The Truth About Liposuction and Its Health Impact, with Dr. Ben Bikman

[@KimtheElder]

Just about one minute in and I want to state that in the 1990s a friend probably in her early 30s then died during liposuction. She died because she didn't have the information she needed from the health community to lose the perhaps 50 to 60 pounds she needed to to be at a "healthy" weight. It infuriates me. Thank you for your work and putting out to the masses for so many years. You are a blessing. Kim

[@kristivice5537]

Liposuction removes areas of fat, not body wide fat.

[@KimtheElder]

@@kristivice5537 Right.

[@ysmetannikov]

This is correct. Liposuction is not intended to be a fat loss procedure. Rather, it should be performed to remove stubborn fat areas after fat loss. Love handles, armpit rolls etc. For significant weight loss there is bariatric surgery. Removing 50-60pounds of fat by liposuction is not a good idea.

[@bibibachmd9995]

I would see morbidly obese and obese nurses and others undergo liposuction. I knew they had no counseling re weight loss. Today, I would speculate that most plastic surgeons do not correctly counsel these patients. Most likely they have not heard of insulin resistance.

[@nanagracetraditions7688]

I work in wound care and appreciate very much your previous lecture on lipidema and also your reference to the benefit of liposuction on pain relief for lipidema. Thank you for your time, knowledge, and dedication to education. You’re making a tremendous difference!

[@SuperBlondieblonde]

I have Lipidema and had Liposuction on my outer thighs, inner knee, back of thighs ( banana roll) hips, flanks , and feathered up the sides of waist. It has helped me a lot. I can fit into & look better in jeans now. I eat healthy & have maintained weight. I also had Cool Sculpting done over the Lipo suction on inner knees, inner thighs and part above knee. That took things down another 20%. However neither did anything for dimpled fat- still got it just smaller version. Over all I’m glad the lipo reduced the fat ( Lipidema) on my legs although 4 years ago I did not realize it to actually be Lipidema. Thank you Dr Bikman for this new information

[@doddgarger6806]

Unfortunately people don't realize they can easily drop 50 lbs just by changing their diet and not have to spend $20,000 or more for liposuction

[@marlinatelena4579]

@@doddgarger6806people with lipedema will reduce the weight everywhere except the lipedema fat. It’s impossible to get rid of it unless you so lipo.

[@bleon5956]

​@@doddgarger6806 wow you obviously know nothing about lipedema. Not that simple unfortunately. Don't be so quick to judge. Also because this is a medical condition many times insurance pays for surgery

[@Lisa12T82]

Thank you for you comment. I am considering Vaser Liposuction for my lipoedema as it is apparently kinder to the lymphatic structures.

[@sunrisetacticalgear2676]

Thank you Dr. Ben, it only took me 55 years to learn that we don’t “loose fat” on a diet, we shrink our “fat cells”. Since I am a Male T.O.F.I. I would like to know how I can grow more Healthy sub cutaneous fat cells. Thank you for educating the public!!

[@drirene57]

Carbohydrates cause insulin secretion, insulin pushes your food into fat cells. Stop eating carbohydrates.

[@monnoo8221]

first, the word is "lose" = get rid of, while to loosen means the oppposite of tightening. If you loosen up sth far enough you will lose it. :)) your interest in growing more Healthy sub cutaneous fat cells is contradictory. Be content with the fat you have, and take care that it does not grow. Any growth of fat tissue is due to too much insulin (bad timing behavior = snacking all the time) and too much energy intake, from intense guzzling. Your aim should be 12..15 body fat. Anything else is too much

[@AngC-k9k]

Look into intermittent fasting and keto

[@MossGlenAK]

I had wondered what happened to the body. I never had any interest but I have seen a lot of ads lately. Thanks for the information.

[@Psmfmyway]

I truly believe the lymphatic system is underemphasized. Now scientists have found that even the brain is cleared by the lymphatic system. Dry brushing, lymphatic massage, lymphatic stimulating movement and exercise…so important. If in sucking out or cutting out the fat you damage the lymphatic system or remove lymph nodes it will cause problems. Any breast cancer survivor who has had lymph nodes removed can attest to the issues they have faced subsequently.

