The body mass index (the previous name Quetelet Index) was developed by Belgian astronomer, mathematician, sociologist and statistician Lambert Adolphe Jacques Quetelet about 200 years ago. In order to count your BMI, you should divide your weight in kilograms by the square of your height in meters or you can use the online BMI calculator. The normal range of BMI varies from 18.50 to 24.99 (Tab. 1). This index shows the risk of certain diseases and is used for evaluation of patients before surgical procedure (for example, liposuction). However, there is a gap in calculating the BMI for a person who has a lot of muscles. Although such person has an excess weight, the body mass is mostly composed of lean muscles and not of fat. In this case, the BMI equal to 25 or higher does not show overweight or obesity.
|Moderate thinness||16.00 – 16.99|
|Mild thinness||17.00 – 18.49|
|Normal range||18.50 – 24.99|
|Pre-obese||25.00 – 29.99|
|Obese class I||30.00 – 34.99|
|Obese class II||35.00 – 39.99|
|Obese class III||≥40.00|
Liposuction is an aesthetic procedure designed to change your body shape but not to achieve weight loss. The goal of this procedure is to safely remove the excessive fat from certain areas of your body. Therefore you should not expect a dramatic weight loss effect after liposuction (bariatric surgery is designed for this goal). In addition, the best candidates for liposuction are patients who are close to their normal weight. Meanwhile, obese people (whose BMI is high) are considered to be poor candidates for this procedure because results are usually not very satisfying and the complication rate is higher.
As mentioned earlier, liposuction is not the best option for people with high BMI. According to the standard guidelines of liposuction, a safe amount of fat removed during liposuction should not exceed 5.000 mL in a single procedure. 5.000 mL of fat is equal to about 11 pounds (or 5 kilograms). So, if your BMI is high and you have for example 44 pounds (or 20 kg) of excessive weight, the loss of this amount of fat will probably be barely noticeable and the result will not satisfy you.
Also obese people are considered to be poor candidates for liposuction because other diseases accompany their high BMI, for instance, diabetes, high blood pressure, heart disease and higher risk of stroke make the surgery more risky and complicated.
A removal of more than 5.000 mL of total fluids is called the large volume liposuction. These fluids include fat, wetting solution (a mixture of saline, adrenaline and local anaesthetic) and blood. The large volume procedure is more complicated and physiologically different as compared to conventional liposuction. Moreover, the candidate for this procedure is a person who has excessive fat but is overall healthy.
The harm-benefit ratio of the large volume liposuction is disputable. This procedure is accompanied with a high risk of serious complications and mortality. The major complications are mostly related to the changes of fluid balance or damage to the circulation and include necrosis of the skin or underlying tissue, severe bleeding, pulmonary embolus, deep vein thrombosis, hypovolemic shock, unplanned blood transfusion, fat embolus and death.
There are also minor complications which include contour irregularities, seromas, complicated wound healing accompanied with prolonged swelling and scar formation and changes in sensation of the operated area. Additionally, skin elasticity issues are common after the removal of large volume of fat.
If you are considering losing weight with an assistance of surgery, you should choose bariatric surgery. This is a weight loss surgery that includes various procedures such as gastric bypass, gastric sleeve, gastric band and gastric balloon. Consult your doctor to choose the best option for you.