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Mayo Clinic Q&A: a close look at liposuction; reducing dementia risk

iStockphoto Close up of senior woman's hand putting together puzzle.

ONCE THE FAT CELLS ARE GONE, THEYíRE GONE, BUT ...

How long are the effects of liposuction supposed to last, and how does it affect the skin around it? Is it true that if you get liposuction in one area of the body, the fat will eventually move to another area?

Liposuction is a permanent removal of fat cells. But getting liposuction doesnít guarantee permanently stable weight over time. You can still gain and lose weight. Although the fat cells do not move, if you gain weight after you have liposuction, other areas of your body unaffected by the procedure may get bigger than they did with previous weight gains.

The medical term for liposuction is suction-assisted lipectomy. This surgical procedure removes fatty deposits in specific areas of the body, such as the abdomen, hips, thighs, arms or neck. As adults, we have a fixed number of fat cells in our bodies that grow and shrink as we gain or lose weight. The number of fat cells themselves is stable. This means that the removal of fatty deposits ó and the fat cells that make up the deposit ó is permanent, and it has a permanent effect.

Liposuction can affect how the skin looks in the area where itís done. For example, if you have dimples in that area, they may get worse after liposuction. Even if you donít have any noticeable abnormalities or dimples on your skin before the procedure, some may appear as a result of liposuction. Liposuction doesnít improve the look of skin irregularities such as stretch marks.

After liposuction, skin molds to the new contours of the treated areas. Some areas of skin shrink to fit the new volume of fat in that area better than others, and that can affect the skinís appearance, too. If you have good skin tone and elasticity, your skin is likely to appear smooth. If your skin is thin with poor elasticity, however, skin in treated areas might appear loose.

Before you have liposuction, itís important that you undergo a thorough evaluation, including a careful assessment of your skinís quality and appearance in the area where youíd like to have liposuction, with a board-certified plastic surgeon who is trained and experienced in liposuction. Based on results of that evaluation, the surgeon can give you a better idea of how the procedure may affect your skin.

If you gain weight after you have liposuction, the way your body stores the fat and the fatís distribution throughout your body will be different than before. Fat cells do not regenerate in the area where liposuction is done, and nor do they move to another area of the body. But, because there are a limited number of fat cells where your body can store new fat, if you gain weight, some areas may get bigger than during previous weight gain, therefore giving an appearance of the fat moving.

Keep in mind that liposuction is a cosmetic procedure intended to improve the look of certain areas of the body. It isnít designed to be used as a method for weight loss or as an alternative to healthy weight-loss strategies, such as regular exercise and a healthy diet.

Finally, be cautious about the provider you consult regarding liposuction. Some facilities offer liposuction and other cosmetic procedures without the oversight of a credentialed physician. Avoid them. If youíre considering liposuction, your best option is to work with a board-certified plastic surgeon at a reputable health care organization.

Alanna Rebecca, M.D., Plastic and Reconstructive Surgery, Mayo Clinic, Scottsdale, Ariz.e_SClBSTAY ENGAGED OVER A LIFETIME TO REDUCE DEMENTIA RISK

Do puzzles and other activities or apps that claim to lower oneís risk of developing dementia actually work? Are there other things people can do to decrease the risk?

Doing activities that stimulate your brain may reduce your risk of developing dementia. But itís more complex than taking up puzzles or computer games at age 65. Research suggests that the value of cognitively stimulating activities builds up over a lifetime. That means acquiring a good education; working in a job that is mentally stimulating; and engaging in pastimes, hobbies and social activities that are mentally engaging are all part of reducing your risk for developing dementia.

For example, studies have shown that the more years of education a person has, the lower the dementia risk. This appears to be because people who spend more time engaged in learning across their lifetimes tend to develop more robust networks of nerve cells and connections between those nerve cells within their brains. Those networks are better equipped to handle the cell damage that can happen as a result of brain disorders that may lead to dementia.

Before continuing, it would be wise to define "dementia." Dementia describes symptoms that affect a personís memory, thinking and social abilities to the point that itís difficult to perform normal daily activities. Dementia is caused by brain disease. Alzheimerís disease is the most common and one of the most well-known. Diseases that affect the blood vessels ó the same diseases that cause heart attacks and stroke ó are the second most common cause of dementia.

So, in addition to participating in activities that are mentally engaging, avoiding conditions that increase heart attacks and strokes also reduces your risk of dementia. Maintaining healthy levels of cholesterol and blood pressure, avoiding diabetes, not smoking, staying at a healthy weight and exercising regularly all have been shown to improve cognitive health later in life. Again, however, itís best if you make them components of a healthy lifestyle in your younger years and sustain them as you get older. Thatís because all of them affect the health of the blood vessels in your brain.

If your brain blood vessels stay in good condition throughout your young adulthood and midlife, they are more likely to be able to remain healthy as you age. If the health of those blood vessels deteriorates when you are younger, itís difficult to mend the damage later. And damage to the brainís blood vessels can be a factor in dementia.

This is not to say that incorporating healthy choices into your lifestyle if you are older wonít make any difference. They can positively affect your cognitive and physical health. But to gain the most benefit for your brain, itís best to have them in place as soon as possible.

Social interaction is an area where anyone can make a change at any time, and it will likely have positive cognitive benefits. Regularly interacting with others ó family, friends, neighbors, co-workers, community members ó can lift your mood, improve your outlook and engage your brain. All of these positively affect your cognitive abilities, and being socially engaged has been shown to ease symptoms of dementia.

David Knopman, M.D., Neurology, Mayo Clinic, Rochester, Minn.

Mayo Clinic Q & A is an educational resource and doesnít replace regular medical care. Email a question to MayoClinicQ&A@mayo.edu. For more information, visit mayoclinic.org. © 2017 Mayo Foundation for Medical Education and Research. Distributed by Tribune Content Agency, LLC. All rights reserved.