and lose the weight. But this is not to say that liposuction is a weight loss procedure. It's definitely not. Liposuction is a shape change procedure.
So if you're a little bit above your goal weight and you think that seeing a significant change in a certain area would spur you on to get into a good fitness plan, then liposuction might be a good option for you, even if you're not exactly at your goal weight yet. But liposuction is something you really shouldn't be doing until you're within, I'd say, five to 10 pounds of your goal weight. But if you're five to 10 pounds out and you feel like you could use a little motivation, liposuction can be inspiring and spur you on the right path.
But this is a careful balance and it's a decision to be made in consultation with a Board Certified plastic surgeon that specializes in body contouring so you can have a good sense of what results you can expect and how the additional weight loss that you're planning will affect the results of your procedure.
Am I a good candidate for liposuction?
So if liposuction is not a weight change procedure, then who is a good candidate for liposuction? We have a recent episode dedicated to exactly that question, but in short, the best candidates for liposuction are at or very near their goal weight and they're looking to achieve an improvement in contour of specific areas of their body.
So while liposuction is not a weight change procedure, it's a shape change procedure, and these are changes that you'll see in the mirror, not on the scale. It is an extremely powerful procedure for good candidates and we hope this clarifies some common questions about liposuction and helps you on your journey to get the great aesthetic results that you're looking for.