Liposuction rebound. Does the fat come back after liposuction?

One of the most frequent questions we are asked about liposuction is whether or not the fat will come back after, or is the procedure permanent. First, and foremost, we know that liposuction is very poor at controlling weight. After all, we are what we eat. But a recent study cited by U.S. News & World Report raised the question as to “where the fat might go, if it indeed comes back after liposuction”?

The source of the recent web stir came from a study just this July published by researchers at the University of Sao Paulo in the Journal of Clinical Endocrinology and Metabolism. They looked at 36 eager volunteers who were heavy though not obese (BMI less than 30) and performed liposuction of two to three pounds of fat. Here is the twist. The individuals were then divided into two groups, one participated in a program of exercise, and the other maintained a more sedentary life. Remarkably for both, the ‘cosmetics’ were good, though we all know that liposuction does indeed ‘work’, and at four months weight was stable and comparable.

So where is the problem? Think of the fat distribution as the ‘whack-a-mole contest’ of body contouring; reduce the fat bump in one place, up pops the fat in another. We have two fat spaces, the fat under the skin, and visceral fat around internal organs. The visceral fat is linked to poor health and an inactive lifestyle, and as you now might have guessed, the Brazilian study showed that after liposuction the couch potato group had an increase in visceral fat where the active group did not. Could you be less healthy after liposuction? The answer is perhaps. We have known for a very long time that visceral fat is more ‘active’ than fat under the skin, and that exercise works to reduce it. The conclusion we draw from the study is that you could be less healthy after liposuction as the fat goes through its whack-a-mole rebalancing act, but exercise after surgery works! No need to starve the moles out of existence, but regular exercise after liposuction will help you not only look the best, but keep you in the best of health. Didn’t we know that all along?