Top

Published in:

01-10-2015 | Review Article

Short- and Long-Term Effects of Abdominal Lipectomy on Weight and Fat Mass in Females: a Systematic Review

Authors: Konstantinos Seretis, Dimitrios G. Goulis, Georgios Koliakos, Efterpi Demiri

Published in: Obesity Surgery | Issue 10/2015

Abstract

Adipose tissue is considered as an endocrine organ, which is developed in specific depots, distinguished either as subcutaneous or visceral. Lipectomy, by means of liposuction or abdominoplasty, is a common plastic surgery procedure, which can remove substantial amounts of subcutaneous fat. This systematic review aims to evaluate the impact of surgical removal of abdominal subcutaneous adipose tissue on body weight and fat mass in females in the short- and long-term. A systematic review was conducted using a predetermined protocol established according to the Cochrane Handbook’s recommendations. PubMed, Scopus, CENTRAL, and the Cochrane Library were searched from inception to December 2014. Eligible studies were prospective studies with ≥1 month of follow-up that included female only individuals who underwent lipectomy of the abdominal region and reported on body weight, body mass index (BMI), or fat mass. Ten studies were included in this systematic review with a total of 231 individuals. A significant weight loss and BMI improvement were reported in 4 out of 5 studies with a mean follow-up of 1–2 months, but in none of the 5 studies with a longer follow-up (3–20 months). Fat mass showed a similar to weight change. The risk of bias was low for the two clinical trials but high for the observational studies included in the review. This systematic review revealed only a transient effect of abdominal lipectomy in body fat and weight in women, which fades a few months after the operation. These results corroborate the evidence from experimental and clinical studies, which support fat redistribution and compensatory fat growth, as a result of feedback mechanisms, triggered by fat removal. Additional clinical studies, with adequate follow-up, may further elucidate the long-term effects of abdominal lipectomy in body weight and composition. Systematic review registration PROSPERO CRD42015017564 (www.crd.york.ac.uk/PROSPERO)

Available only for authorised users

Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004;89:2548–56.CrossRefPubMed

Jensen MD. Role of body fat distribution and the metabolic complications of obesity. J Clin Endocrinol Metab. 2008;93:S57–63.PubMedCentralCrossRefPubMed

Smith SR, Lovejoy JC, Greenway F, et al. Contributions of total body fat, abdominal subcutaneous adipose tissue compartments, and visceral adipose tissue to the metabolic complications of obesity. Metabolism. 2001;50:425–35.CrossRefPubMed

Spalding KL, Arner E, Westermark PO, et al. Dynamics of fat cell turnover in humans. Nature. 2008;453:783–7.CrossRefPubMed

Krotkiewski M, Bjorntorp P, Sjostrom L, et al. Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution. J Clin Invest. 1983;72:1150–62.PubMedCentralCrossRefPubMed

Boriani F, Villani R, Morselli PG. Metabolic effects of large-volume liposuction for obese healthy women: a meta-analysis of fasting insulin levels. Aesthet Plast Surg. 2014;38:1050–6.CrossRef

Seretis K, Goulis DG, Koliakos G, et al. Weight reduction following abdominoplasty: a systematic review. Plast Reconstr Surg. 2013;132:314e–6e.CrossRefPubMed

Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated march 2011]. In Higgins JPT GSe (ed) The Cochrane Collaboration, 2011.

Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the prisma statement. J Clin Epidemiol. 2009;62:1006–12.CrossRefPubMed

10.

Geer EB, Shen W. Gender differences in insulin resistance, body composition, and energy balance. Gend Med. 2009;6 Suppl 1:60–75.PubMedCentralCrossRefPubMed

11.

Shi H, Strader AD, Woods SC, et al. Sexually dimorphic responses to fat loss after caloric restriction or surgical lipectomy. Am J Physiol Endocrinol Metab. 2007;293:E316–26.CrossRefPubMed

12.

