I can say unequivocally that the answer to this question is yes and no!  I don’t mean to be vague or evasive, but what happens here is directly related to how we put on fat.  The fat cell (lipocyte) is nothing more that a storage container.  It looks a lot like a bubble and when we gain weight fat, the bubble blows up and becomes larger; we don’t make more fat cells.  When we lose fat, the bubbles shrink. The fact that fat cells are essentially non-dividing is the key to understanding how your appearance might change after liposuction and how your body will behave with any gains in weight. As many of you know, there are shapes related to our bodies that, no matter how much we exercise and watch our diets, we can’t change.  The example I like to use is that of the saddle bags that some women have on the outside of their thighs.  No matter how much they try, they can’t get these to go away, they are just larger or smaller versions of the same shape with gains or losses in weight.  You cannot spot reduce a fatty by, say, exercising the outside of the thighs more.  It just doesn’t work that way.  In order to change this shape, the fatty tissue must be removed.  This is a great job for liposuction.  The fat cells are removed, the skin shrinks in and the shape change we have made is permanent.  If the patient gets heavier, she will not reproduce this same contour because we have removed the non-dividing fat cells from this area and no new ones will arise to take their places.  However, since there are fewer cells for the storage of fat there, the body will just look to other places to put fat when the need arises.  If this hypothetical patient were to gain a massive amount of weight, it is likely that the areas treated with liposuction would appear as indentations in the sides of the thighs because the rest of the thigh would be able to plump up normally while the treated areas would not.  If large areas of the body are treated and considerable weight is gained afterward, the patient will put fatty tissue wherever fat cells are available, such as the face, arms and intra-abdominal storage sites.  In addition to this, the treated areas will become lumpy and uneven in appearance as the distribution of fat cells is not completely smooth, so those areas with a slightly greater population of fat cells may gain more than the surrounding areas. 

Liposuction is not for weight loss.  It is for shape change.  The mirror, not scale, is the place to evaluate results and all results must be maintained.  Large weight gains will spoil the results, and can produce shapes that are less desirable than those for which liposuction was originally employed to remedy.

David Luethcke, MD, FACS