[@lucretiasulimay1968]

Agree ! Have had breast cancer double mastectomy bought myself a mini trampoline jump on it for 20 minutes a day , for my lymphatic system !!

[@Boo-bastic]

Thanks for proving this. I try my best to do research before jumping to a decision and this is one of the only videos I’ve found that actually discusses liposuction with a well rounded perspective

[@REIMARAValk]

wonderful, Dr. Bikman that you used the term 'blessing' of carrying a baby, instead of ' burden'. I am sure that some women experience it as a burden at some point, but it is a unique experience that men and women who were never able to conceive , are deprived of. thanks so much again for sharing your knowledge. kind regards miss Reimara

[@lucretiasulimay1968]

Dr bickman , don't ever stop your tangents !!! 😊 Your explanations are spot on , and the tangents only add to your passion for wanting to get important information out there . The body is an amazing thing . Thank you so much for sharing your wealth of information . Have a beautiful day 😊😊

[@zyferion]

What a wonderful lecture from you Dr. Birman. Thank you!

[@bleon5956]

I have Lipedema and want to have liposuction . I am so happy you brought that up! I was so scared to watch this video because I assumed you were going to say it's bad for everyone. I have done as much as I can to reduce my insulin I'm sure I still have some work to do but I definitely do not eat processed food any longer. This weight though won't budge and I have gained about 50 lb, my lipedema exploded in menopause. I had kept my weight stable for over 10 years before that. My mobility is highly affected and at this point I felt like liposuction is my only option. I don't have any huge health issues basically only insulin resistance. My insulin now is down to about 12 I want to get it down to below 6 before surgery.

[@bibibachmd9995]

Thank you Dr. Bikman. Very interesting.

[@Tee667]

EXCEPTIONAL. Another wonderful in-depth lecture on the fat cell!!!

[@sorinj151]

Thank you for this informative class. I'm looking forward for the next one.

[@miztaken7453]

I had stage 4 Lipoedema. As part of my conservative treatment I moved to a low inflammatory, very low carbohydrate lifestyle. This resulted in no more Lipoedema pain (plus many, many more benefits) and 25kilo weight loss. And yes, I even lost significant size off my legs (9cm each calf). I then had x6 Lipoedema extraction surgeries with almost 25 litres of diseased FAT tissue removed. (11 kilos weight wise) This was fat alone. The infiltrate is NOT calculated as a person has erroneously stated in this thread. 🤦🏻‍♀️ It is easy to measure… the fat separates and floats to the top of the infiltrate. Post surgeries I maintain a carnivore lifestyle to ensure that my remaining fat tissue remains in good health and so that I do not gain weight again, or worse: trigger my Lipoedema again. It is genetic, so returning to my previous eating habits would be sure to cause the same problems I used to have. Liposuction for Lipoedema is really effective IF you maintain the correct lifestyle.

[@Lisa12T82]

Thank you. I am currently looking toward surgery for my lipoedema after 2 years on keto then carnivore. This testimony is helping cement my decision.

[@miztaken7453]

@ well done with maintaining your lifestyle for two years. You are awesome 🤩 and best wishes for your upcoming surgery ❤️ Another bonus for me… two years after my last surgery I don’t have to wear my compression all the time 😱😱😱😁

[@melkershaw5174]

There is also an increased awareness of a disease called lipoedema which can be debilitating disease, and liposuction is the only way to remove the diseased fat

[@dw1166a]

He talks about that at the end. I recommend his other video that he did in April about lipedema.

[@fadiyt8816]

Obviously you didn't watch till the end where he cited a study about liposuction in lipoedema patients

[@LisaY4yeshua]

I love this Dr. This information is very insightful. Thank you!

[@Danielle-zq7kb]

I have lipidema and I’ve always felt that if I have liposuction (the new lymph sparing type) then my body would be more proportionate. I know that you can’t address an individual concern because I’m not a patient and you aren’t a medical doctor and you aren’t my doctor. Still I hope you do a follow up on proportional distribution of body fat and whether surgical intervention to make things more proportionate works in the long term or does your body just redistribute your fat to the areas it seems to prefer?

