Large-Volume Liposuction: A Review of 631 Consecutive Cases over 12 Years

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

“…Furthermore, surgical resection of visceral adipose tissue has yielded marked improvement in insulin resistance in animal studies [39,40] in absence of changes in the concentrations of glycerol and FFA. AL removes subcutaneous abdominal fat, and hence, reduces the total number of fat cells without altering visceral fat mass [16,24,28,29,37,39]. In our study, the amount of subcutaneous abdominal fat removed by liposuction results, 4 months later, in a total weight loss of approximately 4.6%.…”

“…However, in contrast to weight loss achieved by diet, pharmacology, and bariatric surgery, the weight loss obtained by means of subcutaneous abdominal fat removal does not modify HOMA index, adiponectin, and CRP levels. The lack of benefits seen in terms of insulin sensitivity and pro-inflammatory adipo-cytokine changes seen with weight loss [41][42][43][44] is in agreement with most [18,19,37], but not all [20][21][22][23][24][25][26][27][28][29][30][31], previous studies. Differences in study population such as age, degree of obesity and fat distribution, as well as the employed methodology may be held responsible for these discrepancies.…”

“…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].…”

Obesity and the skin: Skin physiology and skin manifestations of obesity

“…So-called large-volume liposuction or mega-liposuction for obese patients is highly controversial. [102][103][104] Large-volume liposuction may decrease weight and body fat mass 105,106 ; however, there are conflicting data regarding whether or not it significantly improves insulin resistance and other obesity-associated metabolic abnormalities. [105][106][107] Large-volume liposuction can be associated with significant increases in the proportion of visceral adipose tissue, which is a risk factor for metabolic complications of obesity.…”

Safe Limits for Aspirate Volume Under Wet Liposuction

“…Additionally, severe variations of vital importance due to fluid overload on the cardiopulmonary system and altered thermoregulation [12] could happen. The effect of these variables on blood clotting and hemorrhage is still not fully understood, whereas epinephrine added to the solution injected into the subcutaneous tissue during liposuction is known to decrease bleeding [13][14][15].…”