One of the common questions or concerns in patients considering liposuction (Smartlipo) is the timing of the surgery. Given one’s existing weight, and whatever plans one has for weight loss, at what point should one undergo liposuction?
 Ideally, and the opinion that is most widely espoused, is to wait until one has lost as much weight as possible. Once one has either hit or come close to a desired weight, liposuction can be done to remove those last stubborn areas. This approach certainly maximizes the effect of liposuction on body contouring and theoretically lessens the extent and duration of the procedure. Placing liposuction at the end of the body morphing process following a regimented diet and exercise program likely leads to a more long lasting result. While no long-term clinical studies have ever evaluated the validity of that weight loss and body contouring sequence, it seems logical that using liposuction as a reward for a significant lifestyle change would be better sustained.
The reverse approach, however, is not unreasonable in select patients. There are certainly some patients who, purportedly with good effort, simply can not lose significant weight. They have managed to lose some but then they hit the wall. They simply can not go down in weight further. These patients have hit, what I call in my Indianapolis plastic surgery practice, their lifestyle weight.
This does not mean that it is not possible that they can not lose more weight. It is just that given their habits (i.e., lifestyle), this is the amount of weight that they are willing to lose. They have reached their physiologic weight given their intake vs output ratio. Liposuction in this scenario can serve as a jumpstart toward more weight loss as well as have a body contouring effect. This occurs from the combination of the fat that is removed surgically and the subsequent catabolic effect that occurs from the energy used for healing and recovery. Seeing these bodily changes in a short period of time may serve as a stimulus to seek greater lifestyle changes and, at the least, work to preserving their financial and physical investment. This approach does not produce as a significant body change initially and is likely more prone to relapse and regain of weight.
The timing of liposuction (Smartlipo) and the state of one’s weight is not etched in stone. Numerous factors must be considered to determine the best approach for each individual.
Dr. Barry Eppley
Indianapolis, Indiana