Fat removed by liposuction tends to come back, often around the organs
Liposuction removes fat cells for good, yet within a few months total body fat usually drifts back to where it started, even with diet and exercise unchanged. Much of the regained fat settles in the abdomen, including visceral fat around the organs, the kind tied to diabetes, stroke and heart attack.
The procedure pulls fat out through a hollow tube called a cannula using suction, under general, regional or local anaesthesia. As a cosmetic operation it reshapes contours and seems to work best on people of normal weight with elastic skin. Evidence does not show lasting weight loss beyond a couple of months, and it does not improve obesity-linked metabolic problems such as insulin resistance.
There is also a reconstructive side. Surgeons use liposuction to treat lipedema, to reduce excess tissue in chronic lymphedema and to remove lipomas. That work demands care for already fragile lymph vessels: one protocol, described in a paper by Campisi, uses only small blunt cannulas, maps key lymphatic structures beforehand and can take four to five hours for each body part, removing far more material than cosmetic work. Insurers often reject such claims at first, though many succeed on appeal with proper documentation.
Techniques vary by how much fluid is injected and what energy loosens the fat. Tumescent anaesthesia swells the target tissue with a large volume of dilute lidocaine and epinephrine. Power-assisted systems vibrate the cannula to remove more fat with less effort from the surgeon, while water-jet devices inject anaesthetic in a fan-shaped spray and suction simultaneously. Early ultrasound-assisted machines of the 1980s and 1990s could damage tissue through overexposure; later models pulse the energy. Laser and radiofrequency methods add heat to tighten skin.
Safety depends heavily on scale. Taking out under 1,000 cc while the patient is awake differs sharply from removing over 5,000 cc under anaesthesia with a hospital stay. A 2015 study of 4,534 patients found complications in 69, about 1.5 percent, with higher risk above 100 ml removed per unit of body mass index. Serious problems include deep vein thrombosis, organ perforation, bleeding and infection, and as of 2011 deaths were reported at roughly one in ten thousand cases.
Source: Liposuction
