Metabolic aspects of surgical subcutaneous fat removal: an umbrella review and implications for future research

Abstract

Although obesity is a preventable disease, maintaining a normal body weight can be very challenging and difficult, which has led to a significant increase in the demand for surgical subcutaneous fat removal (SSFR) to improve physical appearance. The need for SSFR is further exacerbated because of the global rise in the number of bariatric surgeries, which is currently the single most durable intervention for mitigating obesity. Fat tissue is now recognized as a vital endocrine organ that produces several bioactive proteins. Thus, SSFR-mediated weight (fat) loss can potentially have significant metabolic effects; however, currently, there is no consensus on this issue. This review focuses on the metabolic sequelae after SSFR interventions for dealing with cosmetic body appearance. Data was extracted from existing systematic reviews and the diversity of possible metabolic changes after SSFR are reported along with gaps in the knowledge and future directions for research and practice. We conclude that there is a potential for metabolic sequelae after SSFR interventions and their clinical implications for the safety of the procedures as well as for our understanding of subcutaneous adipose tissue biology and insulin resistance are discussed.

The impact of prior obesity surgery on glucose metabolism after body contouring surgery: A pilot study

“…Because of the rapid and massive weight loss following the surgery, many patients tend to require body contouring plastic surgery to remove redundant abdominal skin and excess subcutaneous abdominal fat for aesthetic purposes. The precise mechanisms by which obesity surgery affords the protections and the consequences of surgical (and non-surgical) fat removal on human metabolism are not fully clear yet [ 5–7 ]. This study answered a few of the pertinent questions through examination of the early postoperative changes in glucose homeostasis after SSFR at three time points.…”

“…On the other hand, other forms of fat reduction all result in a gradual decrease of both subcutaneous and intraabdominal adipocytes in terms of both size and quantity [4]. The metabolic impacts of the large volume subcutaneous fat removal during body contouring surgery are not known fully [5][6][7]. Several studies have investigated the latter, using different tests that assess glucose homeostasis, such as the homeostasis model assessment-estimated insulin resistance (HOMA-IR) [8][9][10] and fasting insulin levels [11,12].…”