Professional Opinion: If I get liposuction, will the fat return?

loberle@islandpacket.comMay 13, 2014 

Dr. Audrey Klenke

ROB KAUFMAN

This week Dr. Audrey Klenke, Beaufort County's only female plastic surgeon, talks about liposuction, its uses and effectiveness.

Question. If I get liposuction, will fat grow back in that area? Does liposuction cost more if more fat has to be removed? Can liposuction ever be deemed medically necessary? Is liposuction an effective treatment for cellulite? How likely am I to keep the weight off?

Answer. Liposuction is a way to remove fat cells permanently. It is a surgical tool that has been used for decades, but it has evolved to be safer and more effective with less blood loss, less discomfort and less risk.

The idea that we are born with all the fat cells we'll ever have is a myth. Our pool of fat cells increases through childhood and adolescence and plateaus as an adult. Fat cells do die, but in healthy individuals they are replaced at the same rate so the numbers of cells stay the same. Overweight adults can generate up to 10 times more fat cells than a healthy weight person. Even after "losing weight," overweight people will maintain this higher number of cells, each cell just becomes smaller.

Liposuction is not a magic wand and is not meant for weight loss in terms of the number on the scale because fat just doesn't weigh that much. It is also not meant to correct cellulite, which is a problem that resides in a more superficial layer than where liposuction is taking place. In fact, I caution patients that liposuction can actually accentuate cellulite. Liposuction is also not meant to reduce loose, sagging skin or stretch marks. These problems may be better addressed by other procedures like a thigh or body lift.

A good candidate for liposuction eats a healthy diet and exercises regularly, but has stubborn areas of fat that aren't as responsive to lifestyle changes. Liposuction is not a substitute for diet and exercise. It takes burning 3,500 calories to lose 1 pound of fat, so liposuction followed by nachos and ice cream will not get you where you want to be. So, to answer your question, keeping the weight off and maintaining the contour created is up to you.

Different surgeons charge differently for liposuction, but most commonly it is billed per area of the body, so it doesn't necessarily cost more or less depending on size. Liposuction is rarely deemed "medically necessary," unless perhaps it is used strictly to obtain fat to use for certain breast reconstruction techniques. In this case, however, the liposuction is just a means to an end and not meant to be a cosmetic procedure.

I often ask patients, "Where do you want me to put this fat?" Meaning, fat grafting is a great technique to augment areas of the body with your own tissue that have either lost fat over time (like the face) or never had it to begin with (like the buttock). Hey, why waste it?

Follow reporter Laura Oberle at twitter.com/IPBG_Laura.

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