[@LisaY4yeshua]

I wish I had stumbled upon this video and his lectures a few years ago. I decided to have liposuction on both legs because I was about end of stage 2 lipedema and having much difficulty walking. I already had both knees replaced. I'm exactly one year after having liposuction on both legs. Both legs look great and my stomach is huge! For sure...what he's discussing in this video has happened to me. I can walk now which was my main concern, but I'll be turning my focus towards shrinking these fat cells. Another thing...I got sepsis ppst surgery and was hospitalized for months. A friend who is a doctor just recently told me...don't have surgery unless it's absolutely necessary. I think it's good advice...now I need to watch the rest of his videos so I can shrink my fat cells!

[@sharonsmiler4938]

Thank you xxx

[@fronniebealer7808]

I am glad to know the bit of news that lipedema people may benefit from liposuction. I have done ketovore for 4 years and still have quite a large apron of fat, though I have lost 80 pounds. I wonder if liposuction may be helpful in that case. I am not going to have it done. Just wondering.

[@davidzaharik5408]

That was brilliant, thank you Doc...

[@diablominero]

Liposuction isn't only useful for making you look leaner. There's subcutaneous fat everywhere on the body, so liposuction can create shapes anywhere on the body. Breast reduction surgery often includes liposuction, and liposuction can be used to sculpt imitation muscles out of body fat.

[@1timbarrett]

Back in the 90s, several of my wealthier fitness clients opted for liposuction. Eventually every single one of these ladies regained all mass she had “lost”, because she never addressed her eating habits. So sad too that every single one of these women were anxious about “bulking up”, ie gaining more muscle than they found fashionable. 😢

[@suemiller1342]

Love the content. Thank you!

[@vikidevries4441]

Thank you so much professor! ❤ You are the best 🙏

[@LipedemaGuru]

Continuously watching your videos. My area of expertise as medical professional. Huge topic. Very complicated and even more misunderstood. Would be lovely to connect with you Ben.

[@Grumpy_nurse]

I would like to hear about cortisol and the long term effect on health. Specifically for those of us who have survived years of trauma in so many ways - and have big bellies & skinny legs (typically). Trauma/stress can be from decades of working in healthcare (no pee breaks, survival food/grazing from vending machines/etc. and 24/7 shift availability. How to overcome the physical effects of cortisol overload? Yoga with goats isn't an effective strategy IMO. 🙂

[@ivanardila]

Coffee antagonizes cortisol, and licorice does, too. The first is taken in the morning, the second at night. I hope this works for you.

[@nafisaaptekar3601]

Thank you

[@ivanardila]

2nd comment: if lipectomy does indeed remove some endocrine production, we need to replace it, and I suggest using pregnenolone and DHEA to supplement the progesterone and estrogen precursors, and as for the lack of both good and bad fat reservoirs that occur when their deposits are removed, and the liposoluble and lipophilic toxins that were dumped into them, I would suggest the use of Kombucha, because it has glucuronic acid, which intervenes in a key detoxification process, which is glucuronization, and taking it could relieve to a certain extent the process of concentrating waste because even better, it would be excreted, in theory. The video on ferments, on the other hand very good, but it was missing to elaborate on this fascinating subject of glucuronidation in which Kombucha intervenes because it is a not inconsiderable mechanism of purification of the organism.

[@lalaleelee7531]

Thank you for a very good class on the important role of fat.

[@milantoth2045]

awsome content, thanks a lot

[@buharialhassan1522]

Professor Ben Bikman !!!!!!!!❤ You are the best Doctor i have ever seen in my entire life, your youtube videos helped me learnt Carbohydrates are non-essential micronutrients because of that i am able to lose 24kg in 5 months just by controlling Carbohydrates. Thank you for helping me life.

[@LATSRN]

I stupidly had liposuction over my tummy area about 20 years ago! I now have a weird shaped tummy! Big mistake, DO NOT HAVE LIPOSUCTION!

[@rosagarcia7423]

Same here, do not do it….not worth it….

