The belly is a hot spot for so many patients. Who among us does not want a flatter stomach? With the proliferation of treatment options, both surgical and non-surgical, a smooth, flat abdomen is within everyone’s grasp. Or is it?
Dr. Sean Doherty of Boston, MA begins every abdominal contouring consult with a discussion on the differences between subcutaneous and visceral fat. Liposuction, and the non-surgical SculpSure and CoolSculpting procedures can be quite effective for treating the former, but they do nothing for the latter. Furthermore, visceral fat can be very dangerous to your health. Dr. Doherty discusses how to differentiate between the two as well as the best way to reduce a visceral fat bulge.
Visceral vs. Subcutaneous Fat
Dr. Doherty sees a lot of patients who are concerned about their “belly,” or abdomen. It’s changed over the years, maybe due to pregnancy, weight gain/loss, age or hormone fluctuations. These patients want their stomach restored to a more youthful looking contour. What they are really asking about is abdomen contouring either with liposuction, a tummy tuck, or non-surgical options like SculpSure or CoolSculpting.
It’s critical to experience an honest conversation with a surgeon about the fat in our belly. Abdominal fat is stored in two places: inside our abdominal wall (intra-abdominal, or visceral fat) and outside our abdominal wall (extra-abdominal, or subcutaneous fat). “Our abdominal wall is our muscles, our 6 pack, our core,” explains Dr. Doherty. While it may be more toned in some patients than in others, everyone has an abdominal wall of muscle.
Treating Visceral Fat
Visceral fat is stored on the inside of your abdomen, around important organs such as the intestines, pancreas, colon and gallbladder. We all have visceral fat, but some patients have more of it than others. This kind of fat cannot be treated with body contouring procedures such as liposuction. Visceral fat can only be reduced with diet, exercise and weight loss.
It’s important that when patients see a plastic surgeon wanting to improve their abdominal contour that they understand “what can be done,” explains Dr. Doherty. “If a patient has a lot of visceral fat, I can’t really make a big dent in that with liposuction or non-surgical treatments”.
Determining if You Have Visceral Fat
During an abdominal contouring consultation, the surgeon may have the patient stand up straight, and hold his or her belly in tight. It’s almost as if the patient is doing a vertical plank or abdominal crunch. If there is a substantially large difference in the abdominal contour between holding in the belly and letting it go, then the patient may have a lot of visceral fat. If there is not that big of a difference then the issue is more one of subcutaneous or extra-abdominal fat, and surgical body contouring procedures like liposuction and a tummy tuck can be very effective.
Another easy way to tell the difference between intra-abdominal and extra-abdominal fat is that subcutaneous fat is fat that you can grab. If you have ever stood in front of the mirror grabbing a chunk of your belly and admiring how good your stomach contour looks without it then abdominal body contouring procedures might be an ideal option for you.
Dangers of Visceral Fat
Patients have to understand that if they have a lot of visceral fat, they are not going to get the flat stomach of their dreams with liposuction alone. Your best bet is to lose the excess weight first and then do a body contouring procedure once you are at a maintainable goal weight.
The issue with visceral fat is not just its adverse affect on the aesthetic appearance of your stomach. Excess visceral fat is associated with a myriad of heath issues, such as an increased risk for:
- type 2 diabetes
- heart disease
- colon cancer
- breast cancer
- Alzheimer’s
- hypertension
Treating the Whole Patient
The best chance of a 360° approach to body contouring, as well as a global approach to health, is with a board certified plastic surgeon experienced in these procedures. “It’s important for me to talk to patients about being healthy as a whole person,” explains Doherty. “Certainly, I want them to look and feel good. Aesthetics are a big part of my life. But I’m a doctor first.” It is his responsibility to make sure that his patients remain healthy. If patients have an excess of visceral fat, he may direct them towards a nutritionist or eating program that can help them to lose the extra weight.
Many patients are under the false assumption that body contouring procedures like liposuction are weight loss procedures. They are not. It is vital that patients really comprehend the basics of what any abdominal contouring procedure can and can not achieve. It is up to your plastic surgeon to manage your expectations by making an assessment of your anatomy and then having an honest discussion about what is possible. It is then up to you to take the necessary steps to achieve your goals.