This month’s issue of Plastic and Reconstructive Surgery Journal (August 2012) was chock full of great articles. This one is “Photographic Measurements in 301 Cases of Liposuction and Abdominoplasty Reveal Fat Reduction without Redistribution.”
What is this about?
There have been articles published about liposuction which state liposuction doesn’t fully remove fat, or when it does remove fat, it just causes it to go elsewhere. The New York Times published an article in April 2011 stating “fat comes back after surgery.” A drawing included with that study is shown here:
nytimes may 2011
So this author, Dr. Swason out of Kansas wanted to look at a large number of patients using measurements of body dimensions to see if fat returns after liposuction.
Study:
- Prospective Study
- 301 patients for liposuction and abdominoplasty procedures meeting study criteria
- Lower body dimensions were measured with standardized photos before and at least 3 months after surgery
- Upper body photos were taken as well
- Did the fat removed from the abdomen and thighs relocate to the breast and torso?
Findings:
- Average weight loss 2.2 pounds after lipo
- Average weight loss 4.5 pounds after lipo with adominoplasty
- Liposuction significantly reduced width of abdomen, thigh, knee and arm.
- The mid abdomen was more effectively reduced by liposuction with tummy tuck than by lipo alone
- Measurements in patients with 1 year follow up showed no evidence of fat reaccumulation
I like this was a prospective study in a large number of patients. Many of the points he discusses are ones I agree with. Fat removed from liposuction is permenantly gone, as opposed to when you have weight loss and shrink the size of the fat cell. He treated his patients diffusely- meaning he did the abdomen, flank, back, and thighs- he did not “spot” treat a single area, which I think has more potential to create funny fat distribution. He tried to standardize measurements with consistent photos. He is a single surgeon, with a single technique. He did a prospective trial. He had large numbers. He found the result lasted in those with stable weight. (I have found when patients have stable weight, they maintain their results after surgery. If they gain weight, stop exercising, etc, then the fat can come back and distribute to untreated areas which have pockets of fat.)
Issues with his study cited in the review are also valid. Photographs are not as accurate as MRI. (Measurements are not as valid, as they can vary with the person measuring, hydration of the patient, etc). The upper body photos were not standardized. The number of patients at a year was only about 20% of his sample.
But I think his point was made. I have a full copy of the article in my office. You can also link to it here: http://journals.lww.com/plasreconsurg/Fulltext/2012/08000/Photographic_Measurements_in_301_Cases_of.29.aspx