The Weight-ing Game with Bariatric Surgery and Liposuction by Dr. E. Kocak
by Dr. Ergun Kocak
Can bariatric surgery substitute for liposuction and vice-versa? We list the differences between the two most popular procedures that can aid a patient’s weight loss.
For years, a constant comparison has been made between liposuction and bariatric surgery – on their impact and effectiveness in the universal struggle with weight loss. These two aren’t interchangeable procedures but can be either done as stand-alone surgeries or, if weight loss is a serious issue, bariatric surgery first followed by liposuction.
Bariatric surgery involves a direct change in the anatomy of an individual, specifically parts of the digestive system – i.e., the stomach and small intestines – to limit its capacity to hold a certain amount of food. Other bariatric surgical procedures also cause hormonal changes and lessen the amount of nutrients the digestive system absorbs. Those physiological tweaks work together to curb a patient’s appetite and fast-track its way to registering fullness. The end result is massive weight loss for those with a body mass index of at least 35 in a relatively short amount of time.
Some of the most popular bariatric surgery techniques are: gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal swith (BPD/DS) gastric bypass. These involve creating a smaller pouch from the existing stomach either through direct removal of a large portion of the organ or the placement of a band or other restricting equipment around it.
Liposuction, on the other hand, serves a decidedly cosmetic purpose for those within 20 to 30 pounds of their target weight. No organs are touched or altered. Instead, small pockets of fat are removed using a cannula (a small tube that suctions fat) to reshape and re-contour body parts both patients and surgeons deem problematic. The list of possible liposuction areas includes the lower abdomen, arms, knees, outer thighs, hips, neck, and cheeks. It is not considered by medical professionals as a kind of weight loss operation or solution.
In recent years, liposuction has been safely performed with other cosmetic surgery procedures such as a tummy tuck and breast augmentation or reduction. Some plastic surgeons offer it as part of their “Mommy Makeover” packages for women who have had children and who want to get back into shape with a little surgical help.
Occasionally, it can also be used to treat patients suffering from certain conditions, as listed by the American Society for Metabolic and Bariatric Surgery (ASMBS): benign fatty tumors, abnormal enlargement of the male breasts, problems with metabolism of fat, and excessive sweating in the armpit area.
So while liposuction mostly works to refine a patient’s figure for a more flattering silhouette, bariatric surgery goes deeper by making long-lasting improvements right from inside the body. The National Institutes of Health, as cited by the ASMBS, acknowledges that “when combined with a comprehensive treatment plan, bariatric surgery may often act as an effective tool to provide you with long-term weight loss and help you increase your quality of health.”
Studies show that an overwhelming majority – pegged at 90 percent – of bariatric patients are able to keep off about 50 percent of their excess body weight following surgery. The procedure has also been proven to dramatically reduce mortality rates among patients, even among those suffering from conditions such as diabetes and heart disease prior to bariatric surgery.
Considering the complexity of the procedure, surgeons regard its mortality rate of 3 out of 1000 as “exceptionally low” bearing in mind that obese individuals, who usually undergo bariatric surgery, are in relatively poor health to begin with. Patients also have to regularly visit with their surgeons after the operation to make sure that digestive function remains on track and to catch any unexpected changes before they adversely affect the weight loss process.
Once a bariatric patient’s weight has stabilized or has reached his or her goal weight, liposuction can serve as the perfect finishing touch to eliminate those last few pounds of stubborn fat. So for most patients, it is not a matter of choosing one procedure over the other but a matter of assessing and consulting with both your bariatric surgeon and plastic surgeon when each would be most helpful in the long road towards better physical, psychological, and emotional health.