Benatti F, Solis M, Artioli G, et al. Liposuction induces a compensatory increase of visceral fat which is effectively counteracted by physical activity: a randomized trial. J Clin Endocrinol Metab. 2012;97:2388–95.CrossRefPubMed

13.

Cintra W, Modolin M, Faintuch J, et al. C-reactive protein decrease after postbariatric abdominoplasty. Inflammation. 2012;35:316–20.CrossRefPubMed

14.

Davis DA, Pellowski DM, Donahoo WT. Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk. Int J Obes (Lond). 2006;30:1217–22.CrossRef

15.

Marfella R, Grella R, Rizzo MR, et al. Role of subcutaneous abdominal fat on cardiac function and proinflammatory cytokines in premenopausal obese women. Ann Plast Surg. 2009;63:490–5.CrossRefPubMed

16.

Martinez-Abundis E, Molina-Villa CA, Gonzalez-Ortiz M, et al. Effect of surgically removing subcutaneous fat by abdominoplasty on leptin concentrations and insulin sensitivity. Ann Plast Surg. 2007;58:416–9.CrossRefPubMed

17.

Ramos-Gallardo G, Perez Verdin A, Fuentes M, et al. Effect of abdominoplasty in the lipid profile of patients with dyslipidemia. Plast Surg Int. 2013;2013:861348.PubMedCentralPubMed

18.

Rinomhota AS, Bulugahapitiya DU, French SJ, et al. Women gain weight and fat mass despite lipectomy at abdominoplasty and breast reduction. Eur J Endocrinol. 2008;158:349–52.CrossRefPubMed

19.

Rizzo MR, Paolisso G, Grella R, et al. Is dermolipectomy effective in improving insulin action and lowering inflammatory markers in obese women? Clin Endocrinol (Oxf). 2005;63:253–8.CrossRef

20.

Robles-Cervantes JA, Espaillat-Pavonessa M, Cardenas-Camarena L, et al. Dehydroepiandrosterone behavior and lipid profile in non-obese women undergoing abdominoplasty. Obes Surg. 2007;17:361–4.CrossRefPubMed

21.

Swanson E. Prospective clinical study reveals significant reduction in triglyceride level and white blood cell count after liposuction and abdominoplasty and no change in cholesterol levels. Plast Reconstr Surg. 2011;128:182e–97e.CrossRefPubMed

22.

Seretis K, Demiri E. Metabolic effects of large-volume liposuction for obese healthy women: a meta-analysis of fasting insulin levels. Aesthet Plast Surg. 2015;39:278–9.CrossRef

23.

Wirth A, Steinmetz B. Gender differences in changes in subcutaneous and intra-abdominal fat during weight reduction: an ultrasound study. Obes Res. 1998;6:393–9.CrossRefPubMed

24.

Hausman DB, Lu J, Ryan DH, et al. Compensatory growth of adipose tissue after partial lipectomy: involvement of serum factors. Exp Biol Med (Maywood). 2004;229:512–20.

25.

Ling BL, Chiu CT, Lu HC, et al. Short and long-term impact of lipectomy on expression profile of hepatic anabolic genes in rats: a high fat and high cholesterol diet-induced obese model. PLoS One. 2014;9:e108717.PubMedCentralCrossRefPubMed

26.

Liszka TG, Dellon AL, Im M, et al. Effect of lipectomy on growth and development of hyperinsulinemia and hyperlipidemia in the zucker rat. Plast Reconstr Surg. 1998;102:1122–7.CrossRefPubMed

27.

Mauer MM, Harris RB, Bartness TJ. The regulation of total body fat: lessons learned from lipectomy studies. Neurosci Biobehav Rev. 2001;25:15–28.CrossRefPubMed

28.

Weber RV, Buckley MC, Fried SK, et al. Subcutaneous lipectomy causes a metabolic syndrome in hamsters. Am J Physiol Regul Integr Comp Physiol. 2000;279:R936–43.PubMed

29.

