Metabolic response to localized surgical fat removal in nonobese women

Abstract

Although suction lipectomy and dermolipectomy are common surgical procedures, the body's response to localized removal of fat and the long-term efficacy of these procedures remain controversial. Seven women who underwent liposuction or abdominoplasty were studied prior to surgery and between one and two months postoperatively. All patients were weight-stable prior to surgery and the reported daily food intake and nutrient composition of the diet did not change. The following parameters were measured: resting oxygen uptake (VO2), glucose-induced increment in VO2, anthropometry, and site-specific fat cell size. Fat samples were taken by needle aspiration from abdominal and femoral regions. Resting energy expenditure and the response to glucose feeding were not significantly different postoperatively. Furthermore, site-specific fat cell size did not change, nor were there any significant differences in the sum of four skinfold thicknesses. These results suggest that energy balance was not altered as a result of localized fat removal in previously weight-stable women. Thus, short-term follow-up suggests that surgical fat removal does not result in a compensatory change in metabolic efficiency or fat cell size and distribution in these weight-stable women. Therefore, this technique may prove effective for body contouring in nonobese women.

Lower body adipose tissue removal decreases glucose tolerance and insulin sensitivity in mice with exposure to high fat diet

“…Adipose tissue removal in humans 18,23,24 and rodents 30,35 induces compensation in remaining nonexcised adipose tissue depots. Rodent studies demonstrate that compensatory adipose depot mass differences are not detectable 5 weeks post-surgery, 55 but significant compensatory redistribution of lipids to non-excised adipose depots occurs »12 weeks post-surgery.…”

“…22 There is evidence in humans that liposuction increases body fat in non-excised areas, 23,24 such as central/visceral adipose tissue depots. 18 This redistribution of lipid to other adipose tissue depots, in particular visceral adipose tissue, may override, supersede and/or contribute to effects induced directly by LBSAT removal.…”

Diabetes: insulin resistance and derangements in lipid metabolism. Cure through intervention in fat transport and storage

“…There was no evidence in these patients that these increases in the proportion of visceral adipose tissue were medically significant [98]. Other studies of the metabolic effects of lipectomy, have not presented data on body composition, do not seem to have studied the patients in steady state and provide conflicting results [99][100][101].…”

The Effects of Liposuction Removal of Subcutaneous Abdominal Fat on Lipid Metabolism are Independent of Insulin Sensitivity in Normal-Overweight Individuals

“…However, in most studies, AL did not have prominent metabolic effects in terms of insulin sensitivity and pro-inflammatory adipo-cytokines [18][19][20]; nevertheless, some authors have reported transient benefits [21][22][23][24][25][26][27]. Further, the impact of liposuction on FFA and, particularly, in the lipid and lipoprotein profile is not yet fully documented, the available results being either incomplete or inconsistent [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”

“…Visceral adipose tissue (VAT) accumulation appears to play a more significant pathogenic role in IR and MS than subcutaneous adipose tissue (SAT) [8,11,12]. However, because of its greater overall mass, SAT contributes more than VAT to circulating FFAs.…”