[@LATSRN]

@@rosagarcia7423 and I wasn’t even over my bmi I just wanted a flatter tummy! 🤷‍♀️

[@X-157.98]

A great piece on lipo. I couldnt afford it and now im a little bit happier ❤

[@petramaas8574]

Thank you, it is a very interesting subject. Fat is often seen in a negative way, but if it was only a burden, we wouldn't have developed the ability to make fat cells.

[@ivanardila]

2do comentario: si la lipectomía efectivamente resta cierta producción endócrina, debemos reponerla, y sugiero usar pregnenolona y DHEA para suplementar los precursores de progesterona y estrógenos, y en cuanto a la carencia de reservorios de grasa tanto buena como mala que se produce al extirpar sus depósitos, y las toxinas liposolubles y lipófilas que en ellos se vertían, sugeriría el uso de Kombucha, porque tiene ácido glucorónico, que interviene en un proceso clave de desintoxicación, que es la glucuronización, y tomarla podría relevar en cierta medida al proceso de concentrar desechos porque mejor aún, se excretaría, en teoría. En el video sobre los fermentos, por otro lado muy bueno, faltó abundar sobre éste fascinante tema de la glucuronización en la que interviene la Kombucha, porque es un mecanismo nada despreciable de purificación del organismo.

[@gloriagiorgi1026]

Is angioneogenesis mainly happening more with hyperplasia rather than hypertrophy? Would that also explain more incidence of cellulite in women than in men?(I know cellulite is a more complex topic as it also depends on stuck fascia fluid and loss of collagen and elastin through aging and hormonal loss, but I was wondering if the fat inflammation process can contribute to that).

[@Hee-o1p]

Thank you doctor , thanks god that we live in 2024 there is KZbin and there are great people like you who gives the best of his knowledge to the public 🎉

[@DrJackJ]

Great video. How about you do a video on cryolipolysis?

[@petripat5979]

Wow, so much knowledge, thanks. Very interesting

[@LouellaDesouza]

Wonderful

[@Philusteen]

Thanks, doc - you know what I'd like to see is some learnings around gluconeogenesis and how it works in a fasted state. I've seen lots of stuff around "catabolizing lean body mass," but also seen plenty about how fasting for 2-3 days is protective of skeletal muscle, and how things like skin polyps actually can get reabsorbed. Can an obese person effectively utilize stored fat, but ALSO effectively use the excess tissue that accumulates as well? Thanks, and thanks for all you do. 🖖

[@jwscheuerman]

I second this! I know that gluconeogenesis can utilise both amino acids (from protein) and glycerol (from triglycerides)to generate glucose, but I'm interested in learning more about which source is more commonly used, and what factors (if any) might impact the choice of source during a prolonged fast.

[@Philusteen]

@@jwscheuerman YES - and, as I'm experimenting on myself right now, if periodic resistance training can help direct protein scavenging away from musculature and organs, and toward the structural components of excess adipose tissue. I'm down over 70 lb from the beginning of the year, mostly by what I've termed "electrobiotic fasting" 2-4 days mid-week (electrolytes, supplements, and ferments, mostly), bracketed by mostly keto high-quality high-protein weekends, with variable intensities of weight training throughout. So far, so good - but I'm no scientist, lol. 🖖

[@Neolifeketoshari]

​@@jwscheuermanlactate is also turned into glucose by the liver through gluconeogenisis. The body will use fat, lactate and glycerol before using muscle for glucose. Dr. Bikman covered this a bit a couple weeks ago in his talk on lactate.

[@ivanardila]

Lipid cells are more than tissue, they conform to a polycentric organ distributed wisely in certain zones of our bodies to fulfill precise duties, so when you wipe them out through lipectomy, you are amputating a fraction of it, and stopping the functions it realized there, maybe forever, like the endocrine ones (synthesizing as you said dozens of hormones, like leptin, progesterone, estrogens, can you mention more please? ), the replenish of energy derived from fat reserves, the waste accumulation of lipid-soluble toxins, and so on... I don´t think the fat cells leak fatty acids, since they store them. They get saturated, and the fatty acids in the blood don´t find a storage facility where to go, so they show themselves in the analytics. By the way, which fatty acids are you talking about? Nobody clears this point, and I want to know their chemical structure. I think that you should measure after the surgery the amounts of fatty tissue-derived hormones since these hormones have no base to be produced again. Check the before and after ratios. Also, the amount of estrogen-like chemicals and the physical responses to them, because you cleaned them too at a certain degree. As we can see, there are bad and good sides of the operation.

