Why Didn't I Lose Weight After Liposuction?

Hi Maryanne,
What you weigh is essentially determined by two variables: what you eat and what you burn off.
To better understand this, think about the analogy of a bathtub. Water comes into the tub through the faucet and is drained by the drain. The water level to which the tub fills (what you weigh) is determined by how fast water comes into the tub (what you eat) and how fast the tub is drained (what you burn off). At some water level (how much you weigh), these two variables, provided they are constant, will be in what is called equilibrium and the water level (what you weigh) will be constant. Now, suppose you come along and scoop out a bucket of water. The water level will drop. However, eventually the water level will return to the equilibrium level.
A similar thing happens with liposuction. However, for liposuction, it is more complicated because the body swells, following the procedure due to surgical trauma, so fat is replaced by fluid. An equal volume of the fluid weighs more than an equal volume of fat. So while the swelling slowing resolves over a period of months, your body is busy regaining lost fat.
Liposuction is effective at sculpting because the regained fat is more evenly distributed over the body, and not just to the problem area that was liposuctioned. However, it is not expected that your weight will change, unless you change what you eat or how much you metabolize by increasing your work out.
This is why you will hear responsible liposuction surgeons say over and over again that liposuction is not a weight loss method.

Maryanne:
From an absolute standpoint, if 1.5 liters of fat was removed, you should weigh about 80% less than this (accounting for the difference is weight between water and fat, as well as 1.5 liters of removal includes blood and other body fluids). However, there may be many other reasons why you continue to weigh the same.
This is most likely due to fluid retention secondary to inflammation and scarring from the srugical injury. It may also have something to do with your HRT and hormonal balance. Generally, we do not advise pills to correct water retention after surgery.
Weight is not as important as the body contouring changes that are the primary goal. If your goal is to reduce the love handles, belly roll or saddle bags and that was achieved, then your surgery was considered successful. Absolute weight loss is a far less important goal or criteria by which to measure your success.
I hope that helps to explain.

Part of that fat that was removed was injected fluid and water in the fat cells. The water you drink will replace some of the water in the cells in the tissue. I tell my patients you will look different, but your weight will stay the same. Of course, the exercise and muscle mass will also play into the equation.

It is difficult to tell you how much weight you should have lost after liposuction. I tell patients that it is a contour change procedure not necessarily a method of weight loss.

Following Liposuction, a fluid shift occurs in the body to accomodate for the surgery and for the fluid loss. The 1.5 kilogram is a small amount that will go unnoticed after surgery.