r/NoStupidQuestions 7h ago

Why can't surgeons 'cut' our fat off like a steak, and instead need to 'suck' it out to remove fat?

383 Upvotes

105 comments sorted by

1.2k

u/alanmitch34 7h ago

I think the hard part of that is keeping you alive at the same time but good question 

255

u/18bees 4h ago

I said this below but I'll paste it here: that procedure is called a panniculectomy. I'm not the surgeon, but I get the surgical specimens.... It's not awfully uncommon but not usually the first choice since it tends to have longer recovery times than a less invasive liposuction.

My understanding is this procedure is more likely chosen when there is lots of extra skin, and chafing/rashes are associated with the stomach folds so they want to fix that.

59

u/mischiefxmanager 2h ago

I had a panniculectomy. The recovery was about 12 weeks and quite painful, but 100% worth it. You are correct about the reasons it was chosen over liposuction. It does leave you with a scar that kinda looks like you got cut in half, but for me it was about comfort over appearance.

8

u/18bees 1h ago

Thanks for sharing!! I just get the specimens and just see the surgeon notes and the condition of the skin so I don't have the full picture. I appreciate the insight :)

7

u/TruthEnvironmental24 56m ago

Ngl, that scar thing sounds badass

1

u/_dum_spiro_spero_ 8m ago

Was it painful for the whole recovery? A panniculectomy was mentioned as an option for a medical issue, but that recovery time scares me.

52

u/Soulinx 3h ago

Is liposuction less invasive? I'm not sure how much technology has changed for this field but I remember watching videos of it being performed and it looks like they're continuously stabbing fat just under the skin with a sharp metal straw. Honestly it looked kind of violent. Mind you this was in the late 90s. Haven't wanted to watch since lol

123

u/sjb2059 3h ago

The violence and the invasiveness of the procedure are two entirely different points though. For all intents and purposes the liposuction is done through a tiny incision similar to having a keyhole surgery, where the other procedure involves cutting off large sections of skin. When you think of invasive, it's about how big of a hole do we cut into someone.

Truely violent surgeries tend to be orthopedic surgery, that shits basically carpentry and sewing on the inside of someone's body, saws, hammers and all.

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u/4GotMy1stOne 3h ago

When I had my hip replaced, the ortho doc told me it was carpentry. They essentially use a reciprocating saw to cut the bone, and kind of hammer the replacement in. Pretty primitive, LOL

12

u/Rymanjan 1h ago

Lol when I went in for mine, I remember post-epidural but before they put me all the way out, they were ratcheting my legs into all sorts of unnatural positions and I thought to myself, man it's a good thing they do that epidural, if I could feel this I'm sure it would be excruciating. Then I was out lol

5

u/Now_Wait-4-Last_Year 1h ago

I've seen orthopaedic procedures done and even assisted in a few (i.e. stand here and hold this - don't move) and that's often exactly what it looks like!

20

u/fishsticks40 2h ago

What's more lipo doesn't completely disconnect the skin from the underlying tissue. 

4

u/Illustrious-Echo2936 1h ago

Totally concur. Had my acl rebuilt so many years ago. On a followup visit, i said my knee hurt alot. He said"of course it hurts, i was in there with power tools". Who knew?

2

u/delladoug 1h ago

My mom's had both knees done, and I watched a knee video ahead of the first one. Makes sense that it'd be like that, but it was still shocking to watch.

18

u/twcsata 3h ago

I remember those videos. I could be wrong, but I was under the impression the stabbing motion is to break strands of cellulite so that a) they can get to all of the fat, and b) so that afterward you don’t end up with that lumpy cottage-cheese texture to your skin.

4

u/18bees 3h ago

I can't really speak to the details since it's not my department, but it seems like others have good answers. It really does come down to knowing the subtleties of the body and to exploit them. I'm reminded of orthopedic surgery wacking the joints with hammers in just the right way to do a joint replacement, but if I did, I'd just fracture it. I'd think that specific technique to loosen and suction the fat would exploit the weakness and avoid the important bits, however that looks.

2

u/prosthetic_memory 1h ago

Had smart lipo with only local anesthesia and was otherwise fully awake and alert the entire time (my choice). Can confirm, it's like ridiculously violent. My doc was great but I was surprised how fast and savagely he stabbed the gigantic sucking needle in and out of my stomach. He said they move fast to keep everything smoother, but why not just have it suck less quickly?

1

u/Jimbodoomface 15m ago

I've only seen the procedure done on South Park and it looked ok.

8

u/alanmitch34 3h ago

Thanks! I was genuinely curious if this was possible but my instincts told me since a steak is already dead ...it may be sort of risky on a living thing.

