When liposuction first became popular I thought it could be a great way for a patient to quickly drop five or ten pounds and achieve a more flattering figure.
The procedure is fairly straightforward. Just select the area where fat is to be removed, inject saline with lidocaine (local anesthetic) and painlessly suction out the fat. The patient is awake throughout and can resume normal activities right away.
I started doing liposuction and patients seemed pretty happy with the results.
So, where's the downside? If I took off a few pounds of fat from an abdomen, that area stayed flat but the fat came back somewhere else. We started weighing our patients before the procedure and months later when they came back wanting another area suctioned. The weight was either the same as before the procedure or sometimes even higher.
It soon became evident that the basic laws of physics were not suspended for liposuction patients. If 5 pounds were removed and the patients still consumed the same number of calories as before the procedure then they gained back 5 pounds. The patient had to reduce whatever number of calories it takes to support 5 pounds or increase their activity or some combination of decreased calories and increased activity to keep the weight from coming back. Additionally, when the weight comes back, it does so is a different place. So, the patient can achieve a flat abdomen but gain a bigger bust line and or gain fatter arms or legs.. you get the idea.
Now, we prefer to call the procedure Liposculpture. It is best suited for someone who is near their ideal weight but just can't seem to exercise away areas of fatty deposits like the neck or abdomen or saddlebag hips and especially for thick ankles. After the procedure, if the weight is gained back, it usually isn't noticed.
What about the new fat freezing treatments? So far, suctioning is still far and away the fastest, most reliable, and least expensive way to get rid of fatty deposits. Freezing usually requires several treatments and is more costly. In time, freezing may evolve to become more effective and affordable.
What else is on the horizon: This comes under the heading of what's old is new again. 10 years ago we were using injections for fat dissolving. The injections contained ingredients that were no longer available but will again be released after FDA approval which is expected soon.