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Liposuction for Weight Reduction

I am a plastic surgeon. A lot of people who are overweight approach me everyday for getting a good body shape by liposuction. Those who are within 10 percent of their ideal body weight( for example if ideal weight for someone is 60 kilos and he weighs 66 kilos or less) are ideal candidates. Thats because their fat is usually localized in one or two body parts, like belly, thighs hips or arms. By removing a limited quantity of fat – say 5 to 6 kilos from those specific parts I can give them nearly perfect figure,without compromising their safety. But quite often patients are really obese and want to reduce 10 to 20 or even 30 kilos by liposuction. This is a different scenario altogether.
Lets first briefly consider few facts about liposuction. Liposuction is a plastic surgery procedure wherein fat from any body part can be extracted in liquid form through multiple tiny (4 mm) cuts. Since procedure takes 1 to 4 hours to perform depending on the amount of fat and number of body parts treated – it is performed under some kind of anesthesia inside a fully equipped operation theatre. There are no stitches but in every other way it is a major surgery with risks of surgery and anesthesia. There is a healing time and period of rest involved.
People often ask if liposuction is safe? My answer is- yes it is , if done within safe limits. Liposuction involves removal of fat but invariably some amount of blood is mixed in the fat. By using tumescent technique blood loss can be minimized but can not be completely eliminated. Just like in case of blood donation where 300 ml blood can be safely donated by a healthy person, liposuction if done under strict quality conditions fat equivalent to 5-7 percent of person’s body weight( 7 kilos for person weighing 100 kg) can be removed safely in one sitting.
People who are fat all over and 30-40 kgs overweight sometimes ask for liposuction, to reduce weight primarily. There are several problems in this scenario.First of all reducing a lot of fat like 10 kgs or more is risky, involves blood transfusions, long operating time and more dose of anesthesia drugs. This risk though small is not justified just for losing weight which can be done in healthier and safer weighs. Results of liposuction are also inferior in large volume liposuctions due to surgeon working hastily and getting tired instead of doing a fine sculpting job. Irregularities and asymmetries are common after large volume liposuctions.
Then there is the question of long term maintenance of results. If patient says he is obese because he can not diet and has no time for exercise, I ask him how he is going to maintain the results? Fat gain is related to more calorie consumption relative to calorie burning. Weight can be regained if same lifestyle is faulty.

In a moderately overweight person removal of fat from one or 2 areas of body 5 to 7 kilos in a sitting can result in a great figure with safety. One can opt for another sitting after 2 to 3 months gap if more fat from another are needs to be removed. Very obese people( BMI 35 and above ),for example a person of height 5’3″ weighing 100 kilos do not get appreciable improvement in one sitting unless they accept higher risk of high volume liposuction.

For such people I first of all want to know if their weight has been stable in last 6 months. There is no point wasting efforts on person who is still gaining weight because liposuction is not going to stop further weight gain. For obese people who have started healthy diet and moderate regular exercise and who have stopped gaining weight- liposuction can sometimes serve as a kickstart for weight loss. After removal of 5-7 kilos of fat from tummy or thighs often person feels more comfortable exercising and feels motivated to lose weight by further efforts of his/her own.The psychological barrier is broken. After some weight loss on his own person can then reward himself with another sitting of liposuction if needed. This approach takes care of weight loss safely with higher chances of long term maintenance, that the shortcut, quick fix method of large volume liposuctions.

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