By Dr. David Kirn


“Will fat taken out with liposuction just go somewhere else?”

Or stated another way, does fat redistribute after liposuction? We hear these questions and similar concerns all the time during preoperative consultations. An understanding of our body’s fat metabolism provides the answer.

Have you ever heard someone say “I always gain weight in my hips?” This is because of the greater number of fat cells in that person’s hips. These areas of high fat cell concentration are prime targets for liposuction.

The human body does not necessarily contain an even distribution of fat cells. Some areas have a greater number of fat cells and are out of proportion. These areas enlarge the quickest with weight gain and shrink down last with weight loss. They tend to be resistant to change with diet and exercise. Have you ever heard someone say “I always gain weight in my hips?” This is because of the greater number of fat cells in that person’s hips. The same can be true for any other body area – thighs, abdomen, flanks, etc. These areas of high fat cell concentration are prime targets for liposuction.

A prevailing theory is that our bodies have a set number of fat cells which, for the most part, persist throughout life. When excess calories are available, the fat cells store the extra energy by enlarging, not by increasing in number. Hence, the area with the greatest number of fat cells will enlarge the most and the quickest.

When liposuction is performed, the number of fat cells in the treated area is decreased. Those left behind will still behave normally. The goal of liposuction is to decrease the quantity of fat cells to a normal level in the treatment area thereby establishing balance with the rest of the body. If body weight does not change after liposuction, the remaining fat cells in the treated area and the other fat cells in the body will remain unchanged. The result is a lasting decrease of fullness in the liposuctioned area which remains in proportion. If the patient loses weight after liposuction, as occurs commonly, then all the fat cells in the body will decrease in size including those in the treated zone, again remaining proportionate.  If the patient gains weight after liposuction, all of the fat cells in the body enlarge including those remaining in treated zone. But again, the treated zone should remain in proportion. With the treated zone now in balance, the next greatest area of fat cell concentration may outpace the other body areas with significant weight gain and therefore become out of proportion. Likely, this occurrence is the basis of the myth about fat redistribution.

This topic was addressed scientifically in a study published in 2012 in the Plastic and Reconstructive Surgery journal. It looked at 301 cases of liposuction and tummy tuck. Using measurements and standardized photographs the author evaluated patients before, and one year later. The study patients lost an average of 2.2 pounds. The treated areas maintained a significant reduction. Untreated areas including the up-per body, arms, and face did not show an increase. In fact, those areas tended to show a slight decrease as well. Some patients did gain weight after surgery, yet they maintained reduced measurements in the treated areas. In summary, the study showed persistence of con-tour improvement in the treated areas without evidence of fat redistribution. The study supports the concepts dis-cussed above. My professional experience performing liposuction is the same.  

Over the last few years, we have been using an advanced liposuction technique known as “SAFE Lipo.”  SAFE is an acronym where S stands for fat Separation, A stands for Aspiration (the part where the fat cells are removed), and FE stands for Fat Equalization. Utilizing a power-assisted liposuction instrument, the SAFE Lipo technique further enhances fat removal and the ability of the surgeon to create a smooth contour. As with most Plastic Surgery Procedures, obtaining top results is all about attention to detail and meticulous technique. Liposuction is no exception. If you are thinking about permanently removing some fat, be sure to consult with an American Board of Plastic Surgery certified surgeon. And, don’t worry about it “redistributing” somewhere else.

Dr. David Kirn is a Board Certified Plastic Surgeon who is devoted to advanced techniques in Cosmetic Surgery of the Face, Breast, and Body. In private practice since 1998, he is located in a state of the art facility which includes a full service skin care center. The practice is focused on personalized patient care and attention to detail. Where possible, Dr. Kirn utilizes minimally invasive procedures. The goal is to deliver quality clinical results while minimizing patient recovery time. Examples of this include a no-drain tummy tuck, armpit incision breast augmentation with gel or saline implants, fat grafting, and a short scar facelift. In addition, Dr. Kirn and nurse-injectors Carey Sanders, RN and Shirley Ramsey DNP, APRN, offer a full spectrum of non-surgical treatments such as Botox®, Dysport®, Dermal Fillers, Kybella®, & Laser.