Northern Virginia Liposuction

What happens if I gain weight after liposuction?

Patients frequently ask me this question during consultation, and my answer usually surprises them. There is a common misconception among patients that they should be as ‘fit as possible’ at the time of surgery to get the best result. This is wrong for a couple reasons.

Before going into detail, you need to understand some ‘rules’ about liposuction. One ‘rule’ is that there are a limited number of fat cells in the human body, and those cells have the ability to get larger or get smaller with weight gain and loss, respectively. Except in very extreme circumstances, you don’t get more fat cells or lose any fat cells. The ones you are born with just grow and shrink.

Another ‘rule’ is that liposuction removes fat cells. If you are born with 100 fat cells, liposuction will remove a percentage of them. For an example, let’s say we remove 10 fat cells during liposuction, so now you are left with 90 fat cells. Those cells have the ability to grow/shrink but you’re not going to get any more new fat cells.

So, knowing these ‘rules,’ if follows that if you gain weight after liposuction, your 90 remaining fat cells will grow. You won’t necessarily get bigger in the areas that underwent liposuction, but in the areas where you still have fat cells, they will be able to grow.  If you typically gain weight in your hips and abdomen, and then we do abdominal liposuction and you gain weight, you can expect your hips to get proportionally larger.

You also need to understand that some places you gain weight, cannot be treated with more liposuction. Sure we can suction the hips, thighs, arms, etc, but some patients gain weight INSIDE the abdomen. There are fat cells around the kidneys and liver and these are not touched during liposuction. So, if you have liposuction of the abdomen, it’s really the superficial fat layers that are between the muscle and skin that are removed. The fat cells below the muscle and around the organs can still grow, and if those fat cells grow after liposuction, the abdominal circumference can grow and more liposuction can’t improve the result. Only weight loss will shrink those cells.

Which is why it is a fallacy to think you should be as ‘fit as possible’ before surgery. You should be at a happy and MAINTAINABLE weight after surgery. If you are working out how you want to work out and eating how you want to eat, you will be able to maintain your result after surgery. We use the scale to measure this.

Preoperatively, you will be weighed. Then, in surgery we weigh all the fat that is removed. Once all the swelling has resolved after liposuction (3-4 months), you should weight your pre-op weight minus the amount removed to have the best result possible.

If you are considering liposuction, just know the best candidates for liposuction are at a STABLE AND MAINTAINABLE  weight, and if that’s you, then you are getting set up for a great postop result.

Christopher D. Knotts, MD
Board-Certified Plastic Surgeon

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