Liposuction—Permanent fat removal?

Dear Alice,

My husband and I are having a debate over the value of liposuction as a means to permanent fat removal. He has read that we are born with specific number of fat cells and therefore believes liposuction has the ability to reduce the number, resulting in permanent fat loss in the areas that are surgically treated. I differ in the belief that fat loss and its permanency depends on maintaining and correcting diet that is related to metabolism. I also maintain that there is no such thing as permanent fat loss from liposuction. Have you an answer to our debate?

Dear Reader, 

You and your husband are probably not the only ones having this debate. Various health professionals have conflicting notions regarding the long-term outcomes of liposuction. Although some research has been conducted on the effects of liposuction, more research with larger sample sizes studying the long-term effects of this procedure is needed. A challenge is that much of the evidence about the long-term outcomes of liposuction is based on self-reports. That being said, the evidence suggests that while some people maintain fat loss, others re-gain fat, and some people even gain more weight than where they were pre-liposuction. Multiple factors, including gender, age, lifestyle, and genetic factors, all impact weight. Therefore, liposuction alone may not be enough to keep the weight from coming back. Instead, after receiving liposuction, it’s recommended that people accompany the procedure with dietary changes and physical activity. 

Liposuction procedures tend to target the abdominal area and sometimes the back of the upper arms and legs, but fat can be deposited in muscle, on organs, and in several other places throughout the body. Because these areas can’t be reached by liposuction, their reduction in size is often dependent on the person losing weight through changes in eating habits and exercise. Even in those individuals who are considered obese, typically no more than 20 pounds of fat is removed in one surgical procedure. In the absence of lifestyle changes to accompany the surgical procedure, the individual can regain the excess fatty tissue that is removed. 

On the point about being born with all your fat cells, research indicates that while the number of fat cells continues to increase as you grow, it’s not until adolescence that your fat cells begin to level off. In adulthood, the number of fat cells remain constant unless a person gains a significant amount of weight. While liposuction does remove entire fat cells, if the individual eats more calories than the body can store within its current supply of fat cells, the body will create more storage space (i.e., fat cells) to accommodate the excess fat. 

Liposuction is conducted for a variety of reasons from cosmetic to medical necessity. However, research suggests that long-term, sustainable weight loss should be carried out by reducing calorie intake and increasing energy expended through exercise. 

Hope this clears up the debate! 

Last updated May 19, 2023
Originally published Apr 11, 1997