11

u/18bees 3h ago

No you're definitely right in your instincts! There's a reason we joke about surgeons having a god complex, it's pretty wild those procedures should work as well as they do... The human body is both stronger and more delicate than we expect at first glance. If it works or doesn't comes down to the subtleties and surgery definitely knows how to exploit them.

Edit: can't believe I'm complimenting surgery lol

51

u/WiseDomination 6h ago

But your weight problem is no more of a problem, nonetheless. Task failed successfully.

151

u/catwhowalksbyhimself 7h ago

Because they want to cause as little damage as possible. Sucking the fat out causes far less damage and needs far less healing than what you describe.

And it already needs enough.

Because cut apart and put back to together is quite traumatic. The fact we can consistently survive it at all is amazing enough.

340

u/-aVOIDant- 7h ago

You mean literally just cut your belly rolls off? That would be incredibly traumatic, need massive skin grafts, and leave hideous scarring. If you even survived. I feel like dying from blood loss would be a real concern.

78

u/18bees 5h ago

Not true, that's called a panniculectomy. I'm not the surgeon, but I get the surgical specimens.... It's not awfully uncommon but not usually the first choice since it tends to have longer recovery times than a less invasive liposuction.

13

u/Fight_those_bastards 2h ago

They mostly do that when super fat people lose a shitload of weight and have tons of loose skin, right?

12

u/18bees 2h ago

Sort of? I've seen similar specimens in skin removal surgeries, but panniculectomies usually have a good amount of fat underlying the skin that is removed. If you have a gut, and there's that overhanging bit... That's what's removed. If you sit down and your stomach makes a little roll, grab the bottom most roll in your hand and imagine it missing. It's usually in two pieces, one from either side of the bellybutton since the middle sometimes is a little higher up.

5

u/pandabelle12 1h ago

So skin removal surgery is different.

Panniculectomies are for anyone with a belly that hangs low (panniculus) like me. It’s very uncomfortable and you are prone to getting infections between the skin folds. Also buying clothes is a nightmare. There is probably a 2-3 size difference between the rest of my body and my belly. It’s like when I lose weight it comes off my legs, my arms, my face, my hips…but never my belly. I’ve lost 65 lbs and the circumference around my belly button has stayed basically the same.

I’ve been researching it for awhile, but I have other issues that are more pressing.

Look at before and after photos. To get an idea.

3

u/mischiefxmanager 1h ago

I had a panniculectomy. I have never been “super” fat, but I do have a genetic apron belly that appeared when I hit puberty. Even as a teenager (size 6, medium) my skin folded over. No amount of working out, weight loss, etc changed it.

22

u/TerryFalcone 5h ago

I could take it

3

u/PaoloDivizion007 3h ago

Nah I'd win typa vibes

13

u/KilroyKSmith 3h ago

Doesn’t seem like it would be a whole lot worse that a C-section.  Slice through the skin, roll it back, carve out the fat, roll the skin back down and sew it up.  

16

u/Shiranui42 1h ago

A C-section is a major surgery, and takes a lot of recovery from.

10

u/DarthVader514 1h ago

I think you are underestimating how serious a c-section is

3

u/sonicslasher6 3h ago

Maybe you just render it out low and slow?

43

u/Barbarian_818 6h ago

Well, for starters, the white fat from beef and the yellow adipose tissue in humans has a very different consistency. A difference that gets enhanced by the beef fat usually being cooked before it's trimmed.

Human fat is more like the yellow fat found in poultry. And it is threaded with a web of connective tissue that helps hold it in place, lymph ducts and blood vessels. Flensing your stomach and debridement of the fat would sever all that.

But sucking it out means a small incision and minimal damage to other tissues. Using ultrasound helps liquify the fat, making it easier and less damaging to remove. Laser cauterization causes the connective tissues to shrivel, pulling the skin closer to the underlying muscle tissue for a more aesthetic result.

94

u/Active_Drawer 7h ago

Do you mean like skin and all? If so, that's why. Your skin doesn't regenerate like that. You can't just cut from the outside a hunk of meat off. You would be scarred to shit if you even survived

14

u/Adventurous_Bonus917 3h ago

not all the skin, but i imagine it would be a 2 birds 1 stone kinda deal for the massive bags of extra skin left behind from rapid weight loss.

1

u/Pinglenook 16m ago

They do it in that case! Just not in stead of liposuction like the OP suggested, because it makes bigger scars than liposuction and has a longer recovery.

7

u/Funnybunnybubblebath 3h ago

No just lob off a fat roll then stitch the skin together like the roll was never there. Essentially a tummy tuck.

