Can Liposuction Treat Visceral Fat?

Liposuction has remained one of the most popular cosmetic procedures year after year—and for good reason. It’s a surgical procedure designed to remove stubborn fat pockets that aren't responsive to diet and exercise alone. You work out hard, eat well, but these areas somehow always remain. Common areas that I see in my patient populations are the chin, upper arms, lower abdomen, inner thighs and the flanks. While liposuction is a highly effective tool for reshaping and contouring the body, it has limits. One rather insidious limitation of liposuction is when up against visceral fat, which is your fat layer deep in your abdomen and wrapped around your internal organs and the fat around it, known as ‘visceral fat.’. Understanding and identifying visceral fat can help weed out bad candidates for liposuction surgery, help guide patients to appropriate lifestyle modifications to implement and, and help to set realistic expectations for postoperative plastic surgery results. Let’s dig into it. 

The Basics.

To better understand what liposuction can and cannot do, it bears reviewing how the procedure itself is performed. Liposuction involves making small incisions through which a cannula (a thin, hollow tube) is inserted. The cannula is connected to suction and is moved back and forth to dislodge and remove fat. There are several variations including ultrasound-assisted and  laser-assisted, but the common goal is to target subcutaneous fat, which sits just below the skin.

What’s the Deal with Visceral Fat? 

So what is visceral fat and how is it different from other layers of fat? Truth be told, there are numerous, distinct layers of fat distributed throughout the anatomic layers of the human body, much of which is beyond the scope of this blog post. For the sake of simplicity, let’s break it down into two layers: 

• Subcutaneous fat is the soft, squishy stuff you can pinch with your fingers. It lives just under your skin. That’s the fat we’re targeting with liposuction.

• Visceral fat, on the other hand, is the deep, firm fat that surrounds your internal organs. It lives underneath your abdominal muscles, wrapped around things like your liver, intestines, and pancreas.

Visceral fat isn’t just stubborn—it’s sneaky. It’s not the kind you can pinch or see bulging under your shirt. It’s often associated with a firm, protruding abdomen, accumulates with age, and is linked to a higher risk of metabolic conditions like type 2 diabetes, heart disease, and high cholesterol. In my plastic surgery practice, I tend to see the highest levels of this in my menopausal and post-menopausal patients, where decreasing levels of estrogen results in deposition of fat around the abdominal viscera (i.e. abdominal organs).

Subcutaneous fat, on the other hand,  is the layer that can be easily targeted with liposuction because it is located just underneath the skin. Anything deeper– under muscles or, in this case, inside the abdominal cavity– cannot be removed with liposuction. In fact, piercing the abdominal cavity with a liposuction cannula is one of the most dangerous complications that can occur with liposuction and one very good reason to choose a highly skilled, appropriately educated provider. 

If Not Liposuction, Then What? 

The good news is that there are ways to reduce visceral fat, but it will require some work on your end. 

• Nutrition: Reducing processed foods, added sugars, and saturated fats while focusing on foods, lean proteins, veggies, and healthy fats can significantly decrease visceral fat over time.

• Exercise: Both cardio and strength training are key. Visceral fat is especially responsive to aerobic activity (walking, jogging, swimming, cycling), but don’t discount the power of lifting weights.

• Sleep and stress management: Chronic stress and poor sleep both raise cortisol levels, which can contribute to visceral fat accumulation. Prioritizing rest and mental health is more than just a wellness cliché—it’s science-backed strategy.

Unlike subcutaneous fat, visceral fat is metabolically active. That means your body will tap into it as an energy source when you’re in a calorie deficit and living an active lifestyle. While your motivation to lose visceral fat may be with plastic surgery results in mind, the end result is a win-win for your overall health, longevity and well being. 

How Visceral Fat Affects Your Results.

The overarching point of understanding and identifying visceral fat for the sake of plastic surgery is because the presence of visceral fat can and will obscure good plastic surgery results.  Abdominal visceral fat pads the organs and produces a bulging appearance to the abdomen. Oftentimes, patients mis-attribute this bulging as originating solely from their loose skin or thick layer of subcutaneous mat, misleading them into thinking that procedures such as a tummy tuck or liposuction will create a flat abdomen. In reality, while these procedures will contour the abdomen and tighten the abdominal skin, patients will still be left with an abdominal wall that protrudes out. For many patients and plastic surgeons alike, this result feels subpar considering the major financial and time commitments that patients undertake in order to obtain plastic surgery and to recover from it. 

So, Who Is a Candidate For Liposuction? 

This is a nuanced topic. There’s no specific number on the scale or body type that either automatically qualifies or disqualifies you. While we do have safety parameters such as BMI restrictions, below are the factors I consider as a Plastic Surgeon when evaluating who may be a good candidate for liposuction: 

• Close to or at THEIR goal weight (I specify ‘their’ because a BMI scale or what I determine is a good goal weight for you is often irrelevant).

• No significant visceral fat if considering an abdominal procedure (i.e. liposuction alone or tummy tuck).

• Already has a healthy lifestyle implemented in order to maintain results post liposuction. 

• Has stubborn, subcutaneous fat pockets that are resistant to weight changes. 

• Someone who has realistic expectations. 

• Someone who is not looking for liposuction as a weight loss procedure (is is NOT).

In Conclusion.

Long story long– visceral fat cannot be removed with liposuction and patients who have a significant amount of it will often be left disappointed if liposuction or a tummy tuck alone are performed. During your consultation, we will discuss your anatomy and realistic goals based on it.  One of the most important parts of my job as a Plastic Surgeon is helping all my patients understand what any plastic surgery procedure can and can’t do.

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Dr. Megan Dreveskracht is a Female Plastic Surgeon in Seattle, Washington who specializes in Aesthetic Surgeries of the Breast, Body & Face. To schedule your consultation, call 206.860.5582 or fill out a contact form here.