Liposuction Shocker: The Fat Comes Back

I love liposuction. I really do. I know bad things can happen — numbness, uneven fat removal, bumpy skin. And there's always the chance, however remote, that you'll be the moron who ends up dead because you wanted to wear skinny jeans. But the whole idea that you can insert a tube in the body, suck out fat, and be up and about in a few days is genius. And to anybody who pooh-poohs the vanity of the endeavor, I say: Stop combing through your hair, stop washing your face, stop buying nice clothes ... and bite me. Vanity exists on a continuum. I may not want to get breast implants or, say, saw off a joint on my toe to fit into certain stylish shoes, but I'll be damned if I'll condemn anyone else for doing it.

So, as I say, I'm all for anybody doing what they want to with their bodies. But here's what amazes me: Many people think that once fat is removed in a given area, problem solved; you're now a thin person. Eat whatever you want because the fat cells are gone. There is nowhere for that chocolate cake to go. Bon appétit!

Well, funny story. I've had liposuction on my hips and thighs twice, and I've gained back all the weight and more. The first time I had it — badly and unevenly, with minor nerve damage that lasted for years — the weight reappeared on my stomach, a place I'd never gained weight before. The second go-around, I had wonderful surgery combined with a tummy tuck (to get rid of stretched skin, the result of having twins) ... and I pudged up again nine months later. This time, the fat seemed more evenly distributed, though I'm pretty sure it found a happy home on my ass. Out of sight, out of mind!

Last April, a study published in Obesity magazine confirmed what was painfully obvious to many of us who've been lipo'ed: Terminator-like, the fat comes back.

In a study led by two researchers at the University of Colorado, 32 non-obese women, mostly in their 30s, with extra weight on their hips, thighs, and stomach, were divided into two groups: One group had lipo on the problem areas (about 6 pounds of fat was removed), one didn't. They were instructed not to change their lifestyles over the next 12 months. And guess what? One year later, the lipo'ed women were pretty much the same weight they were before the procedure — because, the researchers noted, the body "defends" its fat supply. The cruel truth is that your body does not want you to look like Keira Knightley — if you don't happen to be Keira Knightley.

Unless we gain significant weight as adults, we all have more or less the same number of fat cells we had as adolescents (though if we do gain more than 50 pounds, we're screwed — the number of fat cells in our body can, and will, increase). While lipo removes many fat cells, two things happen: 1) The remaining fat cells can expand; and 2) Fat can be stored in new places. Like my ass. And yours.

When the news came out, newspapers and blogs predicted that what was now one of the most popular cosmetic procedures would go the way of bloodletting and lobotomies. Why bother going through the expense, discomfort, and risk if you're likely to just gain the weight back?

Well, here's why: The very fact that the weight doesn't come back in the same places generally means you'll look better, and more balanced, even if you do gain something. "Liposuction isn't about weight loss — you're usually just taking off a couple of pounds — but about contouring," says cosmetic dermatologic surgeon Dr. Howard Sobel. "So if you're bothered by having hips that are out of balance with the rest of your body, liposuction will in all likelihood work for you even if the pounds return. Your body will be more symmetrical."

This was certainly my experience. Gaining some fat in the abdomen was no joy, nor was gaining it in the bottom. But I never again had saddlebags; I was never out of proportion in the way I'd originally been. And when, finally, I determined I would lose weight by the tedious process of diet and exercise (ultimately more expensive than lipo, since I seem incapable of physical exertion without some buff dude standing over me, barking orders), I seemed to lose the weight evenly, all over. I'll always have to be vigilant if I want to stay a size 8 to 10, as my body, appetite, and drinking habits are forever conspiring to make me a size 16. But to me, the moral of the study was not: Liposuction Bad. It was: Know Lipo's Limits. I may chub up again, but at least I won't look like a Weeble.