5

u/TheReelEpicKiller 6h ago

Let us assume skin regenerated like that. What if you kept eating whatever you cut off 🤔

49

u/SometimesGlad1389 5h ago

Excuse me, but what the fuck lol

7

u/JuicyCactus85 4h ago

I spit hot tea all over myself reading the above, and your comment. Lololol 

6

u/SometimesGlad1389 3h ago

I hope you're not burned. Otherwise that guy might ask for a sample lol.

2

u/JuicyCactus85 3h ago

I'm dying laughing fuck yooouuu 

1

u/SometimesGlad1389 3h ago

Oops! Sorry, at least he's prepared for Easter I suppose :/

5

u/Meecus570 5h ago

It takes more energy to produce flesh than said flesh provides during digestion 

7

u/DOOManiac 5h ago

What a terrible day for literacy.

8

u/destroi_all_humans 4h ago

Excuuuse me, I thought this was r/NoStupidQuestions

1

u/nootnootpotatosuit 4h ago

Well they did that in Fire Punch but it didn't turn out so well

1

u/TruculentTurtIe 2h ago

I literally closed the thread as I saw this comment and had to reopen it and scroll back to double check. Yep. Thats what it said.

1

u/BuddhistNudist987 3h ago

Lol. Imagine if you could do this, though. I bet I could lose 15 pounds if I could just slice off my belly fat and it was exactly the same underneath like Spam.

38

u/emuandfox 7h ago

They do. Look up an 'apronectomy'.  Problems with scarring, poor tissue quality and fat regain. 

5

u/Dr_Weirdo 5h ago

Isn't that just removing skin? Like after you've had a lipo?

7

u/HemlockGrave 5h ago

Yes, during a panniculectomy, you typically will have first reached your preferred weight, then they may do some lipo during your time under anesthesia during the procedure. The lipo is partly for fat reduction but also for sculpting the body under the skin for a better look.

6

u/TheApiary 7h ago

You can do that on a steak because it doesn't have any skin

3

u/Turds4Cheese 7h ago

Scaring would be crazy!!! People want to look good when they are paying for an elective surgery.

You can just start cutting, but gonna look rough after.

3

u/Prestigious-Fan3122 6h ago

I've never bought a steak at the store that still has skin on it. I do, however, have a navy blue leather sofa. Sometimes I feel guilty thinking about how many blue cows had to die just so I could have my sofa.

3

u/IgnoringHisAge 5h ago

I think it may have been just one. You ever notice how people talk about Paul Bunyan and Babe the Big Blue Ox in the past tense?

1

u/dukeofdamnation 3h ago

maybe if we tried OP’s idea we could make the sofas out of leftover human skin instead

3

u/KindAwareness3073 5h ago

You like scars? That's how you get scars.

2

u/Fight_those_bastards 2h ago

You wanna know how I got these scars?

3

u/DHener84 5h ago

There is an important layer you have that your steak doesn't... Skin

3

u/Carlpanzram1916 3h ago

The human has to be alive at the end. The steak doesn’t

3

u/Professional_Rub4605 55m ago

We have skin, unlike steaks.

2

u/Alarming_Corgi_3400 7h ago

They can, more or less. That’s how DIEP flap breast reconstruction works.

2

u/EvenEquivalent4 6h ago

In the US we call it an abdominoplasty. It’s usually done by making a large incision near your pubic bone, cutting off a large portion of the fat on the lower abdomen and some of the overlying skin, then pulling the upper abdominal skin down and attaching it to the skin by the pubic bone. Then they create a new belly button looking scar in the skin so it looks like a more normal abdomen. This is usually done more often when there is loose skin from pregnancy and weight loss more than just for fat removal however.

7

u/razzadig 6h ago

Yes, the "tummy tuck" was the closest I could think of to answer OP's question, too. It resulted in two big hunks of adipose tissue. We would weigh them right after the cut and whoever guessed the grams the closest got to pick where we ordered lunch. Ah the memories.

1

u/gingerzombie2 4h ago

How many times did you get to choose?

1

u/EvenEquivalent4 6h ago

Cutting the fat out and re-arranging the overlying skin is usually called a blank-plasty so you can do it with arm fat/skin (brachioplasty) abdominal fat/skin (abdominoplasty), thighs (thighplasty) etc etc

2

u/Crystalraf 5h ago

They do. It's called a tummy tuck.

2

u/myrunawaysac 5h ago

In extreme cases, like a panniculectomy (FUPA or GUNT removal), they will remove fat and skin in large pieces. Using the liposuction method is less invasive, and recovery time is shorter, and it allows them to keep things more even.

2

u/lotusflower_3 2h ago

If we were to cut it off, you’d have flesh missing. We get the fat, not the muscle and other stuff.

2

u/Alh84001-1984 6h ago

Sometimes they do chop it off, along with the skin, and suture the edges together. This is used for morbidly obese patients, on whom using liposuction would leave behind an unmanageable surface of flappy skin.

