Large-Volume Liposuction for Weight Loss

By Laura Segnit

Published on August 07, 2007

Weighing in on a Growing Trend

In the ongoing fight against flab, many Americans are turning to liposuction as a means of combating love handles, retaliating against sagging upper arms, and battling bulky thighs. According to the American Society of Plastic Surgeons (ASPS), liposuction ranked behind only breast augmentation and nose reshaping as the third most commonly performed type of cosmetic surgery in the United States last year, with more than 300,000 procedures performed. Though liposuction has traditionally been used to treat selected problem areas in patients of normal weight, there are some surgeons who offer the procedure to heavier patients seeking moderate weight loss.

Liposuction Overview

Liposuction is typically performed to eliminate pockets of fat that are resistant to conventional methods of weight loss, such as diet and exercise. It can be used to sculpt various areas of the body including the abdominal region, hips, backside, thighs, knees, upper arms, cheeks, chin, and neck.

Most current liposuction techniques involve the injection of a medicated fluid into the area from which fat is being removed. This fluid is a combination of lidocaine (a local anesthetic), epinephrine (a drug to limit blood loss), and a salt solution. In the tumescent technique of liposuction, large volumes of this fluid (up to three times the amount of fat to be removed) are injected into the fatty tissues. The “super-wet” technique is similar to the tumescent technique, except that less fluid is used.

Most cosmetic surgeons stress to patients that liposuction is intended only for body sculpting and should not be considered a method of weight loss. The ASPS website supports this view of the procedure, stating the best candidates for liposuction are normal-weight patients who are in good health and have firm, elastic skin.
Liposuction as an Approach to Weight Loss

Currently, however, some surgeons are challenging the widely accepted belief that liposuction should never be offered as a weight-loss option. Large-volume liposuction involving the removal of more than 5 liters of fat from areas all over the body allows some patients drop pounds while gaining an improved body contour.

Being overweight or obese can be dangerous to a person’s health, increasing the risk of serious problems such as high blood pressure, Type 2 diabetes, heart disease, and stroke. To decrease these risks, overweight and obese people are generally advised to lose weight through diet and exercise. When these traditional methods fail, patients sometimes seek a more drastic approach to weight loss.

Common surgical weight-loss methods include altering the size of the stomach through gastric bypass surgery and slowing the passage of food through the stomach through gastric banding (commonly known as LAP-BAND® Surgery). Although large-volume liposuction typically produces less dramatic results than these methods, it may prove a good option for patients who need to lose only moderate amounts of weight.

Past studies described in the Journal of the American Society of Plastic Surgeons suggest that large-volume liposuction may qualify not only as an effective method of weight loss, but also as a means of improving overall health. A 1999 article published in the journal details a study in which over 150 patients received large-volume liposuction. Based on the weight loss observed after the procedure, the researchers concluded that large-volume circumferential liposuction (performed with the tumescent technique) is a successful alternative weight-loss method.

A 2001 article in the same journal discusses the effect of large-volume liposuction on fourteen women with high body mass indexes. Researchers found that patients’ weight, body fat mass, blood pressure, and fasting insulin levels had decreased four months after the procedure, with no apparent negative consequences. The study concluded that if these improvements in health could be maintained over time, liposuction could prove to be an effective means of reducing the health problems linked to obesity.

Considerations for Patients Seeking Large-Volume Liposuction

Whether performed for body contouring or moderate weight loss, liposuction can be successful and rewarding for many patients. Like any surgery, however, the procedure is not without risks. Potential side effects include the formation of fat clots or blood clots, excessive loss of body fluids, skin or nerve damage, and a poor reaction to the fluid mixture. Patients should be aware that risks may be greater with large-volume liposuction than with smaller scale liposuction procedures. Additionally, risks may increase with the number of incision sites, which has prompted some surgeons to recommend that the surgery be performed in stages.

Liposuction may also carry greater risks for people with existing medical problems. Therefore, patients with heart disease, lung disease, or poor blood circulation might not be good candidates for the procedure. Since these problems are often linked to high body mass, liposuction may not be recommended for some overweight and obese patients.

When seeking liposuction for weight loss, patients should carefully evaluate the surgeons they are considering. It is important for surgeons to be board-certified and experienced in performing large-volume liposuction. To avoid facing unnecessary risks, patients should also diligently assess the hospitals, surgery centers, and aftercare facilities where they will be receiving care.

Though the prospect of losing weight with minimal effort may be enticing, liposuction is by no means a magic cure for an expanding waistline. Cutting calories and boosting physical activity remain a patient’s best weapons for dropping excess pounds. However, as more studies are done and liposuction techniques continue to improve, surgeons may increasingly offer liposuction as an option for weight loss.