Does Fat Removed Via Liposuction Come Back Elsewhere?

There is a fascinating liposuction study recently reported about in the New York Times.  This new study, from the University of Colorado, focused on whether fat removed via liposuction can come back in a different area.  From the NY Times:

In the study, the researchers randomly assigned nonobese women to have liposuction on their protuberant thighs and lower abdomen or to refrain from having the procedure, serving as controls. As compensation, the women who were control subjects were told that when the study was over, after they learned the results, they could get liposuction if they still wanted it. For them, the price would also be reduced from the going rate.

The result, published in the latest issue of Obesity, was that fat came back after it was suctioned out. It took a year, but it all returned. But it did not reappear in the women’s thighs. Instead, Dr. Eckel said, “it was redistributed upstairs,” mostly in the upper abdomen, but also around the shoulders and triceps of the arms.

Is this really possible?  I do a lot of liposuction surgery (probably over 150 a year) and have never had a patient come back and claim that, while their weight remained stable, fat returned to a different body part.  I’ve always believed, as many plastic surgeons, that the fat removed from liposuction is gone forever.  As long as the patient keeps his or her lifestyle the same, the fat should not return.   Dr. Ramona Bates, a board-certified plastic surgeon in Arkansas, and author of the excellent Suture For a Living Blog, explains her theory about this in a recent post, which can be found here.

When I did my fellowship in Beverly Hills, one of our employees underwent liposuction twice.  She would laugh that she could gain weight and every year just have it liposuctioned back out.  Joking, I’d reply that eventually she’d have a tiny little body but chubby fingers and toes.  Maybe there is actually some truth to that!

In Stitches News: I will be doing a book signing and reading at Schuler Books in Okemos, Michigan at 7pm Thursday, May 5th.  Hope you can make it!  For more, click here.  Please be sure to buy a copy of my book, In Stitches, on sale via or today to read all about the shocking, secret life of a plastic surgeon!

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  1. Dr. Youn,
    Dr. Youn,
    I had liposuction of the abdomen and a slight breast reduction (more fat removal) about four years ago. I’ve had weight show up in the non-lipo’ed areas and am especially disturbed by the facial weight gain. (It’s pretty much ruined my looks.) Prior to the procedure, I followed a routine of eating when I was hungry, and with this approach, I was able to maintain a very stable weight. I noticed that my weight trended upward within just a few weeks of having the procedure. I have seen a number of reports on the Internet of patients maintaining that it’s harder to maintain their weight. (When it comes to reporting back to the plastic surgeon, patients are often embarrassed by their weight gain and never report back.)

    I wanted to let you know of the animal studies which show that fat removal results in compensatory weight gain other fat depots. Both the size and number of cells increase in other depots. (It was previously thought that our fat cell number was set, but this is not the case.) According to my research, this weight gain phenomenon is pretty well accepted among the animal research community. Additionally, some animal studies have shown that a metabolic syndrome can results from fat removal. Some researchers have warned against the use of total body liposuction, as there are likely health risks involved. Crazy as it sounds, I’m actually looking into using bone marrow stem cells to replace some of the lost abdominal/breast fat.

    Additionally, the women in this study agreed to not change their lifestyle. I get tired of plastic surgeons advising patients to watch their diet – they’re blaming the patient when the blame needs to be squarely on the procedure (and the surgeons who do it.)

    In my view, the weight redistribution phenomenon should be part of the informed consent. But I doubt this will happen. I don’t even know what group, if any, regulates the content of the informed consents.

    Patients have been reporting weight redistribution for years, I suspect, but unfortunately plastic surgeons are determined not to listen to their patients. I doubt that this study will change things much. It’s sad.

    Comment by Rose on May 10, 2011 at 2:34 am

  2. I have seen this! After an abdominal lip the fat came back as a buffalo hump. On a thin woman!

    Comment by Laurie on May 10, 2011 at 3:28 am

  3. Abdominal lipo. Lipo, not lip. Autocorrect, aaagh!

    Comment by Laurie on May 10, 2011 at 3:29 am

  4. Great article! I am the Marketing Director of I have had several(3) PS myself and I was initially very pleased with my liposuction results. The areas around my legs and thighs showed immediate results after the first week when swelling and bruising went down. Now, just over a year later my upper arms have increased in size! I truly believe that my body compensated for the fat removed and redistributed in my upper arms. This is not a plastic surgery myth. I believe it does happen. So decide…do you want thin legs and big arms or just be happy with a little junk in your trunk!

    Comment by Brandie on May 20, 2011 at 7:42 am

  5. I suppose patients haven’t been complaining because they are more focused on the areas where the fat was lipo’d out, and as long as those areas remain stable they’re not unhappy. The NYT article said that an average of 5.8 pounds of fat was removed from the subjects, it’s not very much, and if redistributed evenly in the upper portions of the body it’s not like it would add multiple inches to any one measurement. And if the women were a size larger on the bottom and then gained some weight above the waist, they were probably happy about it. It is super interesting though, and bad news for anyone whose body is going to replace the fat in a less than even manner. I guess it’s one more thing to add to the disclosures, eh ?

    Comment by tamara on July 8, 2011 at 4:26 am

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