Discover the Shocking Long-Term Effects of Liposuction on Weight Loss and Metabolic Health!

Liposuction is a popular cosmetic procedure designed to remove excess fat from specific areas of the body, such as the abdomen, hips, thighs, buttocks, arms, or neck, and to shape these areas. While liposuction can effectively remove fat cells from a specific area, it is not a weight loss method but rather a way to contour and shape the body by targeting stubborn fat deposits that are resistant to diet and exercise.

Abdominal obesity is associated with metabolic risk factors for coronary heart disease (CHD), including insulin resistance, impaired oral glucose tolerance, dyslipidemia, and increased blood pressure. Diet-induced fat loss is recommended for obese patients who have these cardiometabolic risk factors, because even moderate (e.g., 10%) weight loss improves all risk factors simultaneously.

Liposuction: Types and Procedures

There are different types of liposuction procedures available to meet different goals of your treatment. Different types of liposuction include:

Tumescent liposuction: Tumescent liposuction is the most common liposuction procedure. Your surgeon injects a saline (salt water) solution into your fatty areas. The mixture contains medicines such as epinephrine, which shrinks your blood vessels. This solution helps your surgeon remove fat easily and reduces blood loss. Other medications are sometimes included to provide pain relief.
Ultrasound-assisted liposuction (UAL): Your surgeon uses ultrasonic energy via a metal rod placed underneath your skin to liquefy your fat before removing it from your body.
Vibration Amplification of Sound Energy at Resonance (VASER): VASER liposuction uses a stainless steel tool (cannula) with grooves and ultrasound waves to easily break up and remove fat cells and fat from your body. This is a type of UAL.
Suction-assisted liposuction: Suction-assisted liposuction is a traditional form of liposuction that uses a vacuum to remove fat from your body.
Power-assisted liposuction (PAL): Power-assisted liposuction uses a small, stainless steel tool (cannula) that moves back and forth over your fat to break it up.
Laser-assisted liposuction: Laser-assisted liposuction only needs a small incision in your skin to perform the procedure.

A plastic surgeon performs liposuction.

The Study

A study published in Obesity (Silver Spring) in 2008, evaluated the long-term effects of liposuction on body composition and metabolic risk factors for CHD. The purpose of the study was to evaluate the hypothesis that large-volume liposuction has long-term beneficial effects on CHD risk that were missed at a 10-12 week postprocedure evaluation. The study followed seven obese women (39 ± 2 kg/m2) before and at 10, 27, and 84-208 weeks after large-volume liposuction. All subjects in the original study had abdominal obesity and a waist circumference > 100 cm and completed a comprehensive medical evaluation, which included a history and physical examination and standard blood and urine tests.

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Liposuction surgery removed 9.4 ± 1.8 kg of body fat (16 ± 2% of total fat mass; 6.1 ± 1.4 kg decrease in body weight), primarily from abdominal subcutaneous adipose tissue (SAT); body composition and weight remained the same from 10 through 84-208 weeks. Metabolic endpoints (oral glucose tolerance, homeostasis model assessment of insulin resistance, blood pressure and plasma triglyceride (TG), high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol concentrations) obtained at 10 through 208 weeks were not different from baseline and did not change over time.

After all baseline evaluations were obtained, each subject underwent large-volume tumescent liposuction. Superficial and deep subcutaneous abdominal fat was primarily removed, but smaller amounts of fat were removed from the arms, flanks, hips, and thighs, to achieve additional cosmetic benefits. Subjects were instructed to resume their normal lifestyle after the initial recovery period and to weigh themselves weekly at home. Each subject was contacted via phone by one of the investigators, at least once every week until week 27 after liposuction, to reinforce the maintenance of their usual food intake and physical activity and to maintain a stable body weight.

Key Findings

The study revealed several key findings:

Significant Fat Reduction: Liposuction led to a substantial decrease in body fat, with an average reduction of 9.4 ± 1.8 kg, representing 16 ± 2% of total fat mass. This resulted in a corresponding decrease in body weight.
No Improvement in Metabolic Risk Factors: Despite the significant fat reduction, there were no improvements in metabolic risk factors for CHD. Oral glucose tolerance, insulin resistance, blood pressure, and plasma lipid profiles remained unchanged throughout the study period.
Maintenance of Weight Loss: The subjects maintained their body weight and body composition for years after liposuction-induced fat and weight loss. This is in contrast to diet-induced weight loss, where weight regain is common.

