Can Fat Return After Liposuction?

Liposuction remains the most rapid way to lose unwanted fat albeit a surgical one. While it is ideally for those people who have made every effort to lose fat areas on their own through diet and exercise, not every fat area responds the same. Some fat areas are more difficult to lose than others and certain fat areas can not be reduced at all except in the face of extreme weight loss. It is these non-metabolically responsive fat areas that justify liposuction intervention.

One of the very good questions any prospective patient should ask about liposuction is will my fat return? Will I keep this fat off years from now or is this just a short-term fix? Economically does this procedure have a good ROI? (return on investment) There are many urban myths about whether fat can or can not return after liposuction. Where some of these purported claims come from I do not know, but science and a lot of patient experience provides the following insights.

Fat will not return after liposuction. This is patently false and perhaps was started and propogated by what one would hope will happen. The reality is fat can return. The results from liposuction are closely aligned with your weight. If your weight stays the same years from now then so should the result. Fat after liposuction can return just as easily as after weight loss…and then weight gain. Some body areas are more resistant to fat return than others (knees or arms vs stomach and waistline), but no body area or fat cell is completely immune to the allure of extra calories.

If fat comes back after liposuction it will go to other body areas. This is sort of true but not to the extent of what was originally removed. A recent published study showed that fat suctioned from the stomach and thighs from women had some slight increase in measurements in the arms and upper back a year after surgery. But not to the extent that the women noticed or was bothered by it…or that they regretted having the procedure. If fat returns it must go somewhere and it is logical that it may have more trouble going back to a treated area that is now embedded with scar tissue.

Fat cells are permanently destroyed by liposuction. This is not true. Those fat cells that have been suctioned out are permanently removed. But there are always lots of fat cells left behind as you can not or would you want to remove them all. (otherwise your skin would be stuck down to your muscles and wouldn’t move) While the fat cells that are left behind may be damaged, they have a great ability to heal and regrow. Since it has been discovered that fat sites have the highest amounts of stem cells in the body, and stem cells can be easily stimulated to grow and transform into fat cells, liposuctioned fat sites are not immune to  recur. This may be different with the current use of Smartlipo (laser liposuction) where the heat from the laser energy can cause more fat and stem cell damage.

Despite the effectiveness of liposuction to reduce unwanted fat, the long-term success of the procedure is highly dependent on the lifestyle habits on whom it is performed.

Dr. Barry Eppley

Indianapolis, Indiana