Liposuction is one of the most effective procedures for removing unwanted fat and reshaping the body. However, not all fat is created equally, and the presence of visceral fat can significantly impact the results of body contouring surgery. I frequently encounter requests to perform liposuction on individuals with significant amounts of visceral fat. I must explain to these patients that surgical intervention is not a viable option for treating such fat deposits. Understanding the anatomic location and health implications of visceral fat, its limitations in optimizing the results of surgical procedures, and how to reduce it is essential for both patients and surgeons alike.

Visceral Fat

What is visceral fat? Fat in the human body is classified into two main types: subcutaneous fat and visceral fat.

• Subcutaneous fat is the soft, pinchable fat that lies just beneath the skin. This is the type of fat that can be effectively targeted and removed through liposuction.
• Visceral fat, on the other hand, is stored deep within the abdominal cavity, surrounding internal organs such as the liver, intestines, and pancreas. Unlike subcutaneous fat, visceral fat cannot be removed through liposuction due to the high risk of perforating the gastrointestinal tract or damaging solid organs.

Why Is Visceral Fat a Concern for Body Contouring Surgery?

Patients seeking body contouring procedures, such as liposuction or abdominoplasty, often expect dramatic results. However, the presence of excessive visceral fat can limit these outcomes for several key reasons:

1. Inability to Remove Visceral Fat with Liposuction: Liposuction exclusively targets subcutaneous fat, as it involves suctioning fat cells from directly beneath the skin. Visceral fat, which is located inside the abdominal cavity, is inaccessible to liposuction techniques. No surgical method can safely remove visceral fat directly, meaning that patients with a high volume of visceral fat will not achieve the slimmed-down look they desire after surgery.
2. Impact on Abdominal Contouring: Patients with excessive visceral fat will still have a convex abdominal shape after liposuction. This is because the fat pushing outward from inside the abdominal cavity remains unchanged. While liposuction can remove superficial fat and improve body contour, it does not address the deep-seated fat responsible for a bloated midsection.
3. Increased Surgical Risks: Excess visceral fat is associated with a range of health risks, including insulin resistance and type 2 diabetes, high blood pressure, and cardiovascular disease. From a surgical standpoint, patients with excessive visceral fat may face increased risks of complications such as poor wound healing, infections, and prolonged recovery times.
4. Affects Muscle Tightening Procedures: In cases of tummy tuck (abdominoplasty), surgeons not only remove excess skin but also tighten the abdominal muscles to enhance contouring. However, significant visceral fat can put pressure on these muscles, making it more difficult to achieve optimal tightening and a flat abdominal profile. This means that even with muscle repair, the desired abdominal flattening may not be fully realized.

How to Reduce Visceral Fat Before Surgery

Because visceral fat cannot be removed surgically, patients must take steps to reduce it through lifestyle modifications. Some effective ways to reduce visceral fat include:

• Adopt a Healthy Diet: Focus on a high-protein, low-carb, and fiber-rich diet to promote fat loss. Avoiding processed foods, excess sugar, and trans fats can help reduce visceral fat content over time.
• Exercise Regularly: Engaging in cardiovascular exercises, such as running, cycling, or swimming, helps burn visceral fat more effectively than spot-reducing techniques.
• Strength Training: Incorporating weightlifting or resistance training into your routine can boost metabolism and promote overall fat loss.
• Manage Stress and Sleep: Chronic stress and poor sleep are linked to increased visceral fat accumulation. Practicing stress-reduction techniques and maintaining proper sleep hygiene are vital in promoting fat loss.
• Medical Interventions: For some individuals, GLP-1 agonists (such as Mounjaro or Ozempic) or other medically supervised weight-loss treatments may be recommended to help reduce visceral fat before undergoing surgery.

Who Is an Ideal Candidate for Liposuction?

The best candidates for liposuction are those who:

• Have realistic expectations about what liposuction can and cannot achieve.
• Are at or near their ideal body weight with minimal visceral fat.
• Maintain a healthy lifestyle with balanced nutrition and regular exercise.
• Have good skin elasticity, which allows for better contouring post-surgery.

Final Thoughts

Liposuction is a powerful tool for refining body shape, but it is not a solution for deep, visceral fat. Patients must understand that visceral fat reduction requires lifestyle changes, and achieving an optimal body contour involves a combination of surgery and personal health management. By taking proactive steps to lower visceral fat before surgery, patients can improve both their surgical results and their overall health. If you’d like to learn more, do not hesitate to reach out to my Dallas Plastic Surgery office (Dr. Sam Jejurikar) at 214-827-2814.