Despite the common performance of liposuction as part of many body contouring procedures, the long-term consequences of its effects on the body are not well understood. Various studies have indicated that liposuction can cause breast and upper body enlargement due to fat reaccumulation. Such findings fall in line with what is known as the fat homeostasis theory which states that the body has a certain amount of fat and will fight hard to maintain it in the face of surgical removal or weight loss.
In the Online First edition of the June 2014 issue of the Aesthetic Surgery Journal, an article was published entitled ‘No Increase in Female Breast Size or Fat Redistrbution to the Upper Body After Liposuction – A Prospective Controlled Photometric Study’. In this report, eighty-two women underwent cosmetic surgery consisting of liposuction or liposuction combined with a tummy tuck (one group was a control of 24 patients who had no liposuction), breast measurements were done from photographs and the groups compared. The results showed that there were no significant changes in mean body weight, breast size or upper body dimensions. Those women that had liposuction combined with a tummy tuck had a significant decrease in upper abdominal width.
This study provides data that runs contrary to the theory of fat redistribution with unchanged upper body dimensions. It is not a perfect study nor does it absolutely prove that it does not happen in that it does not follow the patients for years. But in the short-term, no immediate or rapid redevelopment of fat could be shown.
One of the most common questions many patients ask considering liposuction is whether the fat will simply come back once it is removed. In essence, they are asking are the long-term results stable and will they enjoy many years of the benefits of the surgery. The traditional answer from most plastic surgeons is that as long as your weight is stable then the results will remain. This seems to make biologic sense and is still believed to be true.
Conversely the fat homeostasis theory also seems logical and runs counter to the weight stability theory after liposuction. This study combined with other contradictory studies keeps this issue unresolved. The answer is likely that both fat theories have some merit and is very patient dependent. But if patients really want to maintain their liposuction results the longest, rigid adherence to diet and exercise is still the best insurance.
Dr. Barry Eppley
Indianapolis, Indiana