Often my patients ask me if they should try to lose weight or invest in smart liposuction. I think this is a very important question and deserves a single discussion dedicated to the explanation of weight loss versus smart lipo, to help people understand the fat physiology of their bodies.
My unequivocal answer to the question of trying to lose weight is absolute. Weight-loss attempts should both precede liposuction, and in patients that decide to do both, continue after laser liposuction is performed. In a nutshell, smart lipo is a shape contouring procedure, not a weight loss procedure, even though fat is being removed.
Weight loss, when successful, is superior to laser liposuction for several reasons
- Weight loss has health benefits and contributes to your body's overall well being. As we all know, weight loss helps your body function better and decreases the risks of many ailments (liposuction has no health benefits, just cosmetic benefits).
- Weight control is important even if you decide to do liposuction. Liposuction can help contour a specific area of your body, but does not help you control or maintain your long term weight (more on that in the “does the fat come back” section below). The successful long term weight control can result in more fat and more proportional shrinkage than liposuction alone.
That said, despite my strong belief that weight loss is extremely important and superior to the procedure I specialize in, liposuction can still play a significant role in body reshaping. When you lose weight, you cannot tell your body where you want the first five pounds to come off, and second five pounds to come off. Your body likes to store and release fat in a manner determined more by genetics rather than anything else.
For instance, a person may find they don’t like their outer thighs, and even after getting down to a very reasonable weight, that area may still be prominent. This is where liposuction can be of assistance. The second area where laser liposuction can be of assistance is in “kick-starting” a body reshaping regimen that will consist of laser lipo and a change in lifestyle. I find that the psychological boost obtained from reshaping the troublesome area can be translated into motivation to keep up the results with a lifestyle change.
Now, back to the important question of “does the fat come back? If I had the procedure and gained a few pounds, where does that new fat go?”
We are all born with a fixed number of fat cells, distributed all over the body in a distribution determined by gender and genetics. Each individual fat cell, or adipocyte, can and does get larger or smaller with weight gain and loss. Laser liposuction will decrease the number of fat cells present in the targeted area. It will not eliminate the ability to gain or lose weight overall and therefore should never be used as a substitute for diet and exercise.
What typically happens is that since the number of fat cells is now much less in the area of concern, the weight that the patient gains with normal fluctuation will go preferentially to other untreated areas with a greater number of fat cells (although some can come back to the treated areas since the fat cells are decreased but not completely eliminated from one area). Therefore, liposuction works well for removing and reshaping stubborn areas of the body, but not as a substitute for proper diet, exercise, and weight maintenance regimen.