From Our 2012 Archives
Liposuction: Why You Still Have to Work Out After It
Study: Lipo May Not Be a Permanent Solution, but Exercise Helps
By Denise Mann
Reviewed by Laura J. Martin, MD
June 15, 2012 -- Liposuction can help get rid of muffin tops, love handles, and other pockets of fat. But new research shows that removing fat from your abdominal area may cause you to gain dangerous visceral or belly fat.
That's the bad news. The good news is that regular physical activity can help counteract this effect. That news appears in the July issue of the Journal of Clinical Endocrinology and Metabolism.
"If someone chooses to undergo liposuction, it is very important, if not essential, that this person exercises after the surgery," researcher Fabiana Braga Benatti, PhD, of the University of Sao Paulo in Brazil, says in a news release.
The fat -- and fat cells -- are removed permanently during liposuction. This means there are markedly fewer fat cells in the treated area, and fat regrowth will not occur there.
Fat cells in other parts of the body, however, may pick up the slack.
The new study included 36 women in Brazil who underwent small-volume liposuction of the abdomen. Half of these women took part in a four-month exercise regimen starting two months after the surgery. Six months later, women who did not exercise showed a 10% increase in visceral fat, compared with women who exercised three times a week.
The women who exercised three times a week began each session with a five-minute warm-up followed by strength training and up to 40 minutes of treadmill time.
The Skinny on Weight Regain After Liposuction
Plastic surgeon Sherrell J. Aston, MD, reminds all of his patients that liposuction is a cosmetic procedure that does not necessarily lead to permanent weight loss. He is the chairman of the department of plastic surgery at Manhattan Eye, Ear, and Throat Hospital in New York. "We can make you lose weight because we can take off, when indicated, a large volume of fat, but liposuction is a contouring procedure."
Liposuction can trim, tighten, and tone a person's physique. "You have to do all the sensible things to maintain this. Without a healthy diet and a good exercise regimen, you will put weight back on," Aston says.
"The findings highlight the importance of exercise and a healthy diet even after liposuction to prevent a compensatory weight gain and maintain the results of the procedure," agrees Pankaj Tiwari, MD. He is an assistant professor of plastic surgery at the Ohio State University College of Medicine in Columbus.
"If you take fat from one area, your body compensates in other areas," Tiwari says. "We gain weight for metabolic reasons and those hormonal drivers are not changed by liposuction."
Exactly, says Lisa M. Donofrio, MD. She is an associate clinical professor of dermatology at Yale University School of Medicine in New Haven, Conn. Various studies have documented weight regain in various body parts following liposuction. "This is the first one that talks about regain of intra-abdominal fat," she says.
"Nobody really knows why this occurs, but the theory is that the body tries to maintain fat homeostasis," Donofrio says. This refers to the amount of fat needed to provide our bodies with energy.
Both Donofrio and Aston agree that the new study may have been too short to really get a handle on weight regain and distribution after liposuction.
Still, "we don't see many patients coming back with globs of fat in other areas of their body," says American Society for Aesthetic Plastic Surgery President-elect Leo McCafferty, MD. "Most are in good shape and have spot areas that don't respond to diet and exercise."
He recommends that his patients start or restart an exercise regimen about six weeks after liposuction. "This really can enhance the results," he says.
SOURCES: Lisa M Donofrio MD, associate clinical professor, dermatology, Yale University School of Medicine, New Haven, Conn. Benatti, F. Journal of Clinical Endocrinology and Metabolism, July 2012. Pankaj Tiwari, MD, assistant professor, plastic surgery, Ohio State University (OSU) College of Medicine. Sherrell J. Aston MD, chairman, department of plastic surgery, Manhattan Eye, Ear and Throat Hospital, New York. Leo McCafferty, MD, president-elect, American Society for Aesthetic Plastic Surgery; plastic surgeon, Pittsburgh.