Body composition analyses at 10 weeks after the liposuction procedure demonstrated that liposuction caused a 9.4 ± 1.8 kg decrease in body fat (16 ± 2% of total fat mass), which resulted in decreases in body weight and BMI, without a significant change in fat-free mass. In addition, abdominal SAT volume decreased by 23 ± 7% 10 weeks after liposuction, whereas visceral adipose tissue and thigh SAT volumes did not change. At baseline, four subjects had normal oral glucose tolerance and three had type 2 diabetes that was being treated with oral hypoglycemic agents only. Liposuction did not alter blood pressure, or plasma LDL-cholesterol, TG, HDL-cholesterol, and fasting glucose concentrations throughout the duration of the study.

During the period between week 84 and week 208 of this study, treatment with medications that affect plasma glucose or lipoproteins was changed in some subjects as directed by their primary physician. Three subjects who had diabetes experienced changes in medications: One began treatment with glimepiride and glargine insulin; one began treatment with glargine insulin and concomitantly decreased pioglitazone from 45 to 30 mg/day; and one decreased glucovance treatment from t.i.d. to b.i.d. Two subjects started statin therapy (pravastatin and rosuvastatin), and one required an increased dose of pravastatin (40-80 mg).

Comparison with Diet-Induced Weight Loss

The absence of metabolic benefits following liposuction-induced fat loss is strikingly different from the outcomes typically observed with diet-induced weight loss. Small long-term reductions in body weight (fat) improve glucose tolerance and the other metabolic CHD risk factors evaluated in the present study.

Possible Explanations for Maintained Weight Loss

Several factors could have contributed to the maintenance of weight loss in the study subjects:

Selective Fat Removal: Liposuction selectively removes fat, without the decrease in body mass of multiple tissues and an obligate decrease in energy expenditure that occurs with dieting. This may make it easier to maintain weight loss.
Improved Physical Activity: Removal of the large panniculus of subcutaneous abdominal fat may have improved the subjects' ability to ambulate and be more physically active.
Cosmetic Benefits: The cosmetic benefits of liposuction may have improved self-esteem and reinforced the desire to maintain weight loss.

Potential Adverse Effects of Weight Gain After Liposuction

Liposuction surgery removes billions of adipocytes from selected adipose tissue depots and disrupts the connective tissue framework that supports adipocytes and other adipose tissue cells. Therefore, it is possible that weight (fat) gain after liposuction could have adverse cosmetic and metabolic effects if newly formed TGs are unable to accumulate in the aspirated areas and are redirected to other sites. Data from studies conducted in lipectomized animal models demonstrate that regeneration of the removed fat pad is rare, but compensatory fat accumulation at other sites commonly occurs. Information obtained from case reports in patients is consistent with the findings in animals, and suggest that weight gain after liposuction results in an increase in subcutaneous fat in areas that were not aspirated, such the back and breasts. In addition, it is possible that the removal of subcutaneous fat by liposuction will enhance ectopic fat deposition in other organs, such as the liver and skeletal muscle, which is associated with insulin resistance and inflammation.

Maintaining Results After Liposuction

To maintain your results, cosmetic surgery team has outlined tips to stay slim, firm, and maintain results after liposuction:

Drink Water: Increasing the amount of water you drink can help you keep your weight stable - or even lose weight. For the best outcome, it is recommended to drink up to 64 ounces of water per day to lose weight and to maintain weight loss.
Follow a Regular Exercise Regimen: It only takes about one to two weeks after surgery to fully exercise again. The sooner you establish a regular exercise routine, the easier it will be to ensure the best liposuction results. Just be sure to follow your cosmetic surgeon’s advice on what exercise is permissible at what time.
Avoid a Sedentary Lifestyle: In addition to aerobic and spot exercises, you should increase your general level of activity to keep yourself active and in good overall physical condition.
Make Healthy Diet Choices: One way to keep extra fat off is to eat a healthy diet that is low in fat, sugar, and processed food.
Reduce Stress: Stress remains one of the main causes of weight gain. This means that to avoid weight gain, you’ll need to learn to relax.

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