Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Early Metabolic Changes and Its Considerations after Liposuction

지방흡입술 후 초기 대사성 변화 및 고찰

  • Yang, Hea Won (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Cho, Jong Je (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Seo, Sang Won (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Chang, Choong Hyun (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Rhee, Eun Jung (Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Sim, Hyung Bo (Baram Clinic BBC) ;
  • Hong, Yoon Gi (Baram Clinic BBC)
  • 양해원 (성균관대학교 의과대학 강북삼성병원 성형외과학교실) ;
  • 조종제 (성균관대학교 의과대학 강북삼성병원 성형외과학교실) ;
  • 서상원 (성균관대학교 의과대학 강북삼성병원 성형외과학교실) ;
  • 장충현 (성균관대학교 의과대학 강북삼성병원 성형외과학교실) ;
  • 이은정 (성균관대학교 의과대학 강북삼성병원 내분비내과학교실) ;
  • 심형보 (바람성형외과) ;
  • 홍윤기 (바람성형외과)
  • Received : 2007.08.02
  • Published : 2008.01.10
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Abstract

Purpose: Advanced techniques now make it possible to remove considerable amounts of subcutaneous adipose tissue more safely with minimum blood loss. However, few have analyzed the metabolic consequences of liposuction. The purpose of this study was to identify the early effects of the surgical removal of subcutaneous fat on metabolic changes in patients who have undergone liposuction. Methods: Nineteen patients were evaluated from June 2005 to December 2005. Preoperative body weight, serums levels of lipids, apolipoprotein A1, dehydroepiandrosterone(DHEA), uric acid, insulin, and glucose were evaluated. Insulin resistance was determined using the homeostasis model assessment of insulin resistance (HOMA-IR), which is based on fasting glucose and insulin concentrations. All of these data were remeasured in 1 and 4 weeks postoperatively. Tumescent fluid was infiltrated using the superwet technique. The liposuction device used was a $Liposlim^{(R)}$ power-assisted unit. Results: Average volumes of infiltrate and aspirate were 3,268mL and 2,892mL, respectively. Results in 1 week postoperatively demonstrated a significant difference in high-density lipoprotein(HDL) cholesterol, apolipoprotein A1, insulin, and HOMA-IR levels. However, all values were within normal limits and returned to baseline in 4 weeks postoperatively.Conclusion: This study provides little to support the presumed therapeutic effect of liposuction. And, it is unclear whether liposuction can prevent or be used to treat the metabolic complications of obesity. However, the results of the present study lead us to believe that liposuction is a metabolically safe procedure.

Keywords

References

  1. Gonzalez-Ortiz M, Robles-Cervantes JA, Cardenas- Camarena L, Bustos-Saldana R, Martínez-Abundis E: The effect of surgically removing subcutaneous fat on the metabolic profile and insulin sensitivity in obese women after large-volume liposuction treatment. Horm Metab Res 34: 446, 2002 https://doi.org/10.1055/s-2002-33603
  2. D'Andrea F, Grella R, Rizzo MR, Grella E, Grella R, Nicoletti G, Barbieri M, Paolisso G: Changing the metabolic profile by large-volume liposuction: a clinical study conducted with 123 obese women. Aesthetic Plast Surg 29: 472, 2005 https://doi.org/10.1007/s00266-005-0089-x
  3. Davis DA, Pellowski DM, Davis DA, Donahoo WT: Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk. Int J Obes(Lond) 30: 1217, 2006 https://doi.org/10.1038/sj.ijo.0803120
  4. Giugliano G, Nicoletti G, Grella E, Giugliano F, Esposito K, Scuderi N, D'Andrea F: Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women. Br J Plast Surg 57: 190, 2004 https://doi.org/10.1016/j.bjps.2003.12.010
  5. Esposito K, Giugliano G, Giugliano D: Metabolic effect of liposuction-yes or no? N Engl J Med 351: 1354, 2004 https://doi.org/10.1056/NEJM200409233511320
  6. Giese SY, Bulan EJ, Commons GW, Spear SL, Yanovski JA: Improvements in cardiovascular risk profile with large-volume liposuction: a pilot study. Plast Reconstr Surg 108: 510, 2001 https://doi.org/10.1097/00006534-200108000-00035
  7. Robles-Cervantes JA, Yanez-Diaz S, Cardenas-Camarena L: Modification of insulin, glucose and cholesterol levels in nonobese women undergoing liposuction: is liposuction metabolically safe? Ann Plast Surg 52: 64, 2004 https://doi.org/10.1097/01.sap.0000096448.59407.43
  8. Samdal F, Birkeland KI, Ose L, AmLand PF: Effect of large-volume liposuction on sex hormones and glucose- and lipid metabolism in females. Aesthetic Plast Surg 19: 131, 1995 https://doi.org/10.1007/BF00450248
  9. Baxter RA: Serum lipid changes following large- volume lipectomy. Aesth Surg J 17: 213, 1997 https://doi.org/10.1016/S1090-820X(97)80001-5
  10. Klein S, Fontana L, Young VL, Coggan AR, Kilo C, Patterson BW, Mohammed BS: Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 350: 2549, 2004 https://doi.org/10.1056/NEJMoa033179
  11. Matarasso A, Kim RW, Kral JG: The impact of liposuction on body fat. Plast Reconstr Surg 102: 1686, 1998 https://doi.org/10.1097/00006534-199810000-00057
  12. Kelley DE: Thermodynamics, liposuction, and metabolism. N Engl J Med 350: 2542, 2004 https://doi.org/10.1056/NEJMp048115
  13. Hansen E, Hajri T, Abumrad NN: Is all fat the same? The role of fat in the pathogenesis of the metabolic syndrome and type 2 diabetes mellitus. Surgery 139: 711, 2006 https://doi.org/10.1016/j.surg.2005.10.018
  14. Smith SR, Lovejoy JC, Greenway F, Ryan D, deJonge L, de la Bretonne J, Volafova J, Bray GA: Contributions of total body fat, abdominal subcutaneous adipose tissue compartments, and visceral adipose tissue to the metabolic complications of obesity. Metabolism 50: 425, 2001 https://doi.org/10.1053/meta.2001.21693
  15. Anuurad E, Shiwaku K, Nogi A, Kitajima K, Enkhmaa B, Shimono K, Yamane Y: The new BMI criteria for asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent metabolic syndrome in elder Japanese workers. J Occup Health 45: 335, 2003 https://doi.org/10.1539/joh.45.335