[@ScienceAppliedForGood]

The last sentence from the 'Fat Redistribution Following Suction Lipectomy: Defense of Body Fat and Patterns of Restoration' paper is very funny and telling: "The fact that the women in this study were healthy and maintained their usual lifestyle throughout the 1-year follow-up period makes it even more remarkable that the patterns of AT restoration were observed across many methods of body composition assessment. Mechanisms behind restoration of the AT mass following surgical removal remain uncertain but are of great interest." Mechanism behind why fat has been restored was a mystery to them. On a somewhat related topic. Ben are you aware of any studies that checked the amount of lose skin following weight loss on a regular (caloric restriction diet), intermittent fasting or fasting in general? Anecdotally, it seems like people who fast has less lose skin after weight loss in comparison to people who follow caloric restriction with sport alone. I wasn't able to find any such study myself.

[@gracemorrison7666]

Can you explain about fat transfer? Such as from belly to face

[@mortenhector]

Dr. Bikman - Loose skin surgery: In my country you can have (free) a loose skin surgery if you loose more than 15 BMI-points. A part of this process, they will do liposuction in the that area. Should I fear that type of liposuction to? (We are talking 70 kg weight loss / 154 pound)

[@ysmetannikov]

Ben, most of your lectures are very interesting and well referenced. However, at times you make strange statements, and I would highly recommend checking facts before saying something. The amount of fat removed is nowhere near "twenty to forty pounds". Guidelines for liposuction are published on the website of the American Society of Plastic Surgeons. The average amount removed is about 5000 ml, and that includes the infiltrate that's hasn't been absorbed during the procedure. Claiming that during liposuction twenty to forty of pounds of fat can be removed is plain ridiculous. A quick literature check or a phone call to a plastic surgeon would clarify this. In many cases liposuction is performed after weight loss, to remove "stubborn spots"; in these cases the amount of fat removed is considerably less. Finally, liposuction is a cosmetic procedure, and is performed "for the looks" and not metabolic effects. You chose to quote a 2004 study showing lack of metabolic benefits from lipo, but there were publications since then, notably meta-analysis published in 2023, that had demonstrated reduction in triglycerides, glucose and insulin after this procedure. Another thing: calorie deficit is the primary factor that needs to be addressed when trying to lose weight, and there is the literature is quite conclusive on this. Correcting insulin resistance is a worthy goal, but in terms of weight loss it's importance is secondary. In terms of weight loss, isocaloric diets with various macronutrient composition produce similar weight loss. Again, before making statements of any practical value it is worthwhile to talk to professionals and patients actually dealing with this. Theories are nice and tidy, but clinical practice is often messy and unpredictable. Have you actually treated obese patients? If not, refraining from categorical statements - such as "insulin is first, calorie deficit second" while having no practical experience would be wise. A simple mental exercise will show you that reducing calorie intake will, at least to some extent, take care of insulin resistance. Regarding hunger that is inevitable triggered by calorie reduction, it is indeed inevitable. Hunger is a complex phenomenon going way beyond insulin and insulin resistance, and controlling hunger during dieting is a separate topic altogether. As I said, most of your lectures are useful. I am a practicing anaesthetist, and I have learned a lot from your talks. I see the effects of insulin resistance pretty much every day. It is a serious topic, and it drives me nuts when I hear what dieticians recommend in terms of a diet to a patient who is getting his toe amputated due to uncontrolled type 2 diabetes. You may guess, it's cereal and wholegrain bread, and strong advice to avoid fat. (Here is another topic for a talk, wholegrain bread!) Educating people on insulin resistance is a very important task, and I commend you on doing that. However, when making statements that have practical value I think it would be worthwhile talking to practitioners in the field. If you are interested to learn about practicalities of weight loss try interview a bodybuilding coach. Bodybuilders are on the extreme end of the weight/fat loss spectrum, and they continuously oscillate between bulking and cutting phases. From what I've seen, these guys have better understanding and give better advice regarding weight loss than most dieticians. More importantly, they deal with people who diet at the extreme while exercising at serious intensities, and this makes them experts at dealing with hunger.

