A Special Report is content that is edited and produced by the Special Reports unit within The Irish Times Content Studio. It is supported by advertisers who may contribute to the report, but who do not have editorial control.

Take the weight off . . . your moobs, cankles and double chin

There are some pockets of fat that no amount of exercise or dieting will shift, which is where liposuction comes in

Where a man has a beer belly, it is not going to be amenable to liposuction, but will be reduced via exercise and diet. Photograph: iStock

Where a man has a beer belly, it is not going to be amenable to liposuction, but will be reduced via exercise and diet. Photograph: iStock


If you want to lose weight, your best bet will always be to eat less and move more.

Unfortunately, there are some parts of the body that no amount of dieting or exercise will get to. Step forward that double chin you inherited from your mother, the moobs you got from your dad, and the cankles last seen on Great Aunt Violet.

They’re the elements of your genetic heritage you’d much sooner not have been bequeathed. If you can’t learn to love them, which of course you should, you can at least do something about them – just not by yourself.

“We always recommend any treatment in conjunction with a healthy lifestyle, including exercise and diet, to get to optimum body mass index, for best results,” says Dr Peter Prendergast of Venus Medical, a cosmetic surgery clinic.

He often has to debunk the myth that anyone can automatically lose all forms of fat via liposuction, without the need for healthy eating and exercise at all. Not so. There are some forms of fat, such as visceral fat, which is found around the organs, that liposuction can’t remove.

Where a man has a beer belly, he points out, that is not going to be amenable to liposuction, but will be reduced via exercise and diet.

Where liposuction does work is for subcutaneous fat, which lies just under the skin. What might surprise, however, is that there are some pockets of subcutaneous fat that no amount of exercise is likely to help with. Chief among these, for men at least, are male boobs, or ‘moobs’.

“In fact, when people lose weight, they can become even more visible,” Prendergast says.

Moobs are caused by hormones present during puberty and in about one third of men they don’t go away, he says. “It’s not a pathology, there’s nothing wrong, but it can cause a lot of anxiety for the man, especially if they lose weight in their stomach through exercise, which can make them more pronounced.”

VASER Lipo can potentially sort them out, and the effect can be transformational for men who were self-conscious about them. “Most of the patients we see for moobs are aged between 25 and 55, and are typically the guy who was previously just loath to take off his tee-shirt on the beach.”

Women patients

Among women patients, a common issue Prendergast sees is lipodema, a build-up of fat in the lower half of the body and particularly around calves and ankles which liposuction can help modify. Again, this kind of fat is not amenable to exercise, he says, and if left unresolved may even progress into lymphedema, a more severe swelling.

Equally, no amount of exercise will eliminate cankles, the slang term used where the flesh of calves and ankles merge, but liposuction can.

VASER Liposuction can even work well for very delicate areas such as under the chin, for inherited characteristics such as that little pocket of flesh that refuses to budge, regardless of weight-loss.

Some of Dr Prendergast’s patients come to him for body contouring, such as help sculpting a “six pack”. It might seem trivial, but if you’re a guy who works out daily in the gym, an inability to develop one – the gym goer’s badge of honour – can be dispiriting, he says. But if you’re not genetically predisposed to having one, no amount of crunches will provide it.

Fat is no longer a feminist issue, it seems. When it comes to excess flesh, Venus Medical’s client base is split evenly between men and women. “I think awareness is growing among men. What were taboo issues for men, such as moobs, are now talked about much more and male grooming is huge,” he says.

One of the other misperceptions people may have about liposuction is that the fat will only come back. Not so, Prendergast says. “As an adult, we have a finite number of fat cells. While the remaining ones can enlarge, fat cells don’t multiply so it is a lasting solution,” he says.

Top three fat-removal procedures


One of the best-known fat-removal options is liposuction, a surgical procedure that first breaks up and then ‘sucks’ fat from parts of the body, including the stomach, thighs, bum, neck and chin, as well as the backs of arms, calves and the back. No sedation or general anaesthetic is required.

Documentary maker and already slim Louis Theroux famously underwent lipo on screen, to get rid of his ‘love handles’.

There is a variety of liposuction techniques available. VASER Liposuction is a minimally invasive ultrasound-assisted liposuction used to contour most parts of the body, including not just large areas such as tummy and thighs, but smaller areas such as the chin.

A diluted anaesthetic solution is passed into the fat through tiny incisions and cannulas. Once the area is completely numb, the fat is liquefied, using fine VASER probes which emit ultrasound waves to break down the fat while preserving other tissues such as blood vessels and nerves. The body is contoured and sculpted and the fat, once emulsified, is extracted.

As part of the treatment, you’ll be fitted for a thin compression garment to wear for four weeks under your clothes, to ensure your skin is smooth as it tightens, to reduce swelling and provide comfort.

Tummy tuck

If you have managed to lose significant weight, you can sometimes find yourself left with excess skin, or flab, in your stomach. An abdominoplasty, better known as the tummy tuck, is a cosmetic, surgical procedure aimed at removing this loose skin and tightening the abdominal muscles.

Methods include the insertion of a gastric balloon, a temporary, non-surgical weight-loss device designed for moderately obese people. It partially fills the stomach, giving you a feeling of fullness while restricting the amount you can consume.

The gastric balloon is seen as a temporary solution and is removed after a number of months – typically six months. Used in conjunction with a healthy diet and a modified lifestyle, it can help patients achieve long-term weight-loss which can also, in turn, help improve any obesity related health problems a person may have. It is best suited for people who want to lose 2½ to three stone in weight.

The gastric balloon is placed in a deflated state into your stomach via an endoscopic tube through the mouth and inflated with sterile saline fluid through an external catheter once it is in place. The procedure is not carried out under general anaesthetic – however, the patient is given a mild sedative to help them relax beforehand, and a local anaesthetic to numb the throat.

The procedure takes about 20 minutes and you can usually return home within a couple of hours after the procedure. There are no incisions made to any part of the body.

Gastric band

For people who need more weight loss than this, up to 60 per cent of their excess weight, a gastric band might be suggested. It’s viewed as a longer term solution, and can be in place for up to 15 years.

This procedure involves using keyhole surgery to place a soft silicone ring around the top part of the stomach, to create a two-compartment stomach, with the smaller top part above the band. You eat normally, but feel fuller more quickly, once the top part of the stomach is filled. The food then passes through the opening of the band into the remainder of the stomach, and is digested as normal.

The band can be adjusted – tightened or loosened – in minutes and the surgery itself takes less than 45 minutes to complete, with minimal scarring from very small incisions. It is also fully reversible and, like the gastric balloon, the resulting weight loss may also help if you suffer from other weight-related medical conditions, such as type 2 diabetes or high blood pressure.