Where Does the Fat Go After Cosmetic Procedures?

The Freezer

Using a paddle-like suction applicator that draws in skin and fat, CoolSculpting freezes excess fat cells, causing them to crystallize. Over a period of two months, these crystallized cells die, which stimulates the immune system to send out enzymes to break down the dying cells. “The crystallized fat cells are no longer viable cells. They undergo a programmed cell death called apoptosis and are slowly eliminated from the body through the natural metabolic process,” says Raleigh, NC, plastic surgeon Cynthia Diehl, MD. “The results are permanent. The fat cells that are removed are gone forever and can no longer shrink and expand with weight gain or loss.”  

The Injection

Kybella is a deoxycholic acid injection used for contouring and improving the appearance of fatty tissue located under the chin, commonly referred to as a double chin. Deoxycholic acid is a naturally occurring molecule in the body that aids in the breakdown and absorption of dietary fat. “Kybella works almost immediately after injection in that it literally digests fat once it comes in contact with it. The fat cells are broken down and cleared out by the natural immune system and ultimately end up in your urine,” says Vero Beach, FL, plastic surgeon Alan Durkin, MD. “Studies have shown excellent results and there is strong evidence to suggest that the effect is completely permanent.” 

The Melter

Vanquish is a body-contouring device that uses focused radio-frequency waves to heat and break down fat cells. Using an applicator that is suspended an inch over the abdomen or thighs, the device emits radio-frequency waves to target fat cells, heating them up enough to cause cell death without damage to the surrounding skin or muscle. Like Kybella and CoolSculpting, over time the cells are removed via the lymphatic system, metabolized in the liver and expelled through urine. Although it may take up to six weeks to see results, they are permanent. 

The Vacuum

Considered the gold standard for eliminating stubborn fat, liposuction is the traditional method of surgical fat removal. A small incision is made underneath the skin and a tube called a cannula is used to mechanically vacuum the fat from the target area. “The fat is literally sucked out. Any fat that remains is damaged fat that will not survive and will ultimately be removed by your immune system. The fat cell contents are then eliminated in your urine over a number of days following the procedure,” says Dr. Durkin. “It’s very unlikely that fat will return to this area. Weight gain can only occur in viable fat cells. Once the cells are removed, they cannot re-store fat.”