One of the very common and good questions most patients ask during a consultation about liposuction is the longevity of the results. How long will my results last? When there is pain, recovery and expense involved, the long-term benefits are extremely important. This is always a great question but the answer to it is somewhat complex.
My first comment about the longevity of liposuction comes from a two-year outcome evaluation of liposuction surgery published in a major plastic surgery journal. The results were disappointing but not surprising. Nearly half of the patients treated had gained weight in the liposuction-treated areas, some even bigger than they were before. (the good news is that half still had good results!) These results do not suggest that liposuction is not a good procedure or that it is not worth it. Rather, it strongly indicates that liposuction alone is not the entire solution to all of your body contouring needs….anymore than the lawn mower is worthless because the grass grows back. The long-term results are only as good as the continued effort you make through other non-surgical body shaping methods, such as proper nutrition and exercise. Liposuction is but one part of your overall body improvement program. If you don’t change what got you there, you will eventually be back to where you started.
This being said….my basic answer to the question of whether the fat will return after liposuction is…if your weight is stable, then the results will be fairly long-term. However, that answer must be tempered by the location of where the fat was removed. Not all fat is metabolically or structurally the same throughout the body. Fat even has a different appearance in different areas of the body. It stands to reason, therefore, that some fat areas function differently and not all fat areas are storage sites for excess calories exclusively. Clearly, for example, the stomach and waistline (flanks) is a preferential depository site. This is where almost everyone gains weight first. Conversely, body areas such as the knees, back, and arms do not get big first and only with a lot of weight gain. These areas do not go up or down as fast as the stomach. Removal of ‘non-depository’ sites will maintain the results much longer as this is not the first place fat will go in most people. This depot site phenomenon is well recognized between the sexes. The buttocks and thighs is much more of a depot site for women but is not for men at all. (how many heavy men with large stomachs have a small butt….very common!) So these factors must be considered as well. Meaning, greater ‘permanency’ will occur from liposuction in areas that are not depot sites. Depot sites are more likely to regain weight than non-depot sites.
One myth of liposuction is that when one gains weight after surgery the fat will go to other non-liposuctioned areas. This is generally not true. There are still plenty of fat cells where liposuction has been, particularly in the stomach area. These remaining fat cells are fully capable of getting big again.
Dr. Barry Eppley
Indianapolis, Indiana