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Does Fat Come Back After Liposuction?

Woman with fat abdomen


When it comes to body contouring procedures, like liposuction, breast reduction, and tummy tuck (or abdominoplasty), the question about when to have the procedure based on weight loss goals is very common. Does one achieve their weight loss goals before the procedure, or is having the procedure part of the weight loss journey itself? Many patients are concerned that their outcome will not be long-lasting unless they are as slim as they will ever be at the time of surgery. While others are hoping to have their procedure so that they can overcome back pain, poor-fitting clothing, or excessively mobile tissue that prevents activities like running to lose weight. So what is the right answer? Well, there is a short answer and a longer one. The short answer is that, for some procedures, there are safe maximums to body weight indicators, such as Body Mass Index (BMI). If you are within those limits, then proceeding with a given procedure is a fine option. The longer answer is that there are optimal conditions in which to have a procedure and recovery from it safely, and your optimal outcome is not achieved in body contouring without diet and exercise follow-through often for months after surgery anyway. So you really cannot separate the two.

What is Ideal Body Weight?

An ideal body weight was actually computed based on extensive research into the weight for a given height that is at the lowest risk of mortality. Put more simply, the intention of ideal body weight is to express the healthiest weight at which a person can live. There are formulas that can compute an ideal body weight. You may consider a certain weight to be your “ideal,” or when you look and/or feel your best. When it comes to targeting a certain weight before a body contouring procedure, you simply need to be within a safe BMI range with your medical conditions under control and living a lifestyle of healthy diet and nutrition.

What is Body Mass Index (or BMI)?

Body mass index, or BMI, refers to a ratio between the height and weight of a person. The formula for BMI is actually your weight in kilograms divided by the squre of your height in meters. Because we know that bone, fat, and muscle weigh different amounts, the BMI of a person implies the composition of their body. Lower BMI levels usually mean a more healthy body composition (to a point). While higher BMI levels can mean someone is overweight (<25), obese (>30), severely obese (>35), morbidly obese (>40), or superobese (>50). There is a spectrum of opinions and practices, and it somewhat depends on the procedure you are having, but a good rule of thumb is that complication rates increase for plastic surgery procedures performed on patients above a BMI of 35 and it is ideal to be less than a BMI of 30 to have plastic surgery.  

Is It Okay to Lose Weight Before Surgery?

Yes and no. It is, of course, preferable to lose weight to attain a healthy weight before undergoing any surgical procedure. However, the immediate preoperative period is not the time for a lot of weight loss. Weight loss occurs when there is a deficit of calories taken in compared to calories used. If your body is nutritionally deficient – such as could occur during aggressive dieting – then you could be breaking down components of your tissues to support your bodies metabolism, a so-called catabolic state. This could have serious detrimental effects on healing after plastic surgery. Your body needs nutrients to serve as building blocks for healing after surgery, especially healthy protein. Otherwise, complications like wound formation could occur. So it is great to lose weight to attain a healthy weight well in advance of surgery, but you do not want to start weight loss right before of right after undergoing surgery, or this could compromise your surgical outcome.

What if I Am a Bariatric Surgery Patient Who Has Experienced Massive Weight Loss?

There are different definitions for “massive weight loss” or large amounts of weight loss, for example, after bariatric surgery. Procedures such as Roux-en-Y gastric bypass, sleeve gastrectomy, gastric banding, and other weight loss surgeries can result in the loss of hundreds of pounds. Massive weight loss typically refers to greater than 50% loss of excess body weight, or weight above an ideal body weight (above). Because of the importance of healthy, stable nutrition at the time of receiving plastic surgery (also above), it is important to reach a steady weight after massive weight loss, especially following a bariatric procedure. The guidelines for what a steady weight means are at least six months at a stable weight and at least one year after bariatric surgery. Often, it takes about 18-24 months following bariatric surgery to achieve stable weight for greater than six months. So this is a good time to seek body contouring surgery after bariatric surgery or other massive weight loss.

Is It Okay to Lose Weight After Surgery?

Yes, if it is in a healthy manner and after the initial healing period. A good rule of thumb is that if healing after plastic surgery is going well at six weeks, then you can likely resume dieting and more rigorous exercise. These efforts can then optimize your results.

Is Liposuction Performed for Weight Loss, and How Much Weight Can it Take Off?

This is a very common question, but it is perhaps not the right one to ask. Liposuction is not a weight loss procedure. The best avenues to healthy weight loss are through diet, exercise, or – in cases of more severe obesity – a medical or surgical weight loss consultation. While it is true that liposuction will result in the permanent removal of fat cells from the area that is treated, the purpose of liposuction is not to produce weight loss but rather contouring of the body.

What is the Best Weight to Have at the Time of Surgery?

The “best” weight is whatever weight you are at your best and within certain guidelines, such as BMI<35 mentioned above. It is also important to be at your most reasonably healthy weight with good nutrition and hydration going into a surgical procedure. But you do not have to necessarily lose that last 10 pounds to have surgery and a good outcome, which is a common question we receive. Simply maintain steady healthy diet and exercise habits and pursue your procedure when you are ready.

If you want to learn more about what will help you achieve the best body form and function through body contouring plastic surgery, reach out to us at Info@PacificSoundPlasticSurgery.com or by calling 425-818-8991. Dr. Kristopher M. Day, MD, FACS is a board-certified plastic surgeon with extensive experience treating all types of patients after weight loss, bariatric surgery, diet and exercise efforts, or who simply want to achieve better contouring of a specific part of their body. He looks forward to helping you achieve your unique goals in a long-lasting and natural way!

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