Liposuction is not a sure fire route to weight loss, US scientists have warned.
Following a healthy lifestyle helps keep clothing size down
Those who view it as a quick fix and a ticket to binge are mistaken and likely to put weight back on, they said.
In a study of 200 patients, reported in the American Society of Plastic Surgery journal, nearly half gained weight after liposuction.
It is important to follow a healthy diet and do regular exercise to ensure the weight stays off, the University of Texas researchers said.
No quick fix
Lead author and plastic surgeon Dr Rod Rohrich said: "If patients want positive long-term results from liposuction, they have to be willing to eat a proper diet and exercise.
"Ultimately, it's a lifestyle choice.
"Liposuction should be used as an adjunct to living a healthy life rather than as a weight loss tool."
He said he turned away about one in five patients requesting liposuction because they were not suitable candidates.
In the study, his team followed up 200 people who had undergone liposuction.
After six months, 43% had gained weight, 25% had lost weight and 32% had experienced no change in weight.
Not only were those with poor eating and exercise habits more likely to gain weight after liposuction, those who did gain weight had a 62% chance of going up in clothing size.
This dress size gain made them 10 times more likely to be unhappy with their surgery results as other patients who followed a healthy lifestyle after their liposuction.
In comparison, those who exercised regularly and ate healthy foods were two times more likely to lose weight, had a 96% chance of going down in clothing size and were 15 times more likely to be satisfied with their surgery outcomes.
Dr Rohrich said: "This is especially important to remember as we approach the holiday season when people are invited to more parties and social activities where diet and exercise may be overlooked."
Dr David Haslam, chairman of the National Obesity Forum, said liposuction was not an obesity treatment, rather purely a cosmetic procedure.
"All it does is take away the subcutaneous fat under the skin, where as the dangerous fat is deep inside our abdomens wrapped around our bowels.
"It would be completely outrageous for people to overindulge during the holiday season just because they think they are going to have the answer by liposuction afterwards.
"The best way to treat obesity and being over weight is by lifestyle changes - eating more healthily and exercising.
"We probably all eat too much on Christmas Day. Bearing that in mind, the answer is to do more exercise and walk it off, and try to avoid too much fatty food such as clotted cream."