THE IMPACT OF LIPOSUCTION ON BODY-FAT

Routine liposuction has very low perioperative complication rates and is thus considered to be innocuous. Some authors have even proposed th at large-volume liposuction could be therapeutic. However, because sub cutaneous adipose tissue has nutritional and thermodynamic metabolic f unctions proportional to the absolute amount and the distribution of f at, it is possible that removal of subcutaneous adipose tissue might b e detrimental. We measured the amount of fat removed by large-volume ( >1000 cc) liposuction and expressed the results in terms of absolute a nd relative changes in total body fat and in visceral adipose tissue ( nonsubcutaneous adipose tissue) in 63 normal weight to mildly obese wo men (n = 51) and men (n = 12). Aspiration of 1.5 +/- 0.7 kg (mean +/- SD) of lipid in women removed 9.2 +/- 3.2 percent of body fat or 10.5 percent of subcutaneous adipose tissue corresponding to a 12-percent i ncrease in the ratio of visceral to subcutaneous adipose tissue. One t hird of the women (n = 17) had a mean increase of 16 percent (range 13 to 21 percent) in the proportion of visceral fat. In the 12 men, aspi ration of 1.7 +/- 0.6 kg of lipid removed 9.8 +/- 2.9 percent of body fat or 12.7 +/- 3.6 percent of subcutaneous adipose tissue, resulting in a 14-percent increase in the ratio of visceral to subcutaneous fat. The correlation between aspirate and body mass index was 0.57 (p < 0. 001). Although large-volume subcutaneous liposuction removed relativel y little body fat, it led to significant increases in the proportion o f visceral adipose tissue. Because the proportion of visceral adipose tissue is a risk factor for metabolic complications of obesity, the me tabolic effects of large-volume liposuction need to be evaluated.