Liposuction and fat

You know that friend of a friend who told you she had liposuction of the belly once and that it caused her to become fat afterwards? Well, she was right. Liposuction, it turns out  makes you fat!

As a cosmetic plastic surgeon, for me to say this is akin to blasphemy. I may even be kicked out of the American Society of Aesthetic Plastic Surgeons. Colleagues may stop talking to me. Plastic surgeons have forever been telling their cosmetic patients that liposuction is one of the pillars for a healthy and fulfilled life.

The triangle of life (a cousin of The Lion King‘s famed circle of life) consists of

  1.  Healthy eating
  2. Exercise
  3. Liposuction

Liposuction is part of the creed of cosmetic plastic surgeons. It’s what we do to remove fat from unwanted areas and banish it forever to… other areas! The latest research from a study in Brazil shows just that. Patients who had liposuction had a significant increase in visceral fat.

Plastic surgeons have of course known that if you have liposuction performed on your body but continue your diet in terms of quality and quantity as before the surgery, you will get fat again. I have often told patients that if they get fat after lipo, the fat will go to their secondary and tertiary body storage areas. For example, if you have liposuction of the abdomen and put on weight afterwards, the fat may go to your face, back or hips.

Now cosmetic plastic surgeons must say something else: “If you have liposuction and do not exercise, even though you may not gain weight, you will have an increase in visceral fat.”

Confused? Let’s see…

There are two main types of fat in our bodies with respect to this type of issue.

Visceral fat

This is fat inside our body cavities: around our stomachs and intestines, around our hearts and inside our livers.

Visceral fat is bad. Numerous studies have correlated an increase in visceral fat with an increased risk of heart disease and stroke. Just think how bad this is for the force-fed geese who end up becoming foie gras—literally “fatty liver.” This fat cannot be suctioned away by liposuction; it reduces only with weight loss.

Skin fat

This is the fat that is under our skin. In various parts of the body it has variable thickness; there is very little skin fat under the skin of our lower legs in comparison with the amount of fat under the belly skin, which can be several inches thick if we are particularly tubby. This is the fat you can pinch. And if you can pinch an inch, you can have liposuction in that area. Less than an inch of fat and you risk disrupting the blood vessels that supply the skin with blood to keep it viable.

New research on liposuction

The latest research shows that even though you can have skin fat removed by liposuction, unless you stick to a moderate exercise and diet program after liposuction, you will have a gain in visceral fat. If you continue your hedonistic ways, liposuction will force the fat created by your body into the visceral area and increase your risk of death.

This is really no different than what we plastic surgeons have always told patients. You must have food control and exercise after liposuction or the fat will go elsewhere. We just didn’t know all the places it was going.

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style=”color: #2f2f2f; font-family: Georgia; font-size:
small;”><br />
My preference is for a Brazilian buttock enlargement or natural buttock
enlargement, in which fat is suctioned from other areas of the body such
as the belly/abdomen. Next, a fat transfer and injection into the
buttocks is performed. This procedure is gaining in popularity. I have
taught several of my cosmetic plastic surgeon colleagues how to perform
this surgery. There are a number of companies that sell cosmetic plastic
surgeons different materials to allow for easier or quicker harvesting
of  fat, but I find that these don’t really help.
<strong>Liposuction</strong> with fat transfer under the
buttocks’ skin and muscle in multiple lines gives the best
<h2><span style=”color: #2f2f2f; font-family: Georgia;
font-size: x-large;”><strong>How long does fat injection into
the buttocks last?</strong></span></h2>
<p><span style=”color: #2f2f2f; font-family: Georgia;
font-size: small;”>When I first started performing this cosmetic
procedure years ago, I would tell my patients what I had been told to
say by the plastic surgery authorities at the time: “We don’t know, but
it should last at least two years.”  I now know that I still don’t know,
but results can sometimes last for almost a lifetime; they might
disappear when you are getting on a bit.</span></p>
<h2><span style=”color: #2f2f2f; font-family: Georgia;
font-size: x-large;”><strong>Risks of Brazilian buttock
<li><span style=”color: #2f2f2f; font-family: Georgia;
font-size: small;”>Infection – can be devastating and eat away all
the injected fat.</span></li>
<li><span style=”color: #2f2f2f; font-family: Georgia;
font-size: small;”>Bleeding – very rare.</span></li>
<li><span style=”color: #2f2f2f; font-family: Georgia;
font-size: small;”>Loss of volume – sometimes occurs
<p><span style=”color: #2f2f2f; font-family: Georgia;
font-size: small;”>With more and more cosmetic plastic surgeons
performing surgery to enlarge buttocks, results are becoming better and
more predictable. So, whether you are a man or a woman, a nice round big
bum is hopefully within your reach…</span></p>
<div><a title=”About Dr. Tavallali”
target=”_blank”>Morad Tavallali, M.D., FACS</a></div>
<p><a title=”Cosmetic Plastic Surgery Information”
target=”_blank”>Cosmetic Plastic Surgeon</a></p>
<div><a title=”Washington DC, Northern Virginia, Maryland”
target=”_blank”>Washington DC, Northern Virginia,

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  • betty lucas says:

    After having 2 ultrasounds I have been told my liver is 90% fat. I had liposuction in 1998. I am very afraid and often ill. Any advice?

    • Fat in the liver is usually associated with increased body fat and is not affected by liposuction one way or another as far as I know. Speak to your Dr. about going on a low fat diet to try to reverse the changes. Good luck!

  • marianne knudsen says:

    Dear doctor
    I am very worried, I had laser liposuction under my chin 8 days ago and now I have gotten these hard lumps right under my chin. They are sore and I got this tingling feeling in them.
    Is this normal? And will the lumps dissapear?

    Sincerely Marianne

    • Hello Marianne. First, don’t worry! It is still early in your healing course and things should get better soon. Having said that I am no fan of laser liposuction because of the many problems its causes. many surgeons in the US are moving away from it but non-surgeons wanting to do liposuction find it an easy technique to perform as it requires minimal skill. The techniques melts the fat, but burns the skin! That makes healing much less predictable and longer specially in areas of thin skin like the neck. I would speak to your Plastic surgeon to see if massages may help. Wishing you all the best,
      Dr. Tavallali

  • marianne knudsen says:

    Thank you for answering me. But I have had it done in Lithuania so my doctor is very far away, and also I kind of regret I have had it done now and dont really trust the answers my doctor gives me. Maybe you would be so kind to answer this too.
    The lumps, are they not fat lumps that the laser didnt manage to melt? I am afraid that they wont dissapear, because that is what happened, and I would really hate to have it done again to melt these lumps. Sincerely Marianne

    • Dr.Tavallali says:

      The lumps may be fat that was left over but at this point are probably areas of healing fat. Fat will clump together for up to 6 weeks as it heals before softening and flattening out. Massage the area and be patient and hopefully it will improve. If not…don’t worry it can be fixed!

  • marianne knudsen says:

    Thank you doctor and thank you so much for taking time to answer question. It means a hole lot to me and Im sure to other people too.

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