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Study: Fat May Return After Liposuction

Liposuction, the popular fat-sucking procedure, can trim problem areas of the body. However, the fat removed returns in a relatively short time, according to a new study.

May 3, 2011 -- Liposuction, the popular fat-sucking procedure, can trim problem areas of the body. However, the fat removed returns in a relatively short time, according to a new study.

''All the fat is back by one year," says researcher Robert H. Eckel, MD, professor of medicine, physiology and biophysics at the University of Colorado Anschutz Medical Campus. However, it does not return to the spot that has been operated on. "The fat comes back in different places," Eckel tells WebMD. In his study, the women had liposuction of the lower abdomen, hips, or thighs and were followed for a year. "The reaccumulation of fat was in the upper abdomen and triceps."

The areas that had liposuction did not regain fat, he says. He speculates that the probing of those areas that occurs during liposuction somehow prevents fat from returning there.

The new study is published in the journal Obesity.

More than 203,000 liposuction procedures were done in 2010, up 2% from the year before, says LaSandra Cooper, a spokeswoman for the American Society of Plastic Surgeons. In the procedure, a thin, hollow tube is inserted through incisions to loosen the fat. Next, the dislodged fat is suctioned out.

Two plastic surgeons who reviewed the findings for WebMD say they have not noticed the fat returning in their liposuction patients.

Tracking the Return of Fat in Liposuction Patients

For the study, Eckel and his colleagues evaluated 32 women. The average body mass index (BMI) was below 25 and considered a healthy weight. The range was 22 to 27.

The women had been at a healthy weight for at least three to six months. None had a history of weight loss of more than 10% of their maximum body weight. They had not had liposuction before.

Their average age was 40. The age range was 18 to 50. None had yet gone through menopause.

Of the 32, 14 were assigned to get liposuction. The other 18 served as the comparison group,

The women agreed not to change their lifestyle habits such as exercise and eating habits.

In the liposuction group, doctors removed up to 5 liters of fat from up to three regions: hips, thighs, and lower abdomen.

At six weeks, the percent body fat in the liposuction group declined by 2.1% and by 0.28% in the comparison group.

At six months, the difference between groups declined. By one year, there was no significant difference in body fat between the two groups.

The fat that came back in different areas was not just the fat that lies directly under the skin, known as subcutaneous, but also the deeper visceral fat, linked with heart disease risk.

However, he says, "We did not see an adverse metabolic effect."

Even though the fat reappeared at different sites, he says, most of the women said they were still satisfied with the results of the procedure.

The study was funded partially by a National Institutes of Health grant.

Eckel's advice to those about to undergo liposuction? "Be prepared. Your fat will come back and it may be distributed in your waist or above [if the areas liposuctioned are below that.]"

Eckel cannot explain for sure why the fat returns in different places. However, he speculates, "the brain senses a loss of fat and restores it."

Liposuction Not for Weight Loss

Phil Haeck, MD, is president of the American Society of Plastic Surgeons and a Seattle plastic surgeon. He reviewed the new research for WebMD and calls it a ''landmark'' study.

"I hope we have more of these," he says.

However, he notes some limitations, such as the small number of women studied.

He would have liked to see before-and-after photos, to gauge how noticeable the fat return was.

Of the fat return, he says, "I haven't seen it in my patients."

Neither has Marcel Daniels, MD, a plastic surgeon in Long Beach, Calif., who also reviewed the study findings for WebMD.

He has performed liposuction for 20 years.

''With that small study, it's preliminary," he says of the findings. "You can't draw a conclusion from that."

He wonders if some of the changes in fat tracked over the year could be age-related, as the women's average age was 40.

Anyone thinking of having liposuction, say Haeck and Daniels, should know that it is no substitute for a healthy lifestyle. Nor is it a weight loss procedure.

When done correctly by a qualified doctor, Haeck says, liposuction "can be a very gratifying operation but it's not a substitute for diet and exercise."

''Liposuction should serve as a springboard to a healthier lifestyle," says Daniels, who is also associate professor of plastic surgery at the University of California Irvine.

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