Liposuction and other body contouring operations such as tummy tucks target localized areas of fat that are in disproportion to the rest of the body. A common question is “Doesn’t the fat just come back or go somewhere else?” The short answer is that when done properly, it doesn’t. That’s because fat cells on those areas are different, more resistant to shrinkage with diet and exercise; think of them as the body’s emergency fuel reserves, to be accessed only in case of near starvation.
The important thing is to recognize the body type and how excess fat is distributed. Women may have a size 4 upper body and several sizes more on the lower body, or vice-versa. It’s also how athletic men come in with “love handles” despite low overall body fat.
Familiar examples are the “apple” body type, where there is excess fat around the middle and upper inner thighs, or the “pear” body, where it is mostly lower body and a thin waistline. The key is to identify and treat all of the areas that are out of proportion. If for instance you are an apple body and you only reduce the abdomen and love handles, the inner thighs will be the only remaining spot and can become even more difficult. The idea is to do all problem areas for each body type so any compensatory weight gain will distribute evenly throughout the body.
Having said all that, there are some things to be aware of. With an apple body for example there is often more internal fat that is inaccessible to liposuction or tummy tuck surgery. In some cases, reduction of the external fat drives more internal fat accumulation. The good news is that internal fat is more responsive to diet and exercise, according to a study from Brazil.
Liposuction by itself will not prevent weight gain or produce weight loss, but it can help control body shape. For example, I have done liposuction on professional ballet dancers who were extremely fit but still had small bulges of fat that could be seen in a leotard. This control of body shape is the real reason for liposuction, because exercise cannot “spot reduce” localized fat. Body contouring surgery gives you back the ability to appreciate the results from diet and exercise.