[@mariettesteynbam]

Good day. I believe I have Lipodema although currently undiagnosed. I'm still looking for a doctor (here in Gauteng, South African) to help me because I'm loaded on my life insurance and house insurance for being "overweight" I had Liposuction many years ago on my saddle sacks and thighs. I've also noticed that the fat came back on my knees and tummy 11years later when I had my first child. And now with the 3rd, I've lost 18kg but still have this massive hanging apron. We are planning a 4th child and I'm still considering having the belly liposucked after I finish with breast feeding. I also have a virus in the fat tissue of the belly apron beta hemolytic streptococcus, so I was advised by the doctor to cut it off... But I will first try the Keto diet and get my lifestyle better (back to exercise etc because I was so demotivated for not ever loosing weight before I found out about Lipodema)

[@prccap]

Have you ever been a part of the study’s with using 5-Amino-1MQ to stop the reduction of a persons metabolic rate during fat loss?

[@chaserock4675]

I like this mormon guy.

[@1timbarrett]

Me too. He is my favourite metabolic researcher. 👍

[@kevinorr6880]

Why does his religion matter in your appraisal of him? Weird.

[@LATSRN]

@@kevinorr6880 yes, I didn’t even know he was Mormon but it’s his knowledge I’m interested in! 😊

[@tuyendo7409]

Agree, hunger is always win💙💙

[@Bama_J]

Hey guys

[@ivanardila]

Las células lipídicas son más que tejido, conforman un órgano policéntrico distribuido sabiamente en determinadas zonas de nuestro cuerpo para cumplir funciones precisas, por lo que cuando las eliminas mediante una lipectomía, estás amputando una fracción de él, y deteniendo las funciones que allí realizaba, quizás para siempre, como las endocrinas (sintetizar como dices decenas de hormonas, como la leptina, la progesterona, los estrógenos, ¿puedes mencionar más por favor?), la reposición de energía derivada de las reservas de grasa, la acumulación de desechos de toxinas liposolubles, etcétera... No creo que las células grasas pierdan ácidos grasos, ya que los almacenan. Se saturan, y los ácidos grasos en la sangre no encuentran un lugar de almacenamiento donde ir, por lo que se muestran en la analítica. Por cierto, ¿de qué ácidos grasos estás hablando? Nadie me aclara este punto, y quiero saber su estructura química. Creo que deberías medir después de la cirugía las cantidades de hormonas derivadas del tejido graso ya que estas hormonas no tienen base para volver a producirse. Compruebe las proporciones antes y después. Además, la cantidad de sustancias químicas similares al estrógeno y las respuestas físicas a ellas, porque también las ha limpiado en cierto grado. Como podemos ver, hay aspectos positivos y negativos de la operación.

[@fiddlerJohn]

14:02 "We say the person lost 40 pounds of fat. Yes, by shrinking fat cells, you don't have fat cells dying. You're not killing your fat cells. You're shrinking them now. That is not the same as liposuction. With liposuction you go in and suck out fat firstly. Where does that fat come from? Is it subcutaneous fat? In other words, fat that is stored beneath the skin, or is it visceral fat. In other words fat that is tucked within the abdominal cavity ."

[@marcwest1000]

Hi Ben, do you know literature from which leptin level females are getting infertile ???

[@monnoo8221]

there is no absolute level. Insulin resistance andd leptin levels can end up in a positive feedback, the triggered inflammation and the rate of androgen productino dependent on it are highly individual. But a good point to start is to get hoMA-IR to a value < 1.5

[@tremfilsccsolutions8902]

Cryo lipolysis is good. Elaborate on this specifically

[@sorinelpugna7371]

❤

[@FireGod1111]

24.26 lipoedema

[@onika700]

I think a person would gain more visceral fat after liposuction.

[@beNETiq_ru]

first