Your Questions

Q: Dr. Eppley, I am 55 years old and am interested in getting my saddle bags reduced that have bothered me my entire life. I am concerned, however, that I may end up with skin that is saggy afterwards given my age and the little bit of cellulite that already exists there. What do you think about using Liposonix instead?

A: When you use the term Liposonix you are referring to an energy-based form of assisted liposuction just like Smartlipo or Vaserlipo. All use different energies to loosen the fat before it is suctioned out such as ultrasonic or laser energies. These are all forms of liposuction that pose the same risk of skin irregularities that any other traditional form of liposuction does, because the support of the skin is deflated as the fat is removed and the quality of your skin is not improving. Of all these energy-based liposuction methods, Smartlipo may be best because the heat that it generates in the treatment process may have some mild skin tightening benefits.

Dr. Barry Eppley

Indianapolis,Indiana

Q: Dr. Eppley, I am 36 yrs old , weigh 132 lbs and work out three to four times a week. Despite these good numbers, I have big saddlebags that definitely don’t fit the rest of my body. I have had them my entire life ever since I was a teen. They make my bottom half completely mismatched to my small and toned upper half. I have read that after liposuction fat can reappear and in different places. I would not want to ruin my upper half at the expense of improvement in my lower half. Is this something that I should be concerned with?

A: Liposuction of your saddlebags will provide great improvement and patients like yourself are exactly what liposuction was designed for and is best at…spot fat removal. There are many fallacies and inaccuracies about what happens  to fat after liposuction. When it comes to potential future weight gain, the saddlebags unlike the stomach and waistline is not an area that fat will reaccumulate. It is not a metabolic depository site for extra calories. But other body areas are and it is certainly possible that fat can appear in other body areas with weight gain. The concept that you are really referring to is known as ‘fat equilibrium’, the  belief that everyone has a certain amount of fat that they are genetically predisposed to have. And by removing one area of fat, the body in an effort to maintain a fat balance will just have it accumulate elsewhere. This fat concept, while often talked about as if fact, has never been scientifically proven. A recent small study in plastic surgery did show that abdominal and thigh liposuction patients one year after surgery did have some measurable increase in thickness in the arms and upper back. But it was not something that the patients noticed. I would not be concerned that your saddlebag liposuction by Smartlipo will change your upper body shape to any noticeable degree if at all.

Dr. Barry Eppley

Indianapolis, Indiana