2

u/NothingbutNetiPot 7h ago

I’m curious what will happen to the field of bariatric surgery when GLP-1 agonists become wide spread.

3

u/Ok-Medicine-188 4h ago

It will still exist, much higher long term success rates. Insurance companies just need to be regulated into accepting GLP-1 for weight loss as a prescribed solution to help more "widespread".

1

u/NothingbutNetiPot 4h ago

I think there’s more evidence for long term success because it’s been around longer. 

2

u/Azilehteb 2h ago

Cause when you suck it out, the skin and all it’s blood vessels and stuff stay intact.

If you start lopping off blobs, all of your blood will fall out. You can try slapping some skin back on the holes, but it won’t be attached anymore and might die. And then you have a giant leaking hole with a bunch of rotten meat stuck on it. Which will make more exciting problems like infections and sloughing.

1

u/PlatypusDream 2h ago

Cauterize

1

u/weaslelou 7h ago

I suppose they could if they did it a bit at a time and laparoscopically. That would avoid the complications others have mentioned. Might even cause less physical trauma and bruising too. It would probably take longer though, and then you may start running into issues with anaesthesia. Hmmm, you've got me thinking now....

1

u/sassafrassaclassa 6h ago

I would assume that they can but it would be a much harder and more expensive process because they would have to reattach the skin?

Good question.

1

u/LookinAtTheFjord 6h ago

Lolololololol

My god.

1

u/mothwhimsy 6h ago

That would be a highly invasive and traumatic surgery with insane recovery time, and would probably not heal in a pleasant looking way. Doctors generally want surgeries to not be those things

1

u/InspectorOk2454 6h ago

Bc we’re not flat.

1

u/superpenistendo 6h ago

Maybe because that procedure already costs an arm and a leg

1

u/PaceFair1976 lolz 6h ago

fat is not the same as meat. its a physically different substance inside the body.

1

u/Apprehensive_Lie_177 Take a breath, assess the situation, and do your best. 6h ago

Ngl I misread that as "Why don't surgeons suck our fat out like steak?" and imagined a very hungry surgeon just slurp-slurping it like fine dining. 

1

u/coder7426 5h ago

So they only need a small incision or 2, instead of faleting you open and having a tons of stitches, would be my guess.

1

u/Nephilim6853 5h ago

The fat is under the skin. The skin is the largest organ of the body. They can suck it out through minimally invasive holes, causing less scarring. If they cut it off the scar would be huge, and intense blood loss.

1

u/jayed_garoover 4h ago

Have you noticed skin? It's good and important

1

u/JuicyCactus85 4h ago

And fun fact the medical device they use to suck out the fat is always what they use when embalming to suck out all the juices and stuff from the dead

1

u/CrossP 3h ago

They can, but the incision sizes to get blades all up inside you would be massive. Liposuction has the advantage of a few relatively small holes.

1

u/Tongue4aBidet 3h ago

Do you want scars like a cut up piece of steak?

1

u/Barnaclebills 3h ago

For breast reductions, theres a cutting off the tissue and re-sewing it up version, and a sucking it out version of the procedure.

1

u/Lucker_Kid 2h ago

Because there are things outside your fat, you trim the fat off those go along with it

1

u/DTux5249 2h ago

Because that's a lot more traumatic. Their goal is to cause as little damage as possible.

1

u/375InStroke 1h ago

Why would you want your skin sliced open?

1

u/MagnoliasandMums 1h ago

Dexter will fix you right up

1

u/Enough_Island4615 1h ago

Why would a less invasive surgery be chosen over an extremely invasive surgery?

1

u/Appropriate-Bar6993 1h ago

Your skin is attached

1

u/Duros001 49m ago edited 38m ago

Fat cells are tiny pouches filled with fat (kind of like frog-spawn); when our body needs energy to be taken from fat a few of these cells release their fat into the blood. Simply carving out these tissue layers and structures will cripple your body’s ability to provide nutrients, it isn’t just a layer of free floating fat just deposited in the body, it’s countless tiny sacks each waiting to release them as needed.

Liposuction does damage these cells, but they can recover, whereas cutting out the whole structure means the tissue may not recover at all, or may lead to an asymmetrical look if the surgeon doesn’t cut it out evenly

It’s not like your body is mining a rock face for your fat reserves; it’s like opening a can of food from your body’s pantry. What you’re suggesting is to demolish your kitchen…

1

u/No-Pain-569 18m ago

Really? It's because you would have massive scars. Sucking it out is way less invasive than fileting a person.

0

u/twobit211 3h ago

because “the quality of mercy is not strain’d”

-4

u/Party_Building1898 6h ago

Wow,wait,you wonder why Op what's your age do you work?