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I find inspiration for my blog posts from the questions I hear every day in my Walnut Creek Plastic Surgery office. The question today is about using Liposuction for Weight Loss. The issue is brought up by patients looking to get rid of a stubborn bulge, and doctors looking to help their patients. With the advent of Bariatric Surgery, there finally is a true weight loss surgery. Liposuction is not weight loss surgery, but it can help to remove the fat that causes unsightly bulges. Liposuction can zero in on specific problem areas like nothing else can.

Liposuction Before and After Pictures


The first time I heard the term Liposculpture my first reaction was: good flamboyant marketing term. However, the more I thought about what Liposculpture implies, the more appropriate the term seems. The procedure for removing fat by vacuuming away localized collections is more descriptively termed Liposuction or suction assisted lipectomy.

Direct Lipectomy

Lipectomy is the generic term for the removal of fat (lipo) not the lip. Lipectomy has a long “i” like liposuction. Direct lipectomy is what is done with Tummy Tucks (Abdominoplasty). During a Tummy Tuck excess fat is removed with any loose skin from the lower abdomen by direct excision. Liposuction can be used to decrease fullness in the hips and around back, and this can lead to a shorter scar in cases where the skin tone is good. Liposuction is not recommended on the tummy during a Tummy Tuck, as this can lead to complications. Direct lipectomy, on the other hand, is performed under direct vision and can safely remove the deep fat during a Abdominoplasty.

Suction Assisted Lipectomy (SAL) aka Liposuction

Liposuction also removes fat. A thin cannula, 2 to 4 millimeters in diameter, is used to vacuum away unwanted fat. The advantages of liposuction over direct lipectomy include smaller incisions and the ability to place the incisions away from the areas of disproportionate fat. This allows me to place the incisions in “hidden” areas, while removing the fat from areas that may be exposed.

The term liposuction is descriptive of the method, and it does allow for the permanent removal of the fat cells from selected areas. Unlike weight loss, your metabolism and genetic programming don’t pick the areas where the fat leaves, you do.


Liposculpture is not a method of liposuction. It is another term used to describe the process Liposuction. By exchanging the suction for sculpture, the emphasis is placed more on the artistry than the process. The engineer in me likes Liposuction, because it is a precise description of the mechanism, but Liposculpture appeals to my artistic side and emphasizes the versatility of technique.

According to Wikipedia:

Fat can be added to the softer (“plastic”) materials. In the hands of a Board Certified Plastic Surgeon, fat too can be contoured to more visually pleasing form. Disporportionate bulges can be reduced, and in some cases, indentations filled by Fat Grafting. The ability to reestablish normal proportions to the body is the real power of Liposculpture. Fat is a living medium, so the results are not written in stone, but there is no better way to remove stubborn deposits of fat when the genetic plan won’t cooperate.

Weight Loss

Weight loss and Lipo are complementary processes. While there is overlap, neither can substitute for the other. Weight loss by definition is the reduction of weight. When we burn more energy than we consume, we lose weight. Our bodies are extremely efficient, and this efficiency can cause health problems. Today, the number of calories that would have taken an entire day to hunt or gather can now be obtained in just a few minutes, a few feet away. Whether it’s a short walk to the kitchen or a ride to the drive-through, calories can be found quickly and with a minimum of energy spent.

When we lose weight, it leaves from whatever area is genetically next in line. We cannot diet or exercise a specific body zone away. Sit-ups do not target the fat of the abdomen. Sit-up strengthen abdominal muscles, and burn calories, but those calories come from wherever your genetics say they should come from. You can’t choose.

Liposuction is not the solution to overconsumption, but it can be a great way to get a disproportionate body back into shape. Unlike weight loss, Liposuction does allow you to selectively remove areas of disproportionate fat. Liposuction does not cause you to burn more or consume fewer calories, however. Your weight is set by your metabolism, not by liposuction.

Liposuction – Like a Fad Diet with a Big But…

Removing fat with Liposuction is like removing fat with a crash diet. Unless other changes are made, when the diet is over, the weight returns. However, there is a big difference. Remember the part about getting to choose where the fat is removed? Unlike a fad diet, your genetics don’t choose where the fat leaves. Liposuction allows disproportionate areas of fat to be removed preferentially. This means that weight gain after Liposuction tends to be more proportionate.

Your Weight After Liposuction

The best candidates for Liposuction are near their ideal weight. One reason for this, is that the upper limit of weight removed with liposuction is around ten pounds. If someone is 100 pounds overweight, removing ten pounds is not likely to make a dramatic visual impact.

If you are near your ideal weight, you are likely to stay near your ideal weight. Fewer areas are likely to be disproportionate, and removing five pounds from a localized area can be a big change (4.4 pounds of fat will fill a two liter beverage bottle). If the weight comes back, usually it does not all come back in the same place, so the results will last.

Combining Weight Loss With Liposculpture

The combination of weight loss and Liposculpture is unbeatable. For some, weight loss alone will give a well proportioned body, but most of us have specific areas that collect the fat first. Out of proportion fat is the Achille’s heel of weight loss; however, the removal of disproportionate fat is the forte of Liposculpture. Liposuction can serve as a positive kick start for further weight loss. We naturally want to protect our investment, and once we can see positive results, we are motivated to make them even better.

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