A welcome side effect of plastic surgery is that many people who have a tummy tuck or liposuction experience additional weight loss. Dr. Shlomo Widder discusses this natural phenomenon and why it is important to maintain healthy eating habits post surgery.
Q: How does the tummy tuck procedure result in weight loss?
The reason you lose weight after a tummy tuck is that the procedure is not only a tightening of the abdominal skin but also tightening of the abdominal muscles. When you tighten the muscles, you increase the pressure on the stomach, and that in turn sends a message to the brain that says, “Stop filling me up. Stop eating.” That’s how patients lose weight.
I always tell my patients about that; it is part of my initial talk. I tell them that hunger is managed in two ways. One is a chemical, which involves sugar. When the blood sugar goes down, you feel hungry and you eat. The other is mechanical. When the stomach is empty, it starts contracting and you might hear all those gurgling noises. It is saying to the brain, “I’m empty – Fill me up.” The stomach has special cells that measure pressure, but the brain is not so sophisticated as to tell the difference between pressure from food in the stomach or pressure from the outside. So we can fool the brain by adding pressure from the outside by tightening the muscles.
I just did a tummy tuck for a military guy. He told me that he was constantly hungry. He was in good shape – trim and muscular – but he hadn’t reached what he physically wanted to achieve. His stomach muscles were loose from lifting heavy weights. Sometimes men, due to heavy lifting, rip the attachments of the abdominal muscles and it causes this problem. For some women, a similar thing can happen when they have children. The pregnancy stretches the abdominals and laxity of the muscles result. If the muscles are loose, they just extend outward when you eat. You don’t feel satisfied, so it is easy to keep on eating. After his tummy tuck surgery, this man I mentioned, felt full and much less hungry. He’s already lost 10 to 15 pounds and he’s achieved his weight goal.
Q: What will occur if you get liposuction or another procedure that encourages weight loss, and then continue a habit of overeating?
It depends on the surgical technique used. When my patients have liposuction, I tell them that they have to lose, at least, the same amount of weight that I remove from them. If they don’t lose that amount of weight, any new fat gained can go into those sections where I did not do the liposuction.
In order to do effective liposuction, you really have to enter with the suctioning cannula from many different directions in order to remove as many fat cells as possible. For this reason, I take a very aggressive approach and go from multiple directions. If a surgeon goes from only one or two entries, fat cells will be left between the tracks of the cannula, the tube that is used to aspirate the fat. Each fat cell is able to store more fat by increasing its size by 50%. So if you leave a lot of fat cells, two to three months after the procedure, it may look as if nothing was done. But if you go from multiple directions and are very aggressive with the fat cells removal, the number of fat cells that remain will be reduced dramatically. Then, no fat or very little can go in those areas in the future. However, it can go elsewhere. If a patient keeps overeating in the same fashion as before, since the fat can’t go into the liposuction area, it might go to the shoulders, face, butt, breasts, and so on. So the secret really is for me to do a very thorough removal of the fat cells and for the patient to lose the same amount of weight that was removed by the liposuction.
Q: If a person has a tummy tuck or liposuction, how long before he or she can take on an exercise regimen? Are there exercises you recommend in addition to a shift in dietary lifestyle?
For liposuction, I limit their exercise for two weeks, and then for the following two weeks, they can increase exercise in a gradual fashion. On the first week back, they can exercise at a 25% capacity of what they did before. The following week, I advise they go to 50% of their former activity level. Then one month after the surgery, they are free of any limitation. For a tummy tuck, they have to wait six weeks before any physical activity or lifting. Then as with the liposuction, they can gradually return to normal activity over a two week period. After two months, they are back to full speed.
The main type of exercise I recommend is cardiovascular, or aerobic. Any type of cardio can get you in good shape. It could be a stationary bike, it could be a treadmill –all of those machines at the gym are good. The key is to put forth at least 20 minutes of constant effort during which the heart rate is raised to two-thirds of maximal capacity. Do this, and you’ll be burning fat and lose weight.
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