Why can’t we just surgically remove/lipo all the unwanted or excess fat at once?

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I’m just curious. I’m sure if it was possible, it would be the most popular cosmetic surgery in the world. No more “my 600 pound life” shows, just go in and come out at your goal weight.

In: Biology
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Not sure if this is one reason but at that size your skin is like 3 times the size of you. So if they did it all I imagine the wind would not be your friend.

The easiest way to explain this is this: there’s actually multiple types of fat, and they differ in how they’re stored, as well as what it would take to remove them.

Subcutaneous fat is, more or less, what people think of when they think of fat. It can be worked off through exercise, or it can be surgically removed relatively safely through medical procedures.

What is NOT easily removed is fat that builds up surrounded the organs (visceral fat), which can not simply be suctioned off easily.

A crucial thing to note, though, is that fluids are stored in fat. If you where to just suction off literally 400 pounds of fat, that would cause MASSIVE issues in the individual and their fluid levels, which would critically effect many major organs, namely the kidneys and heart. That’s not to say that doctors can’t suction off large amounts of fat; but there certainly is a percentage that they can. I personally do not know what that is (that gets medically complicated and needs numerous variables to be taken into consideration), but there is a limit.

Hope that helped.

Because all the fat, as I understand it, isn’t bound up in easily accessible layers of lard, meaning it’s abit more complicated to reach it all. That makes the procedure you propose far more risky, meaning good doctors will be more reluctant to clean you out completely.

Better to just clear out the largest excess pockets of fat, and put the patient on a diet and exercise regimen, to increase the chances of keeping the fat off.

That would be a massive surgery and it would be extremely traumatic for your body. When you become fat/obese, you put on fat *everywhere*. Not just in your tummy, but also in your arms, legs, face, and around your organs as well. To remove it all in one operation would mean basically opening up the skin of your abdomen, all your limbs, and your face and also isolating every organ and removing the fat that surrounds it.

That would be *incredibly* stressful for your body and no surgeon would ever consider doing it.

Most fat removal is done for fat under the skin. You need to make a hole in the skin to insert your fat vacuum. Repeated surgeries mean more incisions that may not heal properly (scar) and increase the risk of infection.

Fat cells also do not divide very quickly as you age. If you surgically remove fat, you end up with fewer fat cells which can cause a “lumpy” appearance if you continue to gain fat.

Much of the “bad” accumulated fat lies in the spaces between organs. This kind of fat is not removed through plastic surgery.

It’s not just existence of the fat that matters. Changing the person’s habits also matters, and there’s no shortcuts for that. If you don’t change the habits, the weight will come right back. It’s the same reason why alcoholics can’t get liver transplants, it’s a pointless surgery and waste of an organ when the likelihood of success is miniscule and risk of failure is still basically guaranteed.

In addition to all the answers here, I think it should be noted that we still don’t know everything about adipose tissue.

Research is showing that fat cells actually send and receive messages to and from the brain, in a similar way to our organs.

Also a healthy individual’s total body weight should be comprised of approx 20-25% of fat.

Simply removing fat doesn’t address the root causes for a person being overweight. Particularly psychological reasons such as binge/comfort eating etc.

Fat is filled with blood vessels. Blood vessels are filled with blood. Sucking out fat can pop blood vessels. Blood vessels can fill the empty space where fat used to be. Skin can stretch and hold a lot more blood than there was fat. Blood outside of blood vessels is not going back to your heart. Blood not going back to your heart is not going to organs that need blood. Blood outside of blood vessels also starts clotting. Clotted blood makes unclotted blood start to clot too. Clotted blood can leak back into blood vessels. Blood clots can break off and block organs from receiving blood. Organs start dying without blood. Organs that get enough damage can’t be repaired. Humans that have enough damaged organs can’t live.