Hernandez TL, Kittelson JM, Law CK, et al. Fat redistribution following suction lipectomy: defense of body fat and patterns of restoration. Obesity (Silver Spring). 2011;19:1388–95.CrossRef

30.

Frew KE, Rossi A, Bruck MC, et al. Breast enlargement after liposuction: comparison of incidence between power liposuction versus traditional liposuction. Dermatol Surg. 2005;31:292–6.CrossRefPubMed

31.

Yun PL, Bruck M, Felsenfeld L, et al. Breast enlargement observed after power liposuction: a retrospective review. Dermatol Surg. 2003;29:165–7. discussion 167.PubMed

32.

van der Lei B, Halbesma GJ, van Nieuwenhoven CA, et al. Spontaneous breast enlargement following liposuction of the abdominal wall: does a link exist? Plast Reconstr Surg. 2007;119:1584–9.CrossRefPubMed

33.

Swanson E. Photographic measurements in 301 cases of liposuction and abdominoplasty reveal fat reduction without redistribution. Plast Reconstr Surg. 2012;130:311e–22e.CrossRefPubMed

34.

Gurunluoglu R. Discussion: photographic measurements in 301 cases of liposuction and abdominoplasty reveal fat reduction without redistribution. Plast Reconstr Surg. 2012;130:323e–4e.CrossRefPubMed

35.

Broughton 2nd G, Horton B, Lipschitz A, et al. Lifestyle outcomes, satisfaction, and attitudes of patients after liposuction: a Dallas experience. Plast Reconstr Surg. 2006;117:1738–49.CrossRefPubMed

36.

Cintra Jr W, Modolin ML, Gemperli R, et al. Quality of life after abdominoplasty in women after bariatric surgery. Obes Surg. 2008;18:728–32.CrossRefPubMed

37.

Lazar CC, Clerc I, Deneuve S, et al. Abdominoplasty after major weight loss: improvement of quality of life and psychological status. Obes Surg. 2009;19:1170–5.CrossRefPubMed

38.

Kennedy GC. The role of depot fat in the hypothalamic control of food intake in the rat. Proc R Soc Lond B Biol Sci. 1953;140:578–96.CrossRefPubMed

39.

Henry RR, Scheaffer L, Olefsky JM. Glycemic effects of intensive caloric restriction and isocaloric refeeding in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab. 1985;61:917–25.CrossRefPubMed

40.

Harris RB, Hausman DB, Bartness TJ. Compensation for partial lipectomy in mice with genetic alterations of leptin and its receptor subtypes. Am J Physiol Regul Integr Comp Physiol. 2002;283:R1094–103.CrossRefPubMed

Title: Short- and Long-Term Effects of Abdominal Lipectomy on Weight and Fat Mass in Females: a Systematic Review
Authors: Konstantinos Seretis
Dimitrios G. Goulis
Georgios Koliakos
Efterpi Demiri
Publication date: 01-10-2015
Publisher: Springer US
Published in: Obesity Surgery / Issue 10/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-015-1797-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Short- and Long-Term Effects of Abdominal Lipectomy on Weight and Fat Mass in Females: a Systematic Review

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2015

Multicenter Randomized Study of Obesity Treatment with Minimally Invasive Injection of Hyaluronic Acid Versus and Combined with Intragastric Balloon

Management of Type 2 Late Sleeve Leak by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report

Use of Enoxaparin in Obese Adolescents During Bariatric Surgery—a Pilot Study

Comparison of Rhabdomyolysis Markers in Patients Undergoing Bariatric Surgery with Propofol and Inhalation-based Anesthesia

Trans-Umbilical Single Incision Laparoscopic Sleeve Gastrectomy in a Patient with Situs Inversus Totalis and Kartagener Syndrome: Video Report

Reply to a Letter to the Editor: Bariatric Surgery in Class I Obesity. A Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)—Obesity Surgery 2014;24:487–519