No return of body fat following liposuction

By MedWire Reporters

Body fat does not return in the treated or untreated areas of patients undergoing liposuction and/or abdominoplasty, research shows.

The study, published in Plastic and Reconstructive Surgery, included standardized photographic measurements of 301 patients treated with one or both of the procedures.

Based on the findings, Eric Swanson (Swanson Center, Leawood, Kansas, USA) concludes that both techniques are valid for the "long-term fat reduction and improvement of body proportions."

Still, an editorial by Raffi Gurunluoglu (University of Colorado Health Sciences Center, Denver, USA) challenges the methodology of the analysis, noting that there could be a significant amount of subjective evaluation and bias.

"Use of additional outcome parameters to assess fat reaccumulation and redistribution would have strengthened the presented data and provided more evidence on the subject," according to Gurunluoglu. Use of abdominal or limb circumference measurements, subcutaneous skinfold measurements, or possibly even magnetic resonance imaging scans would have added more evidence, he says.

In the prospective study, Swanson performed the procedures in predominantly nonobese men and women. Lower-body dimensions were measured using standardized photographs. Upper body measurements were compared between 67 women who underwent simultaneous breast surgery and 78 women who had breast surgery alone.

The women lost an average of 2.2 lbs after lower-body liposuction and 4.6 lbs when liposuction was combined with abdominoplasty.

In terms of measurements, abdominal, thigh, knee, and arm circumferences were all significantly reduced with liposuction. The widths of the mid-abdominal area and hips were reduced to a greater extent with liposuction and abdominoplasty than with liposuction alone.

At one year of follow up, there remained a significant reduction in hip circumference in patients treated with liposuction and in the mid-abdominal and hip measurements of 22 patients who underwent liposuction and abdominoplasty.

In comparing the 67 women who underwent liposuction/abdominoplasty with simultaneous breast surgery to the 78 women who underwent breast surgery alone, there was no difference in outcomes.

"There were no significant changes for any of the three upper body dimensions among women, whether or not they were treated with liposuction and/or abdominoplasty at the time of their cosmetic breast surgery," according to Swanson.

To Gurunluoglu, however, the photographic documentation in these patients was not originally designed to measure changes in shoulder width, mid-humeral width, and upper abdominal width, and this weakens the conclusions regarding fat redistribution.

Much work remains to determine the effects of liposuction on the regrowth of fat, as well as on anatomic patterns of fat redistribution, emphasizes Gurunluoglu. To fully assess the impact of liposuction in subcutaneous, visceral, and breast fat, a randomized, controlled clinical trial is needed, he suggests.

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